A hiatal hernia is an upward protrusion of your stomach into your chest.
Before entering your stomach, your meal passes an ingenious locking system, designed to prevent any leakage of stomach acid.
It consists of two parts:
Your esophagus passes though a small opening (hiatus) in your diaphragm, just before entering your stomach. The size of this diaphragmal opening is just big enough to fit perfectly around your stomach valve. This way, the strong diaphragm assists your stomach valve to keep your stomach closed.
It pulls apart the two parts your stomach's 'locking system'.
Your stomach valve is pushed away from its diaphragmal support. Without help form the diaphragm, this valve loses power. It can't seal off your stomach perfectly and stomach acid leaks through the valve.
In most cases, there are several causes. If you are born with a weakness or a particularly large hiatus, it is possible that your stomach bulges out of this opening some day.
A 'stomach bulging' occurs at moments when you put a lot of pressure on your abdomen:
Once the bulging has occured, the damage is done. It is irriversible, unless you consider surgery.
The most common is a sliding hiatus hernia. The upper part of your stomach penetrates through the opening of the diaphragm and moves upward.
The other is a rolling hiatus hernia. In this case, your stomach stays down. Only a little 'balloon' of stomach tissue is pushed upward through your diaphragmal opening.
Since a hiatus hernia exist in 1 on 5 people, it is seen as a anatomical variation. As long as you don't have symptoms, you don't need any treatment.
Some osteopaths and chiropractors claim to have techniques to reposition a small hernia. They do this by sticking their fingers gently down your chest cavity and 'pulling' your stomach back down.
This can be possible, but your osteopath or chiropractor can't prevent your hernia from popping back. The cause of hiatus hernia is a too large 'hiatus' (opening) in your diaphragm. Once you put pressure on your stomach it will easily bulge back upward.
A hiatus hernia can be seen during a gastroscopy.
To confirm this diagnosis and to get a clearer view, your doctor prescribes a Barium X-Ray.
Before the X-Ray is taken, you need to drink a chalky liquid that contains barium. As you can see on the picture, it coats the walls of the esophagus and the stomach. If a part of your stomach is situated in your chest, you have got a stomach hernia.