Table of ContentsView AllTable of ContentsSymptomsComplicationsWhen to WorryFrequently Asked QuestionsNext in Hiatal Hernia GuideHiatal Hernia Causes and Risk Factors
Table of ContentsView All
View All
Table of Contents
Symptoms
Complications
When to Worry
Frequently Asked Questions
Next in Hiatal Hernia Guide
For most people, a smallhiatal hernia, also known as a stomachhernia, will not cause symptoms.With larger hernias, however, symptoms may include heartburn, belching, a weird taste in your mouth, or regurgitation. Typically, these are not serious, but in some cases, they can cause potentially life-threatening complications.
This article explains symptoms of a large hiatal hernia as well as rare complications and when to seek medical care.
When to Seek Emergency Care
You should seek immediate medical care if:
These may be the signs of a severe and potentially life-threatening hernial complication.
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Unusual or Worsening Hiatal Hernia Symptoms
Typically, a small hiatal hernia may not cause any symptoms. However, a larger hiatal hernia can change the structures and mechanisms that keep food and acids where they belong.
This can lead to symptoms such as:
When a hiatal hernia occurs, it can change the position of a muscular valve called the loweresophageal sphincter(LES). This allows the contents of the stomach to back-flow into theesophagus(known asreflux), which can lead to symptoms.
Generally speaking, problems only occur when a hernia becomes enlarged. If the LES weakens, which can happen with age or during pregnancy, symptoms will get progressively worse.
If you have a hiatal hernia, avoid food that is fatty, oily, highly acidic, or processed. Also avoid citrus fruits such as oranges or limes, which can cause irritation.
People with a hiatal hernia are more likely to developgastroesophageal reflux disease (GERD), a long-term form of reflux that can interfere with your quality of life.The persistence ofGERD symptomscan lead to a chronic cough, chest pain,asthma, and progressive damage to your tooth enamel.
People with a hiatal hernia are more likely to developgastroesophageal reflux disease (GERD), a long-term form of reflux that can interfere with your quality of life.
The persistence ofGERD symptomscan lead to a chronic cough, chest pain,asthma, and progressive damage to your tooth enamel.
How Is GERD Diagnosed
Complications from Hiatal Hernia Symptoms
Broadly speaking, there are two types of hiatal hernia: a sliding hiatal hernia and aparaesophagealhernia. While a sliding hernia is the most common, accounting for around 95% of all diagnoses, a paraesophageal hernia is potentially more serious and related to complications.
To understand the problems that could potentially develop with a hernia, it helps to have an idea of what a hernia is:
Complications may include:
How to Prevent Hernia Formation and Recurrence
Esophageal Compression
Compression of the esophagus can occur as the hernia presses against the esophageal wall. When this happens, food can get stuck in the esophagus, causingchest painafter eating anddifficulty swallowing(dysphagia).
While esophageal compression is not considered a medical emergency, it may require medications to or even surgery to alleviate or prevent worsening symptoms.
Understanding Perineal Hernia
Incarcerated Hiatal Hernia
Incarceration occurs when the herniated portion of the stomach becomes trapped in the hiatus. In some cases, the symptoms of incarceration may be long-term but minimal (mostly a sensation ofchest pressureas food passes through the upper digestive tract). But, it can cause obstruction or impede blood circulation.
Incarceration itself is not a medical emergency unless there’s a severe obstruction or if it results in ischemia (affects blood flow to that part of the stomach).
Volvulus
Volvulusis when a herniated stomach twists more than 180 degrees, causing a severe gastric obstruction. While it can occur with hiatal hernia, it can also occur without it and is very uncommon.
Symptoms may include:
If this problem progresses, it can cause upper abdominal pain and distention, vomiting leading to nonproductive retching, and gastric bleeding (due to the abnormally increased blood pressure).
Acute symptomatic volvulus generally occurs in people over age 50 and is considered a medical emergency with a 30% to 50% risk of mortality.
Strangulation
Strangulation is a cut-off of the blood supply to the stomach, either due to volvulus or incarceration. Symptoms include:
Strangulation is considered a medical emergency as the blockage can result in rapid organ damage.If not treated immediately, strangulation can lead togangrene, shock, and death.
Intrathoracic Stomach
An intrathoracic stomach is a rare condition in which the stomach slips entirely into the chest cavity. Not all cases cause symptoms, but the most common signs aredyspnea(shortness of breath) and a feeling of chest fullness and pressure.
