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Heartburn or acid reflux Chest pain or discomfort Difficulty swallowing Regurgitation of food or liquids Shortness of breath Bloating or burping after meals Several factors may contribute to the development: Age-related weakening of the diaphragm Chronic coughing or straining during bowel movements Injury or trauma to the abdominal area Increased pressure in the abdomen (due to obesity, pregnancy, or heavy lifting) Sliding Hiatal Hernia Most common type, where the stomach and esophagus slide in and out of the chest through the hiatus