A hiatal hernia can cause acid reflux because it is more difficult for food and acid to get to the stomach, which creates a back-up in the esophagus, according to Mayo Clinic. A hiatal hernia occurs when the stomach pushes up into a hole in the diaphragm.
The diaphragm has a pathway, called a hiatus, that allows the esophagus, the tube that carries food from the mouth to the stomach, to travel through the chest cavity, Mayo Clinic explains. Because of a variety of factors, the stomach can begin to protrude up into this hole, which creates a hiatal hernia.
The stomach begins to protrude usually because the tissue surrounding the hiatus opening becomes weak, Mayo Clinic says. This muscle weakness may be due to frequent heavy lifting or being born with a larger-than-normal hiatus. Sometimes the hiatal hernia forms because of persistent coughing, vomiting or straining during bowel movements, which puts strain on surrounding muscles. Obese people over the age of 50 are the most at risk for developing the condition.
Most hiatal hernias do not cause symptoms and are only discovered during examinations for other health problems, Mayo Clinic states. Most symptoms can be treated with self-care measures at home. Occasionally very large hiatal hernias require surgery.