Hiatus hernia, also called hiatal hernia, occurs when part of the stomach pushes into the chest cavity. The condition may happen because of weakening tissue in the stomach area and it is common in people older than age 50, MedlinePlus explains. Risk factors also include obesity and smoking. People born with a large hiatus, the opening to the diaphragm between the chest and abdomen, may experience a hiatus hernia. The condition can also occur from an injury to the area.
Condition Types
Most cases of hiatus hernia occur when a portion of the stomach slides into the chest through the hiatus. Medication to reduce stomach acidity and avoiding heavy meals often help treat the condition. Doctors advise patients to reduce weight if necessary and not smoke, MedlinePlus says.
A less common type of hiatus hernia, called paraesophageal hernia, occurs when part of the stomach squeezes through the opening of the diaphragm and moves next to the esophagus. The stomach may become strangled and lead to the cutting off of blood supply. Nausea, vomiting and gas problems may indicate a strangulated hernia, especially if a hiatus hernia has been diagnosed, the Cleveland Clinic points out. Symptoms may also include pressure in the lower chest after eating or heart palpitations. Sometimes no symptoms occur. The condition requires immediate medical attention and usually requires surgery to return the herniated stomach to the abdomen.
Acid Reflux
A hiatus hernia may contribute to acid reflux and heartburn because the weakening of stomach tissue may weaken the lower esophageal sphincter, a muscle valve in the esophagus. The valve opens when food enters the stomach and closes to prevent stomach acid backup. A weakened sphincter allows more acid reflux, resulting in the burning sensation of the chest and sour taste in the back of the mouth known as heartburn. Pressure on the abdomen from a hiatus hernia promotes acid reflux symptoms. People with frequent heartburn may have gastroesophageal reflux disease, or GERD. A hiatus hernia may be linked to GERD, but each condition does not necessarily cause the other, the Cleveland Clinic notes.
Chest and Throat Pain
Pain and discomfort may result because of the increased gastric acid, air or bile, MedlinePlus explains. Problems with keeping stomach contents down result in swallowing difficulty because of esophageal spasms or chronic inflammation. Feelings of food being stuck in the throat may occur. Some patients experience chest pain or heaviness in the upper or lower chest because of pressure or from swallowing difficulties. The chest pain may feel like the symptoms of a heart attack. Patients need a proper diagnosis from a doctor for treatment of a hiatus hernia.
