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Hiatal Hernia: Expert Explains Symptoms, Causes, And Treatment

When a portion of the stomach pushes through the diaphragm muscle and into the chest cavity, it is known as a hiatal hernia.

Sushmita Sharma
Written by: Sushmita SharmaUpdated at: Apr 21, 2023 17:23 IST
Hiatal Hernia: Expert Explains Symptoms, Causes, And Treatment

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You may be suffering from heartburn, chest pain, shortness of breath, belching, etc and pay little heed to it. However, things may get severe as it may indicate an underlying health condition called a hiatal hernia.

When a portion of the stomach pushes through the diaphragm muscle and into the chest cavity, it is known as a hiatal hernia. This ailment is also known as a hiatus hernia because of the name of its opening. It is mainly of two types: Sliding hiatal hernia and fixed hiatal hernia. The risk factor of this condition includes obesity, ageing, and smoking. 

We spoke to our expert Dr Adi Rakesh Kumar, Consultant Gastroenterologist, Therapeutic Endoscopist & Endosonologist, Yashoda Hospitals Hyderabad, who explained about hiatal hernia, its symptoms, causes, complications, and treatment.

Many people with hiatal hernias don't exhibit any symptoms and don't require medical attention. However, to heal the hernia and relieve bothersome symptoms like heartburn and chest discomfort in those with more severe hernias, therapy with medication, dietary changes, and, occasionally, surgery may be necessary.

Symptoms Of Hiatus Hernia

Hiatal hernias are common and often do not cause symptoms. However, in some cases, they can cause discomfort, acid reflux, and other complications. Here are some symptoms and complications associated with hiatus hernia:

  • Heartburn
  • Difficulty swallowing
  • Chest pain
  • Belching
  • Acid reflux
  • Shortness of breath
  • Vomiting blood or passing black stools (in severe cases)

Causes Of Hiatal Hernia

  • Alterations brought on by ageing in your diaphragm
  • Injury to the region following trauma or particular surgeries
  • Having an exceptionally large hiatus at birth
  • The pressure is applied repeatedly and vigorously to the nearby muscles, such as while exercising, coughing, vomiting, straining during a bowel movement, or carrying large objects.

Complications Caused Due To Hiatus Hernia

  • Gastroesophageal reflux disease (GERD)
  • Esophagitis
  • Barrett's oesophagus
  • Stricture (narrowing of the oesophagus)
  • Ulcers
  • Bleeding
  • Anaemia

Treatment For Hiatal Hernia

In most cases, hiatal hernia requires no treatment. It may be present without any symptoms and cause no harm, however, if you face complications you may need surgery.

Surgical management in the form of Antireflux surgery is an effective procedure for the management of hiatus hernia. However, in early and small hiatus hernia, minimally invasive endoscopic procedures are currently available, which are effective in treating the Hiatus hernia and its complications

Endoscopic Management

Endoluminal fundoplication: A minimally invasive procedure in which the endoscope is used to place sutures around the oesophagus to create a valve that prevents stomach acid from flowing back up. GERDx and Transoral Incisionless Fundoplication (TIF) are two common endoscopic procedures for fundoplication. 

Antireflux Mucosal Ablation (ARMA) is a new kid on the block. It is a minimally endoscopic procedure which can be done as a daycare procedure and is proving to be quite effective in the management of GERD


Hiatal hernias can cause discomfort and complications, although Antireflux surgeries are an effective way of managing them. You should maintain a moderate weight, eat healthy foods, avoid lifting heavy weights, and avoid straining your bowel movements to avoid further complications.