Which are the causes of Hiatus Hernia?

A hiatus hernia, also known as hiatal hernia, is a condition that occurs when a portion of the stomach protrudes through the diaphragm into the chest cavity. This displacement of the stomach can lead to various symptoms such as heartburn, chest pain, difficulty swallowing, and regurgitation of stomach acid. While the exact cause of hiatus hernia is not always clear, there are several factors that can contribute to its development.

1. Weakness in the Diaphragm

The diaphragm is a large muscle that separates the chest cavity from the abdomen. It plays a crucial role in breathing by contracting and relaxing. In some cases, the diaphragm may have a weakness or an opening that allows a portion of the stomach to push through. This weakness can be present from birth or develop over time due to factors such as aging, injury, or increased pressure on the abdomen.

2. Increased Pressure in the Abdomen

One of the primary causes of hiatus hernia is an increase in pressure within the abdomen. This pressure can push the stomach upward and through the diaphragm. Several factors can contribute to this increased pressure, including:

• Obesity: Excess weight can put additional pressure on the abdomen, making it more likely for a hiatus hernia to develop.


• Pregnancy: The growing uterus during pregnancy can exert pressure on the abdomen, potentially leading to a hernia.


• Heavy lifting: Regularly lifting heavy objects can strain the abdominal muscles and increase abdominal pressure.


• Coughing or vomiting: Frequent and forceful coughing or vomiting can also contribute to the development of a hiatus hernia.

3. Age and Muscle Weakness

As we age, the muscles and tissues in our body naturally weaken. This includes the diaphragm and the muscles supporting the lower esophageal sphincter (LES), which is the valve that prevents stomach acid from flowing back into the esophagus. When these muscles weaken, it becomes easier for the stomach to herniate through the diaphragm, leading to a hiatus hernia.

4. Smoking and Alcohol Consumption

Smoking and excessive alcohol consumption have been associated with an increased risk of developing a hiatus hernia. Smoking can weaken the LES, allowing stomach acid to flow back into the esophagus more easily. Alcohol, on the other hand, can irritate the esophagus and contribute to muscle relaxation, making it easier for a hernia to occur.

5. Genetic Predisposition

While the role of genetics in hiatus hernia is not fully understood, there is evidence to suggest that some individuals may have a genetic predisposition to developing this condition. Certain inherited traits or structural abnormalities in the diaphragm or LES may increase the likelihood of a hernia forming.

6. Other Factors

There are several other factors that may contribute to the development of a hiatus hernia, although their direct relationship is not yet fully established. These include:

• Hiatal hernia and GERD: Gastroesophageal reflux disease (GERD) and hiatus hernia often coexist. While the exact relationship between the two is not clear, it is believed that the presence of a hernia can worsen the symptoms of GERD.


• Connective tissue disorders: Certain connective tissue disorders, such as Marfan syndrome or Ehlers-Danlos syndrome, may increase the risk of developing a hiatus hernia.


• Chronic constipation: Straining during bowel movements due to chronic constipation can put pressure on the abdomen and potentially contribute to the development of a hernia.

In conclusion, while the exact cause of hiatus hernia may vary from person to person, it is often a combination of factors that contribute to its development. Weakness in the diaphragm, increased pressure in the abdomen, age-related muscle weakness, smoking, alcohol consumption, genetic predisposition, and other factors can all play a role. It is important to note that individuals experiencing symptoms of a hiatus hernia should consult with a healthcare professional for an accurate diagnosis and appropriate treatment.