The exact cause of many hiatal hernias isn't known.
The diaphragm is a large, dome-shaped muscle that seperates the thoracic cavity from the abdominal cavity. It has a small opening-hiatus, through which the esophagus passes from the thorax to the abdomen to connect with the stomach.
A hiatal hernia occurs as a result of weakening of muscles surrounding the hiatus which leads to the stomach protruding through the diaphragm. The exact reason as to why this happens is not understood.
Researchers believe that age-related changes and pressure on the stomach may contribute to the development of this condition.
Possible causes of hiatal hernia include:
Injury to the area
Being born with an enlarges hiatus
Constant and intense pressure on the surrounding muscles, such as coughing, vomiting or straining during a bowel movement or when lifting heavy objects
An esophagram (barium swallow)- in which a patient is asked to drink a chalky liquid containing barium that coats the upper digestive tract. This provides a clear silhouette of the esophagus, stomach and upper part of the intestines (duodenum) on X-ray.
Endoscopy exam in which a small tube with a light and video camera at one end is inserted into the esophagus and stomach through the mouth to check for any signs of inflammation.
Manometry - a thin pressure-sensitive tube (catheter) is passed through the nose, down into the esophagus and stomach to measure the pressure and movement inside the esophagus.
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