What are hiatal hernia symptoms?
If you only have a sliding hiatal hernia, which is what most people have, you probably won’t feel the hernia itself. Unlike other kinds of hernias, you probably won’t see the bulge from the outside, either.
Many people never have symptoms of hiatal hernias. But among those who do, the most common symptoms are related to chronic acid reflux (gastroesophageal reflux disease, or GERD). These include:
- Heartburn. A burning sensation in your chest, especially after eating.
- Noncardiac chest pain. Recurring chest pain that feels like angina, but isn’t.
- Indigestion. Feeling full soon after eating, with a burning type of abdominal pain.
- Burping and regurgitation. Food, gas and acid rising back into your throat.
- Difficulty swallowing or a lump in your throat when you swallow.
- Sore throat and hoarseness when you speak, due to irritation from the acid.
Not everyone with a hiatal hernia has acid reflux, and not everyone with acid reflux has a hiatal hernia. But if you’ve recently begun to notice these symptoms more often, they might be related.
Other possible warning signs of a hiatal hernia might include:
- Nausea, due to compression of your stomach or acid overflow, or both.
- Shortness of breath, if your hernia is compressing your lungs.
- Pressure or pain in your upper abdomen or your lower chest.
These symptoms are more likely with larger paraesophageal hernias.
What is hiatal hernia pain like?
Your hiatal hernia is located at the junction between your abdomen and your chest. If you feel pain from the hernia itself, it might feel like chest pain or abdominal pain. You might feel a hiatal hernia if it gets compressed or pinched during certain activities or positions. For example, bending over, coughing or lifting something heavy might affect a larger hiatal hernia. Pain might be a sign that it’s getting worse.
Most of the time, pain from a hiatal hernia is related to acid reflux rather than the hernia itself. Acid irritates your esophagus, which runs through your chest up to your throat. You may feel it higher or lower, or the pain may radiate throughout your chest. It may burn. For some people, it may even feel like a heart attack. If you’re in doubt, it’s always best to have chest pain checked out by a healthcare provider.
How does a hiatal hernia cause acid reflux?
When the gastroesophageal junction — the place where your esophagus meets your stomach — rises above your diaphragm, it pulls some of the muscles that would normally contract to prevent acid reflux. When these muscles can’t tighten enough to close your esophagus effectively, stomach acid can wash back into it. The hernia also traps a pocket of acid at the top of your stomach that can’t clear away.
What causes a hiatal hernia?
A hernia becomes possible when there’s a weak spot in the tissues that separate your different body compartments. That weak spot creates an opening for a hernia to come through. A hiatal hernia, in particular, comes through an opening that already exists: the esophageal hiatus, where your esophagus passes through your diaphragm. This opening only has to widen a little to make a hiatal hernia possible.
Sometimes a specific injury, surgery or even a birth defect causes the original weakness that creates a hernia. But more often, it’s cumulative damage from years of daily stress and strain. Anything that produces extra pressure in your abdominal cavity can wear on your diaphragm over time. Some of the most common forces that create abdominal pressure and contribute to hiatal hernias include:
- Chronic coughing or sneezing.
- Chronic straining to poop (constipation).
- Chronic obesity (BMI, or body mass index, greater than 30).
- Frequent vomiting.
- Intense exercise or heavy lifting.
- Pregnancy and childbirth.
Advertisem*nt
How serious is a hiatal hernia?
Most aren’t serious. Most don’t even cause symptoms. You may never know that you have one. But a larger hernia could eventually become serious. You’d probably have symptoms if you had a larger one.
What are the possible complications of a hiatal hernia?
The most common problem that hiatal hernias cause is chronic acid reflux. Chronic acid reflux can do damage to your esophagus over time, if it’s severe and medications don’t manage it well enough.
Complications of chronic acid reflux can include:
- Esophagitis: Acid in your esophagus causes inflammation of your esophagus lining. Chronic inflammation can cause pain, swallowing problems, ulcers and even bleeding.
- Esophageal stricture. Chronic inflammation can cause scarring of your esophagus tissues. Scar tissue can interfere with your swallowing muscles and cause your esophagus to narrow.
- Barrett’s esophagus. Chronic inflammation can also eventually lead to tissue changes called Barrett’s esophagus. This condition isn’t harmful by itself, but it’s considered precancerous.
More rarely, a hiatal hernia may cause complications if it gets stuck or compressed in the hiatus. This usually only happens with the less common types of hiatal hernias. Complications could include:
- Gastrointestinal obstruction. Your stomach or another organ could get stuck and compressed or twisted in the hiatus, creating a blockage in your gastrointestinal tract.
- Gastritis. Trapped acid in the herniated part of your stomach could cause inflammation, stomach ulcers and bleeding inside.
- Ischemia. Your hernia could become so tightly compressed that it cuts off its own blood supply. This leads to inflammation and pain in the organ and, eventually, tissue death.
