The hiatus is an opening in the diaphragm — the muscular wall separating the chest cavity from the abdomen. Normally, the esophagus (food pipe) goes through the hiatus and attaches to the stomach. In a hiatal hernia (also called hiatus hernia) the stomach bulges up into the chest through that opening.

Hiatal hernia could be caused by: Injury to the area. Being born with an unusually large hiatus. Persistent and intense pressure on the surrounding muscles, such as when coughing, vomiting or straining during a bowel movement, or while lifting heavy objects.

Most people who have a hiatal hernia have no symptoms. One symptom you may have is heartburn, which is an uncomfortable feeling of burning, warmth, or pain behind the breastbone. … Pain from the heart usually feels like pressure, heaviness, weight, tightness, squeezing, discomfort, or a dull ache.

SURGICAL REPAIR
The most common procedure of this type is called fundoplication. In this surgery, your surgeon will: First repair the hiatal hernia. This involves tightening the opening in your diaphragm with stitches to keep your stomach from bulging upward through the opening in the muscle wall.