Other symptoms can include:
The enlarged hiatal gap can cause other organs to slip into the chest cavity, including the pancreas, liver, or colon. Surgery is the only means to correct this rare but serious complication.
Coping With a Hiatal Hernia
Hiatal Hernia Pain: When to Worry
Hiatal hernias generally do not need to be medically managed unless the symptoms are getting worse or are persistent. You should see your healthcare provider if your hiatal hernia symptoms don’t improve despite conservative management.
The vast majority of hiatal hernia symptoms can be easily managed with over-the-counter medications, weight loss, and an adjustment to your diet.In some cases, you may need to adjust your prescription drugs.
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Summary
A hiatal or stomach hernia is a common problem, especially for adults over 50. Common symptoms include heartburn, reflux, chest pain, irritation in the throat, belching, and regurgitation.
If a hernia becomes enlarged and slips into the chest cavity, you may experience serious health complications that require immediate medical attention. If you have a high fever, severe chest pain, a rapid heart rate, bloody stool, or dry heaves, go to an emergency room for treatment.
Frequently Asked QuestionsHiatal hernias may occur if the diaphragm muscle has been weakened. This can happen because of trauma and certain conditions; however, some individuals may also be born with a hiatal hernia.Learn MoreCongenital Diaphragmatic (Bochdalek) HerniaYou may experience complications if symptoms worsen or develop and you don’t seek treatment. In some cases, an untreated hiatal hernia can lead to a medical emergency.Learn MoreHow a Hiatal Hernia Is TreatedA hiatal hernia may cause chest and abdominal discomfort. That said, up to 90% of people with a hiatal hernia won’t experience symptoms. Emergency treatment is rarely needed.Learn MoreFacts About Hiatal Hernia
Hiatal hernias may occur if the diaphragm muscle has been weakened. This can happen because of trauma and certain conditions; however, some individuals may also be born with a hiatal hernia.Learn MoreCongenital Diaphragmatic (Bochdalek) Hernia
Hiatal hernias may occur if the diaphragm muscle has been weakened. This can happen because of trauma and certain conditions; however, some individuals may also be born with a hiatal hernia.
Learn MoreCongenital Diaphragmatic (Bochdalek) Hernia
You may experience complications if symptoms worsen or develop and you don’t seek treatment. In some cases, an untreated hiatal hernia can lead to a medical emergency.Learn MoreHow a Hiatal Hernia Is Treated
You may experience complications if symptoms worsen or develop and you don’t seek treatment. In some cases, an untreated hiatal hernia can lead to a medical emergency.
Learn MoreHow a Hiatal Hernia Is Treated
A hiatal hernia may cause chest and abdominal discomfort. That said, up to 90% of people with a hiatal hernia won’t experience symptoms. Emergency treatment is rarely needed.Learn MoreFacts About Hiatal Hernia
A hiatal hernia may cause chest and abdominal discomfort. That said, up to 90% of people with a hiatal hernia won’t experience symptoms. Emergency treatment is rarely needed.
Learn MoreFacts About Hiatal Hernia
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Polomsky, M.; Jones, C.; Sepesi, B. et al. “Should elective repair of intrathoracic stomach be encouraged?“J Gastroint Surg Off J Soc Surg Aliment Tract.2010; 14(2):203-10. doi: 10.1007/s11605-009-1106.Roman, S. “The diagnosis and management of hiatus hernia.“BMJ.2014; 349:g6154. doi: 10.1136/bmj.g6154.Shukla, R.; Mandal, K.; Maltra, S. et al. “Gastric volvulus with partial and complete gastric necrosis.“J Indian Assoc Pediatr Surg. 2014; 19(1):49-51. doi: 10.4103/0971-9261.125968.Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).Guidelines for the Management of Hiatal Herni.
Polomsky, M.; Jones, C.; Sepesi, B. et al. “Should elective repair of intrathoracic stomach be encouraged?“J Gastroint Surg Off J Soc Surg Aliment Tract.2010; 14(2):203-10. doi: 10.1007/s11605-009-1106.
Roman, S. “The diagnosis and management of hiatus hernia.“BMJ.2014; 349:g6154. doi: 10.1136/bmj.g6154.
Shukla, R.; Mandal, K.; Maltra, S. et al. “Gastric volvulus with partial and complete gastric necrosis.“J Indian Assoc Pediatr Surg. 2014; 19(1):49-51. doi: 10.4103/0971-9261.125968.
Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).Guidelines for the Management of Hiatal Herni.
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