A hiatal hernia happens when the upper part of the stomach bulges through the large muscle that separates the abdomen and the chest. The muscle is called the diaphragm.

The diaphragm has a small opening called a hiatus. The tube used for swallowing food, called the esophagus, passes through the hiatus before connecting to the stomach. In a hiatal hernia, the stomach pushes up through that opening and into the chest.

A small hiatal hernia usually doesn't cause problems. You may never know you have one unless your healthcare team discovers it when checking for another condition.

But a large hiatal hernia can allow food and acid to back up into your esophagus. This can cause heartburn. Self-care measures or medicines can usually relieve these symptoms. A very large hiatal hernia might need surgery.


Most small hiatal hernias cause no symptoms. But larger hiatal hernias can cause:

  • Heartburn.
  • Backward flow of swallowed food or liquids into the mouth, called regurgitation.
  • Backflow of stomach acid into the esophagus, called acid reflux.
  • Trouble swallowing.
  • Chest or abdominal pain.
  • Feeling full soon after you eat.
  • Shortness of breath.
  • Vomiting of blood or passing of black stools, which could mean bleeding in the digestive tract.

When to see a doctor

Make an appointment with your doctor or other healthcare professional if you have any lasting symptoms that worry you.

Get the latest health information from Mayo Clinic delivered to your inbox.

Subscribe for free and receive your in-depth guide to digestive health, plus the latest on health innovations and news. You can unsubscribe at any time. Click here for an email preview.

To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.


A hiatal hernia occurs when weakened muscle tissue allows your stomach to bulge up through your diaphragm. It's not always clear why this happens. But a hiatal hernia might be caused by:

  • Age-related changes in your diaphragm.
  • Injury to the area, for example, after trauma or certain types of surgery.
  • Being born with a very large hiatus.
  • Constant and intense pressure on the surrounding muscles. This can happen while coughing, vomiting, straining during a bowel movement, exercising or lifting heavy objects.

Risk factors

Hiatal hernias are most common in people who are:

  • Age 50 or older.
  • Obese.

Hiatal hernia care at Mayo Clinic

Dec. 23, 2023
  1. Ferri FF. Hiatal hernia. In: Ferri's Clinical Advisor 2024. Elsevier; 2024. https://www.clinicalkey.com. Accessed Sept. 25, 2023.
  2. Elsevier Point of Care. Clinical Overview: Hiatal hernia. https://www.clinicalkey.com. Accessed Sept. 25, 2023.
  3. Kahrilas PJ. Haitus hernia. https://www.uptodate.com/contents/search. Accessed Sept. 25, 2023.
  4. Goldman L, et al., eds. Diseases of the esophagus. In: Goldman-Cecil Medicine. 27th ed. Elsevier; 2024. https://www.clinicalkey.com. Accessed Sept. 25, 2023.
  5. Feldman M, et al., eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Sept. 25, 2023.
  6. Ami TR. Allscripts EPSi. Mayo Clinic. Aug. 8, 2023.


Associated Procedures