A hiatal (high-ATE-ul) hernia occurs when the upper stomach pushes upward through an enlarged opening, or 'hiatus' (high-ATE-us), at the point where your esophagus passes through your diaphragm. Sometimes it causes a painful burning sensation in the chest, difficulty swallowing, chest pain, and belching, but other times there are no symptoms at all. The cause is unknown, but it may be the result of a weakening of the supporting tissue. Children who have a hiatal hernia usually have it at birth, and pregnant women also sometimes get them, as well. Hiatal hernias are most common in people over age 50, and obesity and smoking are risk factors. They can cause regurgitation of gastric acid from the stomach, which can result in inflammation or damage to the esophagus. Treatment is aimed at reducing regurgitation of stomach contents into the esophagus through drugs or change in diet. Some ways to alleviate symptoms include avoiding large or heavy meals, not lying down or bending over immediately after a meal, wearing loose-fitting clothing around the waist, losing weight, and quitting smoking. It's best to avoid alcohol, carbonated beverages, and spicy foods if the esophagus is inflamed. If symptoms aren't controlled, or there are complications, surgery may be required.
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