A hiatal hernia is a medical condition in which the stomach pushes upward through the diaphragm, often protruding through the diaphragm. While it can be asymptomatic, in some cases, it can cause irritating symptoms. And, if chronic irritation of the esophagus continues, it can, even, put you at risk for developing esophageal cancer.
Heartburn
When the stomach contents are under increased pressure from the hernia, they can reflux into the esophagus, causing a variety of symptoms. One of them is heartburn, which is caused by reflux of the stomach acid into the esophagus. This is a burning, painful sensation, usually located right behind the breastbone, and can often radiate to the neck or jaw. The heartburn can cause a chronic cough and can mimic asthma, notes Dr. Fred Ferri in "Ferri's Clinical Advisor 2010." Often, if the hernia is undiagnosed, chest pain can be mistakenly diagnosed as having origins in the heart.
Dysphagia
Dysphagia, or trouble with the act of swallowing, is also a possibility with a hiatal hernia. Dysphagia can be caused by the development of scar tissue, or strictures, in the esophagus. This is also one of the consequences of acid refluxing into the esophagus, as it can damage the esophagus lining. As a result of the damage and subsequent healing, scar tissue develops, which narrows the esophagus and makes passage of food and liquids more difficult.
Bleeding
A hiatal hernia is a condition that predisposes the patient to reflux of stomach acid into the esophagus. The acid can then damage the lining of the esophagus, which typically manifests with a cough that expectorates blood or vomit that is stained with bright red blood. However, bleeding is usually not clinically significant. A diagnosis is usually made with the insertion of an endoscope.
Hoarseness
As a hiatal hernia increases the risk of acid reflux, acid irritation of the vocal cords is a possibility. As a result, quality of voice is compromised and hoarseness can develop, explains Townsend in the "Sabiston Textbook of Surgery."
Regurgitation
The presence of regurgitation is an indicator that the hiatal hernia has advanced past its initial stages, states Townsend. Often, patients are unable to bend over without experiencing regurgitation, which warrants further evaluation. Also, air is regurgitated from the stomach into the esophagus, which results in chronic belching.
References
- "Sabiston Textbook of Surgery, 18th Edition"; Townsend; 2007
- "Ferri's Clinical Advisor 2010, 1st Edition"; Ferri; 2009
- "Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 8th Edition"; Feldman; 2006
