The exact cause of hiatal hernias, such as sliding and paraesophageal hernias, is not fully determined, but the cause may be weak supporting tissue around the hernia, according to the National Institutes of Health. A paraesophageal hernia is a rarer form of hiatal hernia, but it also poses a greater health risk than a sliding hernia. Hernias are body parts that protrude to areas where they do not belong, and the hiatus is an area around the opening in the diaphragm.
Sliding hernias occur when a portion of the esophagus slides up the chest through the hiatal opening. This condition is one of the aggravating factors for gastroesophageal reflux disease, or GERD, and why individuals with either condition often experience heartburn.
Paraesophageal hernias pose more health risks because part of the stomach squeezes through the hiatal opening. This may cut off blood supply to the stomach or cause the stomach to get stuck. What makes paraesophageal hernias more dangerous is that they rarely exhibit any early symptoms. Once symptoms such as chest pain, epigastric pain, shortness of breath, ulcers and difficulty in swallowing become more evident, the condition will need to be corrected immediately.
The National Institutes of Health notes that hiatal hernias occur mostly in people over the age of 50 and rarely in children. The risk of developing this condition increases among individuals who are obese and smokers. Treatment options for hiatal hernias include drugs to control the stomach and strengthen the supporting tissue around the hernia and surgery.