Obesity, pregnancy, tight clothing, and movement like bending, coughing, or straining can create the pressure that causes the sliding. Often there are no symptoms or only a sense of heartburn or fullness in the chest after eating. For people who experience heartburn and belching symptoms, an additional problem exists that is called gastroesophageal reflux. This is the backflow of acid contents of the stomach into the esophagus. These symptoms may develop after a meal, or at night.
Dietary changes can often relieve the backflow symptoms completely.
A test called an upper GI series is used to diagnose a hiatal hernia. This exam combines a barium drink with an x-ray exam of the esophagus, stomach, and small intestine. Another common test is done by passing through the mouth a narrow and flexible tube that provides a direct look at the lining of the esophagus and stomach. The results of these tests help your healthcare provider determine the best treatment. Many cases of hiatal hernia can be treated without surgery.