A hiatal hernia is a condition in which the upper part of the stomach bulges through an opening in the diaphragm. The diaphragm is the muscle wall that separates the stomach from the chest. The diaphragm helps keep acid from coming up into the esophagus. When you have a hiatal hernia, it's easier for the acid to come up.
Hiatal hernias are common, especially in people over age 50. If you have symptoms, eating small meals, avoiding certain foods, not smoking or drinking alcohol, and losing weight may help. Your doctor may recommend antacids or other medicines. If these don't help, you may need surgery.
Most people do not experience any symptoms of their hiatal hernia, so no treatment is necessary. Paraesophageal hernias, however, should be repaired by surgery because the danger of strangulation is high. Surgery may also be needed when sliding hernias bleed or become large, strangulated, or inflamed. In surgery, the hiatus is reinforced and the stomach is repositioned. This surgery is now commonly done using a laparoscope, a thin, telescope-like instrument for viewing inside the abdomen.
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