A hiatal hernia occurs when the upper part of the

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A hiatal hernia occurs when the upper part of the stomach bulges through the large muscle separating the abdomen and chest (diaphragm). The diaphragm has a small opening (hiatus) through which the food tube (esophagus) passes before connecting to the stomach. In a hiatal hernia, the stomach pushes up through that opening and into the chest. 2 Etiology A hiatal hernia occurs when weakened muscle tissue allows the stomach to bulge up through the diaphragm. Caused by: Age-related changes, Injury to the area, Being born with an unusually large hiatus, Persistent and intense pressure on the surrounding muscles, such as while coughing, vomiting, straining during a bowel movement, exercising or lifting heavy objects. 3 Epidemiology Hiatal hernia is most common in people who are: Age 50 or older, Obese. Half of patients (50% to 94%) with reflux esophagitis that was diagnosed either endoscopically or radiologically had concomitant hiatal hernias, whereas the prevalence of hiatal hernia was lower (13% to 59%) in the control subjects. 4 Clinical Manifestations Most small hiatal hernias cause no signs or symptoms. But larger hiatal hernias can cause: Heartburn, Regurgitation of food or liquids into the mouth, Backflow of stomach acid into the esophagus (acid
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