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.
Most small hiatal hernias cause no signs or symptoms. But larger hiatal hernias can cause:
- Regurgitation of food or liquids into the mouth
- Backflow of stomach acid into the esophagus (acid reflux)
- Difficulty swallowing
- Chest or abdominal pain
- Shortness of breath
- Vomiting of blood or passing of black stools, which may indicate gastrointestinal bleeding
When to see a doctor
See your doctor if you have any persistent signs or symptoms that worry you.
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 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
Hiatal hernia is most common in people who are:
Hiatal hernia care at Mayo Clinic
Oct. 23, 2019
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