A sliding hiatal hernia is a type of hernia that can either be classified as sliding or esophageal. In sliding hiatal hernias, the gastroesophageal junction—where the esophagus meets the stomach—and part of the stomach itself push into the chest area. This junction might stay in the chest permanently, but it often moves into the chest only when swallowing. This happens because, during swallowing, the esophageal muscles contract, causing the esophagus to shorten and pull the stomach upward. Once swallowing is complete, the herniated portion of the stomach typically returns to the abdomen.In contrast, para-esophageal hernias occur when the gastroesophageal junction remains in its normal position, but a part of the stomach moves or bulges into the chest next to the esophagus. These para-esophageal hernias remain in the chest all the time and are not influenced by swallowing. A large para-esophageal hiatal hernia, especially if it presses on the esophagus, can hinder the movement of food into the stomach, causing food to become stuck in the esophagus after swallowing. Additionally, ulcers may develop in the herniated stomach due to trapped food or stomach acid. Fortunately, such large para-esophageal hernias are rare.
