A hernia occurs when a rupture in smooth muscle tissue allows a body part to protrude into another organ or space. In the case of a hiatal hernia, the upper part of the stomach pushes through the diaphragm. The diaphragm is the large muscle separating the chest and abdomen that helps you breathe. There is a small opening in the diaphragm called a hiatus. This is where the esophagus passes through to the stomach. When a hiatal hernia occurs, the stomach protrudes through this space. Hiatal hernias typically affect people above 50 years of age. According to the Esophageal Cancer Awareness Association , about 60 percent of people develop hiatal hernia by the time they are 60 years old.
The precise cause of hiatal hernia isn’t known. It can be caused by muscle damage or actions that put too much pressure on the diaphragm such as coughing and weight lifting. Some people have a large hiatus and are more likely to develop this type of hernia. Small hiatal hernias usually don’t cause problems or show symptoms. Often, they are only discovered during procedures for other health conditions. Larger hiatal hernias may cause discomfort and can pose serious health problems. A strangulated hernia, for instance, can prevent normal blood flow in the stomach.
The following are signs a person might have a hiatal hernia.
Heartburn  refers to a burning sensation in the chest that typically happens with a bitter taste in the throat. The feeling is usually aggravated by eating large meals, bending over or lying down. Eating spicy foods, chocolate, onions or citrus fruits can also increase your risk of heartburn. People with hiatal hernias may experience heartburns more frequently than others. In many cases, this is not a serious problem and may be resolved with treatments at home. If the heartburn is severe and makes eating or swallowing difficult, you should see a doctor.