A hiatal hernia, also often referred to as a hiatus hernia, is a hernia of the upper gastrointestinal region. It's caused when an upper portion of the stomach tears through a portion of the diaphragm and breaks into the thorax. A hiatal hernia can promote discomfort in individuals and may also pose significant health risks.
A hiatal hernia involves a tear in the lining of the diaphragm, the tissue that physically separates the abdomen and thorax. The stomach can then move up into the diaphragm along with the lower esophageal sphincter. Normally, the sphincter keeps the stomach's digestive acids from traveling back up the digestive tract. With a hernia, the acid may surge upward and cause gastroesophageal reflux (GER) and gastroesophageal reflux disease (GERD). Common symptoms of GERD and GER include a burning sensation in the chest, as well as a sour flavor in the back of the mouth. This is the most common sign or symptom of a hiatal hernia, though the hernia itself typically goes undiagnosed unless individuals have severe GER or GERD that requires a closer examination.
The movement of internal organs due to the weakening of muscle tissue caused by the hiatal hernia can create physical chest pain. The pain is typically a dull ache in the chest. However, some sufferers of a hiatal hernia may experience a sharper pang in the chest.
Nausea and Appetite
As the hiatal hernia grows, more of the stomach organ can move upwards in the chest. This can cause health symptoms related specifically to the stomach. Some individuals may experience varying levels of nausea. Other individuals may notice changes in their appetites, including an increased appetite or a reduced sensation of hunger. In cases of extremely large hernias, individuals may find it difficult or painful to swallow food.
Due to the hernia pushing into the diaphragm, an uncommon but not unheard of symptom is a difficulty breathing. This can feel like a tightness in the chest akin to the sensation caused by asthma. Unlike asthma, individuals who take steroid medications for asthma will likely not notice a significant reduction in breathing problems because the hernia will not react to the steroids.
Typically, a hiatal hernia is treated for its symptoms rather than the actual hernia. Small to mild hernias are usually symptom-free and are not noticed by the individual. If there are symptoms, physicians will often prescribe medications for these symptoms to ease the pain and discomfort of the patient. Only in severe cases will individuals be operated upon to remove the actual hernia. Common medications prescribed to cure symptoms include over-the-counter non-prescription antacids such as Tums, or prescription medications such as proton pump inhibitors to treat GERD caused by a hernia.