Hiatal Hernia Facts and Statistics: What You Need to Know

Hiatal hernias occur when a portion of the upper stomach protrudes into the chest cavity. This diagnosis is common in older people and people with obesity in the United States. Some estimates state that over half of the people over age 60 have this condition to some degree. However, the results of studies vary widely.

This article will outline the key facts and statistics that you need to know about hiatal hernias.

Hiatal Hernia Overview

The diaphragm muscle divides the stomach cavity from the chest cavity in your torso. Hiatal hernias arise when the upper portion of your stomach pokes through a hole in the diaphragm and enters the chest compartment. In severe cases, your stomach can twist as it protrudes into the chest cavity and causes significant pain or gastrointestinal (GI) blockage.

How Common Are Hiatal Hernias?

Because the likelihood of getting a hiatal hernia increases if you are older or overweight, this issue has become much more common given the demographics of the United States. One review estimates that up to 80% of the adult population in North America may deal with this type of hernia at some point in their lifetime.

Because most hiatal hernias cause mild symptoms like heartburn or regurgitation, many people may not even realize they have one.

However, this diagnosis can lead to more severe symptoms in rarer circumstances. These can include stomach or chest pain, difficulty swallowing, or anemia.

Some hiatal hernias are severe enough that they require hospitalization. This condition was found to be a primary or secondary reason for hospital admission in 142 out of every 10,000 admissions in the United States.

Hiatal Hernias by Age and Gender

Hiatal hernias are disproportionally found in older individuals. One study of the general population found that roughly one in 50 adults in their 60s had a hiatal hernia visible on a computed tomography (CT) scan. This compares to approximately eight out of every 50 adults in their 80s.

However, estimates of the prevalence of this condition vary widely. Many people experience minimal or no symptoms, so they are unlikely to have a procedure in which it is detected.

This diagnosis is also much more common in women than in men. The same study found that nearly 13% of women ages 53–94 had this type of hernia. This compares with only 7% of men in this age range. When citing research or health authorities, the terms for sex or gender from those sources are in use.

In addition, pregnant people are also much more likely to develop this issue. One estimate suggested that 15–20% of pregnant people will get a hiatal hernia. This is most common in the second trimester and occurs due to the growing fetus pushing the contents of the stomach upward against the diaphragm.

Causes of Hiatal Hernias and Risk Factors

Though anyone can get a hiatal hernia, several risk factors can increase your chances. These include:

• Overweight or obesity
• Advanced age
• History of multiple pregnancies
• Prior esophageal surgery
• Partial or full gastrectomy (removal of the stomach)
• Disorders causing the decalcification or degeneration of the skeletal system

Discuss your condition with a healthcare provider if you are experiencing any of the GI symptoms noted previously and have one (or several) of these risk factors. 

What Are the Mortality Rates for Hiatal Hernias?

Though hiatal hernias are relatively common, it is extremely rare that they cause mortality. Severe cases can cause stomach obstruction, which can lead to death if left untreated. That said, surgical repair is an effective and evidence-supported solution for this complication.

One review found that the mortality rate for emergency hiatal hernia surgery is between 0% and 5%. Fortunately, only 2% of people with this type of hernia develop an acute blockage that necessitates emergency surgery.

In general, promptly reporting any symptoms you are experiencing to a healthcare provider can help avoid these rare adverse outcomes.

Screening and Diagnosis

Diagnosing a hiatal hernia can be rather challenging because the contents of the torso are constantly moving as you swallow, breathe, and go about your day. Because of this, a thorough examination by a healthcare provider is necessary to properly screen for this condition.

During this exam, they may order these diagnostic tests:  

• Barium swallow X-ray: Helps to assess the size of the herniated stomach and look at the junction between the stomach and the esophagus.
• Endoscopy: Provides a real-time look at the esophagus and stomach, though it may not be able to visualize large hiatal hernias.
• Manometry: For visualizing the esophagus and assessing its movements.
• pH testing: Helps to objectively document reflux episodes, which impact the pH levels in the esophagus.
• CT scan: Provides a more detailed look at the size and location of a hiatal hernia

Summary

Hiatal hernias are common in the United States and are becoming more prevalent as the population ages and obesity rates increase. Though anyone can get this type of hernia, women, people with obesity, older people, and those with prior stomach or esophageal surgeries are most at risk.

Many people with this diagnosis experience very mild symptoms, though it can cause severe pain or hospitalization in rare cases. A thorough examination using tools to visualize the stomach and esophagus is necessary to provide an accurate diagnosis.