The esophagus connects to the stomach at an opening in the diaphragm
called the hiatus. The lower esophageal sphincter (LES), which is normally at
the same level as the diaphragm, keeps stomach contents (food, acid, and other
digestive juices) from backing up (or refluxing) into the esophagus.
But when a sliding hiatal hernia is present, part of the stomach moves up
through the hiatus and into the chest cavity. This pushes the lower esophageal
sphincter (LES) up into the chest cavity away from the hiatus. Away from the
hiatus, the LES loses the support that it needs from the diaphragm to stay
closed. This raises the risk for symptoms of heartburn and gastroesophageal
ByHealthwise Staff Primary Medical ReviewerAdam Husney, MD - Family Medicine Specialist Medical ReviewerPeter J. Kahrilas, MD - Gastroenterology
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