Esophageal hiatal hernia is a condition in which part of the gastric sac projects into the thoracic cavity through a loose diaphragmatic esophageal hiatus. It can be divided into three types: (1) sliding type; (2) paraesophageal type; (3) mixed type. Among the three types, the sliding type is the most common. The main causes are: (1) widening of the esophageal foramen; (2) increased intra-abdominal pressure. The widening of the esophageal fissure can be congenital, but is more often caused by ageing, atrophy of the elastic tissue of the diaphragmatic esophagus membrane, and relaxation of the left and right diaphragmatic feet. There are many causes of increased abdominal pressure, such as pregnancy, obesity, massive ascites, huge intra-abdominal tumors, chronic constipation and violent coughing, which can induce hiatal hernia. Clinical symptoms: 1. Burning pain or hidden pain or distension or tight pressure sensation in the retrosternal or epigastric region, with a wide spread of pain, occurring 30-60 minutes after meals, induced by squatting and bending and lying down, also with precordial pain or full chest pain, and a few may present with acute abdominal manifestations. When a paraoesophageal hernia becomes embedded, sudden and severe epigastric pain occurs, accompanied by vomiting and difficulty in swallowing. 2. Reflux symptoms: belching, acid reflux, heartburn, eructation, vomiting, etc. 3, obstruction symptoms: when part of the stomach herniated into the chest cavity or esophagitis narrowing or spasm of the esophagus, there is obstructive choking, dysphagia or food stagnation in the back of the sternum when eating, initially intermittent, but can become persistent after a long time. 4, asthma symptoms: some asthma patients combined with esophageal hiatal hernia, asthma also relieved after treatment of hiatal hernia. The reason is that hiatal hernia can cause gastroesophageal reflux, and the reflux of gastric contents into the respiratory tract can cause asthma-like attacks. Auxiliary examinations: 1. Barium X-ray examination shows that part of the gastric cavity is located on the diaphragm. 2. Endoscopic examination shows that the dentate line is shifted upward, the esophagus is shortened, and the gastric mucosa can be seen with less than 40 cm insertion. Treatment: 1. avoid elevated abdominal pressure; 2. diet regulation; 3. prohibit or cautiously use drugs that can reduce the tone of the lower esophageal sphincter; 4. improve the tone of the lower esophageal sphincter to promote esophageal and gastric emptying; 5. neutralize or inhibit gastric acid; 6. promote tissue repair and protect the mucosa; 7. surgical treatment: fundoplication.