September 9, 2025

The human body is made up of a large number of organs and systems that function in a coordinated manner to maintain life and health. However, when any organ malfunctions or enters a space in the body not meant for it, it can cause severe complications.

​One such condition that comes to mind is a hiatal hernia. In our body, the diaphragm plays a crucial role in separating the abdomen from the chest. Nevertheless, in the case of a hiatal hernia, a portion of the stomach passes through the diaphragm and enters the chest. This can cause issues such as digestive problems, heartburn, pain, a feeling of discomfort, etc.

​Having said that, there are also certain cases in which the patients do not experience any such symptoms. However, leaving a hiatal hernia untreated can cause major problems ahead. Therefore, knowing about its causes, symptoms, and types is highly crucial. In the blog below, we shall explore this condition in detail.

​What is a Hiatal Hernia?

When a section of the stomach slides through the diaphragm opening and enters the chest cavity, it causes a hiatal hernia.  This occurs when the diaphragm weakens, giving way to other organs to push through. Furthermore, amongst all kinds of hernia, hiatal hernia is one of the most common types of hernia that affects many people.

​In most cases, the hiatal hernia is often small and doesn’t cause any harm. You may not even be aware of its presence unless a doctor notices it while performing routine tests or checking for other illnesses. If the hiatal hernia is large, it can cause food to back up in the oesophagus, leading to symptoms like heartburn. Most often, it can be managed by medications and certain self-care measures. However, in severe cases, doctors may recommend surgery.

​What Causes a Hiatal Hernia?

When the muscles around the diaphragm opening weaken, they give way for the stomach to enter the chest region. There are several contributing factors to such weakening.

​Muscle Weakness: This condition often occurs among people who are above the age of 50, and one of the major causes of hiatal hernia is the weakening of the body’s connective tissues and muscles. Such changes often occur with age, contributing to the development of the condition.

​Increased Abdominal Pressure: Abdominal pressure can increase for a variety of reasons. And this increased pressure can push the diaphragm, widening the hiatus and creating an entry for a part of the stomach to bulge through. Some of the factors that can cause the abdominal pressure to increase are:

• Strained bowel movements (constipation)
• Intensive and continuous vomiting
• Asthma and other lung conditions
• Coughing for long periods of time
• Tight-fitted clothing

​Obesity: When an individual is overweight, the body carries an extra load, especially in the area near the abdomen. This leads to an increase in the abdominal pressure, which can cause a part of the stomach to bulge out through the diaphragm into the chest cavity.

​Pregnancy: Effects similar to those of obesity occur in pregnancy as the body carries additional weight. Women, mostly in their last months of pregnancy, tend to have a hiatal hernia as the baby in the uterus grows to its full potential and pushes the stomach upwards towards the chest.

​Congenital Causes: In some cases, individuals are born with a larger diaphragm opening than normal. This increases their chances of having a hiatal hernia in the later years of their life.

​Injury/Surgery: Individuals who have had surgery done or had an injury closer to the abdomen region are at a higher risk of developing a hiatal hernia. Injuries tend to weaken the tissues and muscles around the diaphragm, allowing a portion of the stomach to enter the chest cavity.

​What are the Types of Hiatal Hernia?

Type 1: In this type, a small portion of the stomach, along with the lower part of the oesophagus, slides through the hiatus into the chest. As these portions slide up and down, they cause symptoms such as acid reflux and heartburn. This type of hiatal hernia is also known as a sliding hiatal hernia.

Type 2: Also known as the Pure Para-oesophageal Hernia, in this condition, only a certain part of the stomach enters the chest cavity, while the lower oesophageal region remains in place. This gives rise to symptoms such as difficulty in swallowing, digestive problems, etc.

Type 3: Commonly known as Mixed Hernia, this condition displays a mixture of the first two types of hiatal hernia. In this type, both the oesophagogastric junction and the stomach push through the opening and enter the chest, causing visible symptoms. If left untreated, it can cause severe complications.

Type 4:  Unlike types 1,2, and 3 hernia, this one is considered to be the most complex type. In this kind, the hiatus opening is very large, allowing more than one abdominal organ to enter. It causes various symptoms and can be life-threatening if left untreated.

​How is a Hiatal Hernia Diagnosed?

A hiatal hernia can be diagnosed with many kinds of tests. Some of the common tests include:

• Chest X-rays: This provides clear images of your chest, allowing your healthcare provider to check for any visible signs of the stomach or oesophageal junction present in this cavity.
• Oesophagram: It offers a video X-ray of the Oesophagus.
• Upper GI Endoscopy: In an endoscopy, a camera attached to a thin tube is inserted into the throat, providing a clear live view of your internal organs on the screen.
• Oesophageal Monametry: In this, a thin tube is passed down through the nose to get a better view of the oesophageal functioning. This test doesn’t necessarily give any information about the hernia, but helps analyse symptoms like breathing or swallowing difficulty.

​Conclusion

Hiatal hernia, though common, often goes unnoticed. Signs such as heartburn, chest discomfort, etc., are ignored or mistaken for common digestive problems. This can cause severe complications in the long run. Therefore, understanding these symptoms and taking appropriate steps at the right time is crucial for your health. Awareness is the first step towards healthy living and well-being. Simple care can make all the difference. Take the step towards awareness and better health today.

​FAQs

1. How is a hiatal hernia diagnosed?

Hiatal hernia, although common, isn’t easily noticeable. Some of the common tests used to diagnose it include chest X-rays, oesophagram, upper GI endoscopy, and oesophageal manometry.

​2. What foods should I avoid with a hiatal hernia?

Doctors recommend avoiding highly acidic or spicy foods in cases of a hiatal hernia. Patients are also advised to consume more frequent and smaller portions of food to avoid causing unnecessary pressure on the stomach.

​3. Can certain sleeping positions reduce symptoms?

Yes, sleeping on your left side or with your head slightly elevated helps reduce symptoms such as acid reflux.