Hiatal Hernia

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Specialists at Houston Methodist Lynda K. and David M. Underwood Center for Digestive Disorders treat simple to complex cases of upper intestinal bulging with expertise. Our gastroenterologists use top-rated nonsurgical and surgical procedures to improve your quality of life.


A hiatal (gap) hernia (protrusion) is a type of hernia  that involves the upper part of your stomach, the large muscle responsible for breathing (diaphragm) and an abnormal opening in the diaphragm.

A hiatal hernia occurs when certain risk factors allow the stomach to bulge through the diaphragm’s hole. People aged 50 or older most often experience this gastrointestinal (GI) condition because the muscles of the diaphragm can weaken with age.


Certain exercises, such as holding your breath or stretching, can strengthen the diaphragmatic muscles and repair this common condition. If symptoms do not improve and become severe, consult an Underwood Center gastroenterologist.


Houston Methodist Hospital is ranked No. 5 by U.S. News & World Report for Gastroenterology & GI Surgery. U.S. News & World Report has also named Houston Methodist Hospital the No. 1 hospital in Texas every year since the award began and one of the nation’s best as a nationally ranked Honor Roll hospital. 

Expert Hiatal Hernia Diagnosis & Care

Our experts quickly and accurately diagnose all types of hernias — including hiatal hernias. Medication and minimally invasive surgery often treat the symptoms of hiatal hernia. If medicines and lifestyle measures do not help control symptoms, you may need surgery.


Underwood Center gastroenterologists are experts in the most advanced hernia procedures, fundoplication and laparoscopic surgery. Our goal is to close your hiatal hernia, tighten the opening in your diaphragm and prevent recurrence.

Hiatal Hernia Associated Conditions We Treat

The occurrence of a hole in your diaphragm can lead to associated conditions where stomach acid backflows into that hole. Hiatal hernia can also mimic conditions with similar symptoms. Our diagnosis can rule out or confirm the following related conditions:

Hiatal Hernia Symptoms, Diagnosis & Treatment

What are the signs and symptoms of hiatal hernia?

Most small hiatal hernias cause no signs or symptoms, but larger hiatal hernias can cause warning signs. Contact our gastroenterologists for testing if you have any of the symptoms below:

  • Backflow of stomach acid into the esophagus
  • Chest or abdominal pain
  • Difficulty swallowing
  • Feeling full soon after you eat
  • Heartburn
  • Passing black stools
  • Regurgitation of food or liquids into the mouth
  • Shortness of breath
  • Vomiting blood

How is hiatal hernia diagnosed?

Your doctor will choose a diagnostic procedure based on a discussion of your symptoms.

  • Barium swallow – a white liquid that traces the pathway from the esophagus into the stomach shows the size of the hiatal hernia
  • Esophageal manometry  – measures how well the esophagus squeezes to aid digestion
  • Gastric emptying study – examines how fast food leaves the stomach to eliminate other causes of symptoms
  • pH probe test  – measures backflow of acid from the stomach into the esophagus
  • Upper endoscopy – assesses interior surfaces of the esophagus and stomach by inserting an endoscope (thin tube with light and camera attached) into the body

What causes hiatal hernia?

Hiatal hernia may have the following causes:

  • Age-related changes in your diaphragm
  • Being born with an enlarged hiatus (opening in the diaphragm, between the chest and stomach)
  • Injury to the area
  • Persistent coughing, vomiting, straining during a bowel movement, exercising or heavy lifting

How is hiatal hernia treated?

Our goal is to provide a comprehensive plan that relieves symptoms and prevents complications. Recommendations and treatments may include:

Antacid medication

Avoid large or heavy meals

Lose weight

Raise the head of the bed 4 to 6 inches

Sit up after a meal

Smoking cessation


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