Hiatus Hernia

A hiatus hernia is due to a weakness of the diaphragm muscle which allows the stomach to herniate back into the chest. This commonly causes symptoms such as heartburn, nausea and can sometimes cause difficulty with swallowing. This occurs because the formation of the hernia often interferes with the barrier (lower oesophageal sphincter) which prevents acid from refluxing from the stomach into the oesophagus. See Image >>

Normally, the oesophagus or food tube passes down through the chest, crosses the diaphragm, and enters the abdomen through a hole in the diaphragm called the oesophageal hiatus. Just below the diaphragm, the oesophagus joins the stomach.

In individuals with hiatal hernias, the opening of the oesophageal hiatus (hiatal opening) is larger than normal, and a portion of the upper stomach slips up or passes (herniates) through the hiatus and into the chest. Although hiatal hernias are occasionally seen in infants, where they probably have been present from birth, most hiatal hernias in adults are believed to have developed over many years.

Other factors contributing to the development of such a Hernia include: A permanent shortening of the oesophagus (perhaps caused by inflammation and scarring from the reflux or regurgitation of stomach acid) which pulls the stomach up; and an abnormally loose attachment of the esophagus to the diaphragm which allows the esophagus and stomach to slip upwards. They are more common in overweight people.