Causes and Diagnoses

Causes and Diagnoses of a Hiatal Hernia

The exact cause of hiatal hernias isn’t known, but experts do know that some people are born with an especially large hiatus (hole in the diaphragm). Suspected causes of hiatal hernias include:

  • Coughing
  • Vomiting
  • Straining to move your bowels
  • Sudden physical movement, such as lifting
  • Pregnancy
  • Obesity

People who are over age 50, who are overweight, and who smoke are at the greatest risk of developing a hiatal hernia.

Diagnosing a hiatal hernia

A hiatal hernia is often discovered during diagnostic or screening tests for other conditions. Those tests may include:

  • Chest X-ray: This common X-ray image may show that you have a hiatal hernia.
  • Fiberoptic endoscopy: An endoscope (a thin, lighted tube with a camera attached to it) is passed through your mouth and esophagus. Your physician can look at pictures of your digestive tract and determine if there is a hiatal hernia.
  • Capsule endoscopy: A tiny camera, embedded in a small capsule that you swallow, takes pictures of your esophagus.
  • Esophagram/barium swallow: A special series of X-rays is taken of your esophagus after you drink small amounts of a liquid containing barium, a contrast material that coats your esophagus and shows up well on X-rays.
  • Pharyngeal manometry: A pressure-sensitive tube is passed through your nose and into your stomach to measure pressure inside your esophagus.