A hiatal hernia is different from other abdominal hernias in that the abdominal contents protrude into the chest cavity rather than to the outside world. The diaphragm is a sheet of muscle that separates the chest from the abdomen. Most often, a portion of the stomach protrudes upward into the chest through an opening in the diaphragm although with larger hiatal hernias, other organs such as the spleen, colon, pancreas, or small intestine can also herniate. Increasing age, obesity, and smoking are known risk factors in adults.
Hiatal hernias are very common, especially in people over 50 years old. Symptoms may include reflux, chest pain, heartburn, or difficulty swallowing.
The goals of treatment of hiatal hernias are to relieve symptoms and prevent complications. Reflux is often controlled effectively with medications that neutralize stomach acidity, decrease acid production, or strengthen the lower esophageal sphincter. If conservative measures fail to control the symptoms or if complications such as pulmonary (lung) aspiration, iron deficiency anemia (slow bleeding due to a large hernia), or strangulation of the hernia occur, surgical repair is indicated. Typically, this type of hernia is optimally repaired using laparoscopic techniques. We have extensive advanced laparoscopic expertise in all variations of hiatal hernias and will individualize treatment in conjunction with our expert team of gastroenterologists, radiologists, and pulmonologists.