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A hiatus hernia or hiatal hernia is the protrusion (or herniation) of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm
Symptoms
The symptoms include acid reflux, and pain, similar to heartburn, in the chest, and upper stomach.
In most patients, hiatus hernias cause no symptoms. Sometimes patients experience heartburn and regurgitation, when stomach acid refluxes back into the esophagus.
Risk factors
The following are risk factors for having a hiatus hernia.
• Increased pressure within the abdomen caused by:
o Heavy lifting or bending over
o Frequent or hard coughing
o Hard sneezing
o Pregnancy and delivery
o Violent vomiting
o Straining with constipation
o Obesity (extra weight pushes down on the abdomen increasing the pressure)
o Use of the sitting position for defecation[1] (See epidemiology below)
• Heredity
• Smoking
• Drug use, such as cocaine.[citation needed]
• Stress
• Diaphragm weakness[citation
Treatment
The surgical procedure used is called Nissen fundoplication. In fundoplication, the gastric fundus (upper part) of the stomach is wrapped, or plicated, around the inferior part of the esophagus, preventing herniation of the stomach through the hiatus in the diaphragm and the reflux of gastric acid. The procedure is now commonly performed laparoscopically. With proper patient selection, laparoscopic fundoplication has low complication rates and a quick recovery.[