A hernia is when part of an organ goes through an opening in the muscle wall around it.

In a hiatal hernia, part of your stomach pushes up into an opening (the hiatus) in your diaphragm. The diaphragm is the muscle between your stomach and your chest.

In most cases, your food pipe (esophagus) goes through the hiatus and joins your stomach. But with a hiatal hernia, the top part of your stomach moves up through that opening into your chest.

The top part of your stomach gets pinched. Stomach acid can back up (reflux) through the opening. This may cause heartburn and other symptoms.

There are 2 types of hiatal hernias: sliding and paraesophageal.

Sliding hiatal hernia

  • Is most common
  • Happens when part of the stomach, and the place where the stomach and esophagus meet, slide up into your chest through the opening (hiatus)

Paraesophageal hernia

  • Is less common but can be more serious
  • Happens when part of your stomach pushes up through the opening (hiatus) into your chest and is next to your esophagus


In many cases a hiatal hernia has no symptoms.

Some people do have symptoms. These may include:

  • Burping
  • Feeling nauseous
  • Vomiting
  • Backflow (reflux) of acid or stomach contents into the esophagus or throat
  • Heartburn
  • Regurgitation
  • Trouble swallowing

Paraesophageal hernias may have more severe symptoms. These can include:

  • Having trouble swallowing sometimes, most often with solid foods
  • Feeling full after eating only a small amount of food
  • Belly (abdominal) or chest pain
  • Abdominal bleeding
  • Blood loss (anemia)

In some cases a paraesophageal hernia can lead to a medical emergency. The stomach or abdominal organs may turn or twist, causing very bad pain. There is a danger that the stomach’s blood supply may be cut off (strangulation). This is an emergency. You will likely need surgery right away.

The symptoms of a hiatal hernia may look like other health problems. Always see your healthcare provider to be sure.

When to Call Your Doctor

Call your healthcare provider if your symptoms come back after treatment has stopped them. Let him or her know if symptoms get worse or you have new symptoms.