What are the Causes of Hiatal Hernia?

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  • Written By: Marco Sumayao
  • Edited By: Lauren Fritsky
  • Last Modified Date: 16 October 2019
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Common causes of hiatal hernia include genetic or induced weakness in the hiatal muscles, such as through physical trauma. Regular and intense pressure on the muscles, such as frequent and powerful coughing, can also weaken them and result in herniation. Certain risk factors apply stress on the hiatal muscles, increasing the likelihood of herniation. These include constipation, cigarette smoking, and heavy lifting. Although these are not considered direct causes of hiatal hernia, experts recommend avoiding these factors to prevent any possible herniation.

A hiatal hernia occurs when the stomach bulges upward into the chest cavity. This reaction is due to weak muscles surrounding the hiatus, an opening in the diaphragm that connects the esophagus to the stomach. Any sudden or intense motion that pushes the stomach upwards into the chest is often counteracted by these muscles; weak muscles allow for the stomach's displacement.

One of the most unavoidable causes of hiatal hernia is genetic inheritance. Individuals can be born with weak hiatal muscles if their parents possess weak muscles themselves. The risk of developing hiatal hernia increases if the patient has a family history of the condition. Other risk factors for herniation include genetic muscular dystrophy and the development of an abnormally large hiatus during fetal maturation.


The most common causes of hiatal hernia, however, involve physical trauma. A direct blow to the diaphragm, for example, can cause a significant amount of damage to the muscles surrounding the hiatus. Recovery from the blow might take much time, if the muscle recovers at all. This leaves a very high risk period for herniation.

Constant pressure on the hiatal muscles can also wear them down and weaken them. Unusually frequent coughs and hiccups are known to be causes of hiatal hernia. Violent shaking, such as the type experienced when riding on motor vehicles with defective shock absorbers, can also increase the risk of developing a hernia. Certain conditions that add strain to the hiatal muscles, such as obesity, increase the likelihood of hiatal herniation as well.

Although a number of individuals consider hiatal herniation a manageable condition, several experts recommend immediate surgical correction. Aside from occasional discomfort, a hiatal hernia places the patient under greater risk of developing gastroesophageal reflux disease (GERD), in which stomach acids and other enzymes overflow into the esophagous, causing serious damage. The condition has resulted in numerous fatalities, leading physicians to advise avoiding the causes of hiatal hernia as much as possible.


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