When the upper part of the stomach pokes through the esophageal hiatus, because of a weakness in its muscles, hiatal hernia occurs. The esophageal hiatus is the opening in the diaphragm through which the esophagus enters the abdominal cavity.

At the esophagus’ end there is the lower esophageal sphincter which has the role of a valve – it only allows food to travel one-way. There is also a second valve, which is the esophageal hiatus. The two valves are synchronized so that food from the stomach does not return back where it came from.
If the muscles get weak and the abdominal pressure increases, eventually the hiatus will stretch so much that the upper part of the stomach will pass through it thus causing the hiatal hernia.

In the early phases hiatal hernia does not present any symptoms so mostly it is discovered when you visit your doctor for a routine check. But as the illness advances symptoms are starting to appear. Among these there is heartburn, epigastric pain and rarely some infections
Paraesophageal hernia may cause some incarcerations or more acute epigastric pain, because of a strangulation. This type of hernia is rare but it is dangerous, life threatening maybe. Sometimes complications like stomach strangulation appear but in most cases this does not happen.

The most common hiatal hernias are the sliding hernias. These are not that dangerous, one of their bad symptoms is reflux esophagitis, which was noticed in any people that suffer from hiatal hernia. Some of them were also affected by Barrett’s esophagus because of the hernia. Barrett’s esophagus may present dysphagia or reflux symptoms.

Unfortunately hiatal hernia has parsyntoms that are multifactorial, like esophagitis and peptic ulcer. In extreme cases a carchinoma appears in the hernia or chest infections.

Doctors advise people who are suffering from hiatal hernia to try to lose some weight and not to wear tight clothes.