For people who have an abnormality called a hiatal hernia, the opening of their esophageal hiatus is larger than normal, which means that a portion of their upper stomach slips up or passes through their hiatus and into their chest. In other words, part of their stomach comes through their diaphragm and into their chest. If this description makes a hiatal hernia sound like a rare and strange disease, think again. The fact is, approximately 15 percent of the population has it.

A hiatal hernia can be congenital (present at birth). Unfortunately, in this instance there is no way to prevent a hiatal hernia. However, because most hiatal hernias in adults are believed to have developed over many years, preventative measures can be taken.

1. Basics. In learning how to handle a hiatal hernia, the first thing you should know is some basic facts. According to Penn State University's Milton S. Hershey Medical Center, a hiatal hernia is more likely to occur in females than males.[1] They are very common during middle age, and the risk for them increases with age. Having had abdominal surgery puts you at a higher risk for them, as does obesity. This is because hiatal hernias are caused by a weakness is in the muscle tissue at the diaphragm. So activities (like heavy lifting) or bodily functions (pregnancy, constipation) that place stress upon the abdomen are particularly harmful.

2. Symptoms. Though a hiatal hernia cannot be seen outside the body and may not cause any symptoms, patients who do experience symptoms will often have heartburn or acid reflux. When the part of the stomach that is herniated becomes twisted or pinched by the diaphragm, the result is called a strangulated hiatal hernia, which can result in that portion of the stomach losing its blood supply. At this point, symptoms include severe chest pain, bloating, and difficulty swallowing.

3. Diagnosis. Your doctor can test for a hiatal hernia in one of two ways. A. Endoscopy, in which a flexible viewing tube is inserted through your mouth and into your stomach. B. Barium swallow, in which x-rays are taken after you drink a special barium solution.

4. Treatment. Fortunately, a hiatal hernia rarely requires surgery. Instead, a focused diet is the key to recovery (and prevention). Essentially, you should use an approach similar to those who suffer from GERD: limit spicy, fatty, and acidic foods and beverages, in addition to caffeinated beverages and chocolate. Also, try to eat small meals throughout the day. And using antacids after a meal is fine. When it comes to handling a hiatal hernia, a little medicine never hurts.