The diaphragm is a muscular membrane that separates the chest from the abdomen and is in constant motion due to breathing. The hiatus is an opening in the diaphragm, through which the esophagus descends from the chest to the abdomen and attaches to the stomach. In a hiatal hernia, the stomach bulges up into the chest through that opening.


  • Regurgitation of gastric fluids or food.
  • Burning chest pain
  • Pain in stomach
  • Dysphagia
  • Vomiting


  • A hiatal hernia can be diagnosed with endoscopy
  • Additional tests are
  • Barium shallow under x-ray
  • C/T scan


Small hiatal hernias do not need treatment
Symptoms of GERD can be treated with medication
Surgical therapy is indicated in severe esophageal injury or relapses while on medical therapy. The surgery is typically performed laparoscopically (key hole surgery).The stomach is pulled down into the abdominal cavity and the top part of it, is “wrapped” around the esophagus, while the gap of the diaphragm is closed with stiches. This provides a permanent and definitive therapy.