A hernia protrudes into or next to the esophagus through the hiatus — an opening that connects the esophagus to the stomach — and potential causes include injury, extreme coughing and pregnancy. There are two primary types of hiatal hernia as listed by the Cleveland Clinic. The more common sliding hiatal hernia is when the connection between the stomach and the esophagus pushes up into the chest, and the more severe paraesophageal hernia is where the stomach gets pushed up through the diaphragm and next to the esophagus.
While injuries that are specific to the chest/abdomen juncture area can cause hiatal hernias, the Cleveland Clinic notes that increased abdominal pressure may be a more common cause. This increased pressure can be brought about by the straining that happens during bowel movements, coughing or giving birth. Other factors, such as severe weight gain, may also have an impact. Genetic factors such as a naturally weak hiatus may also increase the likelihood of hiatal hernia
WebMD notes that common symptoms of a hiatal hernia include heartburn and acid reflux and chest pain, which means that this condition occasionally gets confused for a heart attack. Some patients experience no symptoms.