Symptoms Of A Hiatal Hernia

Heartburn And Acid Reflux

There are four type classifications of hiatal hernias. Type I, a sliding hiatal hernia, is the most common. It accounts for approximately ninety-five percent of all hiatal hernias. Type II, also known as a paraesophageal hiatal hernia, accounts for five percent of all cases, but causes most of the complications. In this type of hiatal hernia, the herniated portion of the stomach can torsion, cutting off its blood supply. This may lead to a serious infection if left untreated. A paraesophageal hiatal hernia is associated with heartburn and acid reflux as the dominant symptoms. These symptoms are greatest immediately after a meal or at night when one lays flat. With a pH probe study, these hiatal hernias will have a higher than normal acid content which accounts for the symptoms. Medications known as proton-pump inhibitors are often utilized to reduce stomach acid and symptoms of reflux. However, with the risks involved in a paraesophageal hiatal hernia, this type is most likely to require surgical correction.

Pain In The Chest Or Abdomen

The structures involved in a hiatal hernia are all extensively innervated, have a good nerve supply, giving the potential for any one or more of them to generate pain. While heartburn is a type of discomfort, the pain in the chest or abdomen from a hiatal hernia is more likely to be severe or intense. The pain is typically located behind the sternum or breast bone. Its location, as well as the burning or heavy pain, may cause concern regarding a cardiac component to the pain. One distinguishing characteristic is that the pain itself increases after eating, or postprandially, and when lying down. Cardiac pain does not typically change in intensity or character based upon any change in activity or function.