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Abstract
The majority of hiatus hernias are acquired lesions and are observed in patients of middle age. The symptoms are attributable to the anatomic derangement of the thoracic stomach and the terminal esophagus. Care must be taken to distinguish between complications and symptoms. Therapy, to be successful, must correct the defect by reducing the stomach below the diaphragm. Medical therapy is palliative only; it is indicated when there is relief of symptoms and when there are no complications present.