Overview

A hiatal hernia occurs when the top part of the stomach pushes through the diaphragm (the muscle separating the abdomen and the chest). Everyone has a small opening in this area, known as a hiatus. An unusually large hiatus can lead to a hiatal hernia. This condition can occur in a child of any age.

There are three main types of hiatal hernias:

• Sliding hiatal hernia. The most common type causes part of the stomach to move from the abdomen up into the chest.
• Paraesophageal hiatal hernia. This rare type occurs when the stomach bulges through an opening in the diaphragm alongside the esophagus (tube that carries food from the mouth to the stomach).
• Mixed hiatal hernia. This type combines the above two types.

Symptoms of Hiatal Hernia

Small hiatal hernias may not cause any symptoms and can remain undetected. Larger hiatal hernias can cause troublesome symptoms and usually requires treatment. Signs and symptoms of larger hiatal hernias may include:

• Acid reflux (stomach acid flowing into the throat) or heartburn
• Trouble swallowing
• Vomiting liquids or food into the mouth
• Black stool
• Pain in the chest or abdomen
• Shortness of breath
• Vomiting blood

When to see a doctor

Take your child to see a pediatrician (doctor who specializes in treating children) right away if they experience any of the above symptoms.

Causes of Hiatal Hernia

Causes of this condition can include:

• Having an unusually large hiatus (diaphragm opening)
• Injury to the upper abdomen
• Repeated strain on the diaphragm, such as from coughing, vomiting, straining during a bowel movement, lifting heavy objects or heavy exercise

Who’s at risk

Being born with a large hiatus or having suffered an injury to the upper abdomen can put a child at an increased risk of developing a hiatal hernia.