Diaphragmatic Aperture - Hiatal Hernia

Diaphragmatic hernia is also termed as hiatal hernia and it occurs where the esophagus connects to the stomach.  The esophagus is a muscular tube, which connects the pharynx and the stomach through the cardiac sphincter.

Hernia occurs when one body part pushes its way into another body area where it does not belong anatomically.  The diaphragm is dome shaped muscle, with its convexity towards the upper chamber. It divides the torso into two parts which are thorax or the upper part and abdomen or the lower chamber.  Diaphragm is directly involved in the action of breathing as its contraction increases the size of the thorax and the air pressure within the thorax comes down and outer air rushes in through the nose into the lungs to take its place and the lungs inflate and thus inspiration takes place.  Similarly upon relaxation of the diaphragm the size of the thorax comes down and the air within the lungs is pushed out into the atmosphere.  Hence the diaphragm is in a state of almost constant movement.  The organs like the esophagus pierce through the diaphragm and come into the abdomen to connect to the stomach.  Here in some cases the stomach (an abdominal organ) pushes into the thorax through the opening in the diaphragm or the hiatus, hence the term hiatal hernia.

Mostly hernia occurs as a result of weakness of the supporting tissue. But certain factors are said to be associated with this problem such as smoking, being overweigh and advancing age.

Most of the hiatal hernia cases are asymptomatic or is presented as GERD (Gastroesophageal reflux disease).  The symptoms of hiatal hernia include heartburn, chest pain, and dysphagia. These symptoms are not directly caused by the hernia but are results of backflow of the acidic stomach contents into the esophagus and increase with lying down, lifting heavy objects as well as leaning forward or straining.  Hiatal hernia hardly ever need treatment until and unless it is of the paraesophageal variety.