A  hiatal hernia is a relatively common finding.  A hiatal hernia occurs when part of the stomach migrates up into the chest area.  The stomach is usually located below the diaphragm, a muscular layer that separates the chest and abdominal cavities.  There is an opening in the diaphragm through which the esophagus passes.  This is the same opening that the stomach pushes through when you have a hiatal hernia.  Hiatal hernias occur in two forms.  A sliding hernia occurs when the top of the stomach and the lower part of the esophagus migrate upward into the space above the diaphragm.  The orientation of the stomach does not change.  A paraesophageal hernia occurs when the top of the stomach migrates upward into the space above the diaphragm and lies alongside the esophagus.  This is a less common type of hernia, but it can be serious.  The main concern is that the stomach can twist onto itself and lead to a lack of blood flow to the area.

Hiatal hernias usually do not cause symptoms. Symptoms associated with sliding hiatal hernias tend to be similar to gastroesophageal reflux symptoms, such as heartburn and regurgitation, because the hiatal hernia can cause stomach acid to leak into the esophagus.

Paraesophageal hernias may also be asymptomatic. When they are symptomatic they tend to cause pain that comes and goes, nausea, and a feeling of fullness after eating that occurs earlier than expected.

Hiatal hernias can be seen on imaging tests, such as an xray or during an upper endoscopy, which involves a doctor putting a tube down your throat with a camera attached to the end.

The treatment for a hiatal hernia depends on the symptoms. People who experience acid reflux symptoms can be treated with acid reflux medications.  Surgery is sometimes recommended if the hernia is large, or is causing significant symptoms.