A paraesophageal or hiatal hernia is the protrusion of the stomach through the diaphragm into the chest cavity, explains Mayo Clinic. Normally, the esophagus passes through an opening in the diaphragm to enter the stomach. This opening is referred to as a hiatus.
With a hiatal hernia, the stomach pushes up through the hiatus. Individuals with hiatal hernia also experience gastroesophageal reflux, but reflux is not always linked to hiatal hernia and can occur by itself, according to WebMD. The incidence of hiatal hernia is greater in women who are obese and over 50 years old. The reason it occurs is not clear in some cases; however, in certain individuals the hiatus is larger than normal and may predispose to herniation.
A hiatal hernia may be asymptomatic, or it can cause chest pain or heartburn, notes WebMD. In some cases, the stomach may be strangulated, which can cause the blood supply to be restricted. When this happens, surgery is needed. Diagnosis is made by doing a barium swallow, also called an upper G.I. or endoscopy where the doctor can look directly into the esophagus as it makes its way into the stomach. Many times, palliative care is used to treat heartburn.