Stomach or Esophagus Bulges Through the Diaphragm

When an internal organ pushes through an area in your body where it doesn’t belong, it is called a hernia. A hiatal hernia or paraesophageal hernia occurs at the esophageal hiatus in the diaphragm. The esophagus hiatus is a natural opening in the muscle separating the chest cavity from the abdomen, the diaphragm. Your esophagus passes through the hiatus and attaches to the stomach. When the stomach bulges through the hiatus, its called a hiatal hernia or paraesophageal hernia.

While, sometimes, the cause is unknown, it might include:

• Changes in your diaphragm as you age
• Having a larger hiatal opening than usual at birth
• Obesity
• Pressure from lifting, coughing or straining during a bowel movement
• Trauma or injury

Hiatal hernias occur more often in women and people older than 50.

Symptoms, Diagnosis and Outlook

Symptoms of a hiatal hernia include:

• Bloating after eating
• Food getting stuck when eating
• Nausea and vomiting
• Pain with eating
• Shortness of breath if the hernia is large and compressing the lung
• Worsening reflux

To diagnose a hiatal hernia, your doctor may order tests, including:

• Barium swallow – using X-ray imaging, a radiologist examines your esophagus and stomach after you drink a contrasting liquid
• Computed Tomography (CT) scan –a radiologist looks at the anatomy of your diaphragm and stomach after you drink a contrasting liquid
• Endoscopy – a camera is inserted into the esophagus and stomach through a long, thin tube to examine your esophagus and stomach
• Esophageal manometry – a small probe is placed in the esophagus to measure how well the esophagus contracts
• Esophageal pH study – examines the presence and severity of gastroesophageal reflux associated with a hiatal hernia

Lifestyle changes and over-the-counter medications can sometimes improve hiatal hernia symptoms. If surgery is required, the experts at Penn State Health specialize in minimally invasive, laparoscopic and robotic-assisted surgery to repair hernias. Our goal is to help you recover quickly and improve your quality of life.

Why Choose Penn State Health for Care

Recognized Leaders in Gastrointestinal Surgery

As the only academic medical center in central Pennsylvania, we can offer some of the latest treatments, backed by clinical research and medical innovation. Because we have unmatched expertise in a wide range of conditions, with advanced experience in the digestive system, you can get leading-edge care right here.

These are a few reasons why families choose us:

• We perform more minimally invasive surgeries than any other gastrointestinal surgery group in central Pennsylvania, including laparoscopic, single-site and robotic-assisted surgery.
• Our digestive health experts use leading-edge endoscopic approaches – with a scope, camera and very small instruments – to diagnose and treat many conditions without surgery.
• We use advanced technology to enhance safety and precision. Our surgical SUPERSUITE® integrates imaging, robotics and precision instrumentation into a complete system that allows surgeons to provide safer, more efficient care.

A Comprehensive, Multidisciplinary Team Approach

Our team of medical and surgical specialists works together to offer both surgical and nonsurgical solutions to give you the best possible function and control of your hiatal hernia symptoms. Our multidisciplinary gastrointestinal team meets regularly to develop personalized treatment plans for complex hiatal hernias and esophageal disorders.