The exact cause of hiatal hernias is unknown. The condition may be due to weakness of the supporting tissue. Your risk for the problem goes up with age, obesity, and smoking. Hiatal hernias are very common. This occurs when the stomach protrudes upwards through the hiatus of the diaphragm. Most common symptoms are belching, acid reflux, hearburn, abdominal pain, difficulty swallowing, fullness, and vomiting. Avoid large or heavy meals. Limit foods that are acidic, such as citrus fruits and foods with caffeine or alcohol. Do not lay down or bend over after eating a meal. Reduce weight and do not smoke.