Hiatal Hernia (cont.)
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
Hiatal Hernia Symptoms
For most people, a hiatal hernia by itself causes no symptoms.
- Chest pain or pressure
- Difficulty swallowing
- Pain: At times, a hiatal hernia causes chest pain or upper abdominal pain when the stomach becomes trapped above the diaphragm through the narrow esophageal hiatus.
- Other causes: Rarely, with a fixed hiatal hernia, the blood supply is cut off to the trapped portion of the stomach, causing great pain and serious illness. This is called a strangulated hiatal hernia, and it is a true medical emergency.
- Hiatal hernia also causes symptoms of discomfort when it is associated with a condition called gastroesophageal reflux disease, commonly called GERD. This condition is characterized by
upwelling of stomach acids and digestive enzymes into the esophagus through a
weakened sphincter that is supposed to act as a one-way valve between the
esophagus and stomach. Hiatal hernia is thought to contribute to the weakening
of this sphincter muscle.
- Although it is true that hiatal hernia or GERD can cause chest pain similar to angina (or heart
pain) including chest pressure that can radiate to the arm or neck, do not assume that such pain is caused by the less serious condition of the two. When in doubt, it is safer to be seen by a doctor immediately in order to rule out more serious problems first.
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