Hiatal hernia

Hiatal hernia
Other names	Hiatus hernia
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]