A hiatal hernia occurs when the top of the stomach pushes up through the diaphragm, a flexible muscle that separates the abdomen and the chest. The diaphragm controls breathing and stops acid from entering the esophagus, but when a hiatal hernia develops, an individual is at a greater risk of GERD-related discomfort. A hiatal hernia may develop over time, though some people are born with one. When developed in adulthood, they are usually the result of excessive straining or age-related changes to the diaphragm. Chronic coughing, pregnancy, obesity, constipation, straining excessively during bowel movements, and physical injury can also lead to a hiatal hernia. Small hiatal hernias are common and may cause no symptoms at all. Larger ones are more likely to cause acid reflux and other symptoms.
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