Hiatal hernia | |
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Other names | Hiatus hernia |
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A drawing of a hiatal hernia | |
Specialty | Gastroenterology, general surgery |
Symptoms | Taste of acid in the back of the mouth, heartburn, trouble swallowing[1] |
Complications | Iron deficiency anemia, volvulus, bowel obstruction[1] |
Types | Sliding, paraesophageal[1] |
Risk factors | Obesity, older age, major trauma[1] |
Diagnostic method | Endoscopy, medical imaging, manometry[1] |
Treatment | Raising the head of the bed, weight loss, medications, surgery[1] |
Medication | H2 blockers, proton pump inhibitors[1] |
Frequency | 10–80% (US)[1] |
A hiatal hernia or hiatus hernia[2] is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest.[1][3] This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn.[1][3] Other symptoms may include trouble swallowing and chest pains.[1] Complications may include iron deficiency anemia, volvulus, or bowel obstruction.[1]
The most common risk factors are obesity and older age.[1] Other risk factors include major trauma, scoliosis, and certain types of surgery.[1] There are two main types: sliding hernia, in which the body of the stomach moves up; and paraesophageal hernia, in which an abdominal organ moves beside the esophagus.[1] The diagnosis may be confirmed with endoscopy or medical imaging.[1] Endoscopy is typically only required when concerning symptoms are present, symptoms are resistant to treatment, or the person is over 50 years of age.[1]
Symptoms from a hiatal hernia may be improved by changes such as raising the head of the bed, weight loss, and adjusting eating habits.[1] Medications that reduce gastric acid such as H2 blockers or proton pump inhibitors may also help with the symptoms.[1] If the condition does not improve with medications, a surgery to carry out a laparoscopic fundoplication may be an option.[1] Between 10% and 80% of adults in the United States are affected.[1]
However, the exact prevalence of hiatus hernia is difficult to determine because of the inherent subjectivity in diagnostic criteria. Consequently, estimates vary widely—for example, from 10% to 80% of the adult population in North America
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