Symptoms of a Hiatal Hernia

Common and Surpising Symptoms of a Hiatal Hernia

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What are the symptoms of a hiatal hernia?. PhotoAlto/Alix Minde/PhotoAlto Agency RF Collections/Getty Images

What are the symptoms of a hiatal hernia? Do people always have symptoms?

What is a Hiatal Hernia?

A hiatal hernia occurs when the upper portion pushes through the opening in the diaphragm which normally acts as a valve an into the esophagus. There are two primary types of hiatal hernias, though both enable acid in the stomach to enter the esophagus and damage these sensitive tissues.

Symptoms of a Hiatal Hernia

People do not always have symptoms if they have a hiatal hernia.

In fact, around 50 people percent of people do not have any symptoms. If no symptoms are present, the diagnosis of hiatal hernia may be made based on imaging studies or endoscopy.

For those people who have symptoms, some of the symptoms are common and easily point to a hiatal hernia (such as heartburn), whereas others, though common, are often mistaken as being due to something else. An example is a persistent cough. In one study looking at non-smokers with a chronic cough, 41 percent had a cough due to gastroesophageal reflux disease (GERD).

Heartburn is the Most Common Symptom

While heartburn is the most common symptom of a hiatal hernia, it's easy to become confused wondering exactly what heartburn is. How is it described? Below is a list of "symptoms" which describe the sensation of heartburn:

  • A burning sensation in the chest - The burning sensation associated with a hiatal hernia usually starts behind the breastbone (the sternum), and may travel up to the throat. It usually occurs shortly after eating, and can last from a few minutes to several hours. It may be worse when bending over or lying down shortly after eating.
  • A burning feeling in the throat - There can be several causes of a burning throat, such as a sore throat or inflammation of the adenoids. A more common cause of this burning sensation is gastroesophageal reflux disease (GERD). There can also be a sour, salty, or acidic taste in the mouth. This is a sensation of burning, usually high up in the neck though it can occur lower. The pain may worsen with swallowing. This burning sensation can result from irritation when stomach contents reflux up into the throat.
  • Sour or bitter taste in the mouth - This sour or bitter taste can occur when stomach contents reflux up into the esophagus and may reach the back of the throat. When the contents enter the back of the throat, a person will often have a sour or bitter taste in their mouth.
  • Difficulty swallowing - Trouble with swallowing (dysphagia) occurs when food does not pass normally from the mouth through the esophagus to the stomach. There may be a sensation of food sticking in the throat, chest pressure or "burning" after eating, or a feeling of choking. A sensation of difficulty swallowing should always be evaluated by a physician. In addition to hiatal hernias, dysphagia can also be a sign of conditions such as erosive esophagitis and esophageal cancer.
  • Chronic coughing - As noted above, GERD is a significant cause of a chronic cough (especially in people who do not smoke) accounting for nearly half of chronic coughs in one study. When stomach acid backs up (refluxes) into the esophagus and is aspirated, it can cause coughing. (Learn more about the relationship between GERD and chronic coughing.)
  • Wheezing or other asthma like symptoms - Several studies suggest a significant link between GERD and asthma. The results of these studies show that up to 60 percent of people with asthma also have GERD compared with 10 percent of the general population. GERD can affect asthma when stomach acid reflux into the esophagus and is aspirated into the airways and lungs, and can make breathing difficult and cause the patient to wheeze and cough.

Other Symptoms of Hiatal Hernias

There are many other symptoms that may be associated with a hiatal hernia. Many of these overlap with the symptoms of heartburn noted above and includes:

  • Regurgitation (backflow of stomach contents into the back of the throat) - This is the sensation of food returning to your mouth such as what often happens just before vomiting
  • Vomiting
  • Bad breath
  • Frequent belching (burping)
  • Frequent hiccups
  • Chest pain radiating from below the breastbone (the sternum)
  • Feeling of pressure in the chest
  • A bloated feeling after eating
  • Abdominal discomfort
  • Abdominal pressure, especially soon after eating
  • Discomfort or pain in the stomach
  • Gas

Treating Hiatal Hernias

The treatment of hiatal hernias depends both on symptoms and the type of hernia. With a paraesophageal hiatal hernia, surgery may be required to prevent complications.

With other hiatal hernias, especially if small, treatment may encompass a combination of dietary measures as well as medications. Learn more about the treatment options for hiatal hernias.

Sources:

U.S. National Library of Medicine. Hiatal Hernia. Updated 04/20/15. https://medlineplus.gov/ency/article/001137.htm

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