A hiatal hernia occurs when the upper part of your stomach bulges through the large muscle separating your abdomen and chest (diaphragm). Your diaphragm has a small opening (hiatus) through which your food tube (esophagus) passes before connecting to your stomach.

Risk Factors
Several risk factors make a weakening of the hiatus, an opening in the diaphragm through which the food pipe passes, more likely. For example, hiatal hernias are more common among people over 50 years of age and those who have obesity.

Other risk factors include an upward force that occurs due to weightlifting, straining to empty the bowel, or persistent coughing or vomiting. These actions temporarily increase the pressure inside the abdominal cavity. Injury to the diaphragm, such as trauma from a fall or traffic accident, can also lead to a hiatal hernia.

Symptoms
Symptoms are usually the result of acid moving up from the stomach. This acid can cause heartburn, which is a burning sensation around the lower chest area.

Heartburn tends to get worse in response to certain foods and beverages, and it often occurs when a person is lying down or bending over, especially soon after eating. It can lead to bloating, belching, and a bad taste in the back of the throat.

If heartburn becomes a regular problem, this might signify that a person has acid reflux. Acid reflux is a condition in which heartburn occurs at least twice a week. If acid reflux happens too regularly for a prolonged period, it might progress to gastroesophageal reflux disease.

Treatments
Lifesytle changes including weight loss, timing and size of meals, avoidance of acid producing foods can help minimize acid refluz
Over the counter antacida and prescription medication can also help.

Surgery
People who develop severe and long-term reflux problems may need to consider having an operation if lifestyle changes and drug treatments are not effective. Surgery also becomes necessary if a hernia is large enough to disrupt the blood supply.

The operations for hiatal hernias are laparoscopic. Surgeons perform these procedures through small “keyhole” cuts, so they are minimally invasive.