Print Overview Hiatal hernia Enlarge image Close Hiatal hernia Hiatal hernia A hiatal hernia occurs when the upper part of your stomach bulges through your diaphragm into your chest cavity. A hiatal hernia occurs when the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm). Your diaphragm has a small opening (hiatus) through which your food tube (esophagus) passes before connecting to your stomach. In a hiatal hernia, the stomach pushes up through that opening and into your chest. A small hiatal hernia usually doesn't cause problems. You may never know you have one unless your doctor discovers it when checking for another condition. But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn. Self-care measures or medications can usually relieve these symptoms. A very large hiatal hernia might require surgery.Products & ServicesA Book: Mayo Clinic on Digestive Health SymptomsMost small hiatal hernias cause no signs or symptoms. But larger hiatal hernias can cause: Heartburn Regurgitation of food or liquids into the mouth Backflow of stomach acid into the esophagus (acid reflux) Difficulty swallowing Chest or abdominal pain Feeling full soon after you eat Shortness of breath Vomiting of blood or passing of black stools, which may indicate gastrointestinal bleeding When to see a doctorSee your doctor if you have any persistent signs or symptoms that worry you. Request an appointment There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. 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. 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If you don’t receive our email within 5 minutes, check your SPAM folder, then contact us at newsletters@mayoclinic.com. Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry CausesA 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 an unusually large hiatus Persistent and intense pressure on the surrounding muscles, such as while coughing, vomiting, straining during a bowel movement, exercising or lifting heavy objects Risk factorsHiatal hernias are most common in people who are: Age 50 or older Obese By Mayo Clinic Staff Hiatal hernia care at Mayo Clinic Request an appointment Diagnosis & treatment Feb. 23, 2021 Print Show references Sfara A, et al. The management of hiatal hernia: An update on diagnosis and treatment. Medicine and Pharmacy Reports. 2019; doi:10.15386/mpr-1323. Ferri FF. Hiatal hernia. In: Ferri's Clinical Advisor 2021. Elsevier; 2021. https://www.clinicalkey.com. Accessed Nov. 10, 2020. Kliegman RM, et al. Hiatal hernia. In: Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Nov. 10, 2020. Goldman L, et al., eds. Diseases of the esophagus. In: Goldman-Cecil Medicine. 26th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed Nov. 10, 2020. Feldman M, et al., eds. Gastroesophageal reflux disease. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Nov. 11, 2020. Yun JS, et al. Laparoscopic repair of hiatal hernia. Journal of Thoracic Disease. 2019; doi:10.21037/jtd.2019.08.94. Brown AY. Allscripts EPSi. Mayo Clinic. Nov. 10, 2020. Related Hiatal hernia Associated Procedures Upper endoscopy Products & Services A Book: Mayo Clinic on Digestive Health Mayo Clinic in Rochester, Minnesota, has been recognized as the best Gastroenterology & GI Surgery hospital in the nation for 2023-2024 by U.S. News & World Report. Learn more about this top honor Hiatal herniaSymptoms&causesDiagnosis&treatmentDoctors&departmentsCare atMayoClinic Advertisement Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Advertising & Sponsorship Policy Opportunities Ad Choices Mayo Clinic Press Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. 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There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form. 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. Email address ErrorEmail field is required ErrorInclude a valid email address Subscribe Learn more about Mayo Clinic’s use of data. 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. Thank you for subscribing Your in-depth digestive health guide will be in your inbox shortly. You will also receive emails from Mayo Clinic on the latest health news, research, and care. If you don’t receive our email within 5 minutes, check your SPAM folder, then contact us at newsletters@mayoclinic.com. Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry