Which anatomical abnormality involves a portion of the stomach protruding upward into the chest through an opening in the diaphragm?

• A. Esophageal varices
• B. Hiatal hernia
• C. Anorexia
• D. Bulimia

Answer: (B)

Hiatal hernia is when part of the stomach pushes upward through the diaphragm, specifically through the esophageal hiatus, into the chest cavity. The diaphragm has an opening for the esophagus, and when part of the stomach slips through, that upward protrusion occurs. There are two main forms: sliding, where the gastroesophageal junction itself moves above the diaphragm, and paraesophageal, where part of the stomach herniates alongside the esophagus while the junction stays below. This condition often presents with reflux-like symptoms such as heartburn and regurgitation, especially after meals. Diagnosis is typically with imaging like a barium swallow X-ray or endoscopy. Treatment ranges from lifestyle adjustments and acid-suppressing medications to surgical repair in more severe cases. This is distinct from esophageal varices, which are enlarged veins not related to a herniation, and from eating disorders like anorexia or bulimia, which are behavioral conditions rather than anatomical abnormalities.