What causes a hiatal hernia?

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A hiatal hernia occurs when weakened muscle tissue allows your stomach to bulge up through your diaphragm. It's not always clear why this happens. But a hiatal hernia might be caused by:

  • Age-related changes in your diaphragm
  • Injury to the area, for example, after trauma or certain types of surgery
  • Being born with an unusually large hiatus
  • Persistent and intense pressure on the surrounding muscles, such as while coughing, vomiting, straining during a bowel movement, exercising or lifting heavy objects
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