Normally, the diaphragm separates the chest area (i.e. heart, lungs and esophagus) from the lower thoracic regions (i.e. stomach and intestines). A hiatal hernia (also know as a hiatus hernia) occurs in one of 2 ways:
- Sliding hiatal hernia: when the stomach and section of the esophagus that connects to the stomach slide up through the hiatus.
- Paraesophageal hernia: when part of the stomach goes through the hiatus causing a bulge next to the esophagus.
Typically, gastroesophageal reflux (GERD) are associated with sliding hiatal hernias.
However, with paraesophageal hernias, the stomach can get pinched by the diaphragm causing loss of blood or strangulation. Paraesophageal hernias can be extremely painful and uncomfortable.