Hiatal Hernia Causes And Symptoms
A hernia occurs when tissue from the abdomen is exhibited through an orifice of the abdominal muscle wall. When the herniation forms inside the thoracic cavity it is called hiatal hernia. There are three types of hiatal hernia: sliding hernia, paraesophageal hernia and mixed type. Sliding hiatal hernia is the most common and usually it is not serious condition. Paraesophageal Hernia and the mixt type hernia may develop complications making them more severe conditions.
Hiatal Hernia Causes
The limit between the abdomen and thorax is formed by a thin muscle called the diaphragm. The passage of the esophagus (a muscular tube that connects the throat and stomach) through the diaphragm is made through a hole called the hiatus. Hiatal hernia occurs when muscle tissue from the hiatus weakens. In case of sliding hernia, a small portion of the stomach slides into the chest through the diaphragm and is positioned above the abdomen in the thorax. The esophageal sphincter, which separates the esophagus from the stomach, is also positioned above the diaphragm.
Hiatal Hernia Symptoms
Usually in case of sliding hernia there are no symptoms present. If they do appear, they are caused by acid reflux (ie, gastric reflux from the stomach into the esophagus) due to the loosened esophageal sphincter. Gastro-oesophageal reflux symptoms include:
- Heartburn, accompanied by heat and pain. Occurs after eating, lying down or bending forward. In medical terms it is called heartburn.
- Sour or salty taste in mouth. Is also due to reflux of stomach acid into the esophagus. Usually this symptoms accompanies heartburn, but can sometimes be the one and only symptom.
- Upper abdominal fullness after meals
- Difficulties in food ingestion (dysphagia) and the feeling of a “lump” in throat
- Hoarse voice.
If symptoms are severe or continue for a long period of time, they may be gastroesophageal reflux disease (GERD), food and gastric reflux into the esophagus, with an increased duration and frequency than for heartburn. Hiatal hernia and GERD, are diseases that usually occur together but it is not a rule.
Treatment of GERD may require medication rigorously followed or in some severe cases surgical treatment. In case of shortness of breath or chest pain the possibility of heart disease should be taken into account. Heartburn usually occurs after meals when stomach contents reflux. Heart pain is usually felt as a pressure sensation, stinging, tightness, or generalized discomfort in the chest, which usually occurs after the patient exercises. Large sliding hernias can cause gastric ulcers, gastric mucosal erosions which are located in the hiatus. These ulcers are diagnosed using endoscopy in up to 5% of patients with hiatal hernia.