Symptoms of Hiatal Hernia

surgeonThe trunk of the body is divided into chest and the belly by the diaphragm.  Under normal circumstances the stomach and its parts are situated in the belly or the abdomen below the diaphragm. The esophagus passes through the diaphragm through a hole called the hiatus. Depending on many factors this hiatus may increase in size.  This allows the upper part of the stomach to pass upward into the chest cavity. The portion of stomach which lies above the hiatus is known as hiatal hernia.

The causes of the hiatal hernia are multiple and unique. The mechanical causes are:  improper lifting of weight, sharp blows to the abdomen, severe bouts of cough, wearing tight clothes and incorrect posture and decubitus are some of them.  One should breathe out while trying to lift some heavy weight. If one does not breath out, the increased intra-abdominal pressure forces a part of the stomach into the chest cavity.  This displacement of the stomach does not allow the lower esophageal sphincter (LES) to function properly as the diaphragmatic support is lost and the acid stomach content to flow back into the esophagus, resulting in pain, heartburn and acidity.

Types of hiatal hernia:

  • The commonest type of hiatal hernia is the sliding or reducing type of hiatal hernia. In this the herniated part of the stomach slides back and forth or in and out from the abdomen into the chest cavity. Theses hernias are usually small and asymptomatic.
  • Fixed hiatal hernias are more symptomatic, and a bigger part of the stomach goes up into chest cavity.  In this type the potential danger is a little more but usually the symptoms are less.

In case of complicated hiatal hernias a big part or the whole stomach goes into the chest cavity causing a lot of problems, this causes severe symptoms and a surgical repair is required. Hiatal hernia symptoms are chest pain and dysphagia and it increases with lying down and leaning forward.

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