When the junction and part of the stomach is located above the diaphragm it is called a hiatal hernia. The condition is common in patients with gastroesophageal reflux disease. Patients with a hiatal hernia have a weak muscle at the gastroesophageal junction, making the gastroesophageal reflux worse. Severe chest pain after eating. 2  This is often the case when there is a large hiatal hernia with all or most of the stomach located above the diaphragm. 3  This symptom suggests that the stomach is twisting. 4  Twisting causes the blood flow to the stomach to be too low.