A hiatal hernia is a condition in which part of the stomach passes upward through an abnormally large opening--a hiatus--in the diaphragm, which is the drum-like muscle that separates the chest from the abdomen. It is the primary muscle involved in the process of breathing in and out, also known as respiration. There are two main types of hernias, which are each associated with certain symptoms in infants.
Types of Hiatal Hernias
There are two main types of hiatal hernias, each associated with certain symptoms. The paraesophageal hiatal hernias are hernias in which part of the stomach protrudes abnormally into the chest cavity; however, the gastroesophageal junction, which is the point at which the stomach joins the esophagus, stays in the correct place. According to "Current Diagnosis and Treatment: Pediatrics," paraesophageal hernias are rare in infancy and childhood. Sliding hiatal hernias are those in which part of the stomach enters the chest cavity along with the gastroesophageal junction. This type of hernia is more common.
Gastroesophageal Reflux Disease Symptoms
The textbook "Current Diagnosis and Treatment: Pediatrics" suggests that infants with a sliding hiatal hernia may experience symptoms of gastroesophageal reflux disease, or GERD. In GERD, the contents of the stomach are passed upward from the stomach to the esophagus, resulting in uncomfortable symptoms or complications. Symptoms suggesting that an infant with a hiatal hernia may have GERD include irritability associated with eating, vomiting and poor feeding. The National Digestive Diseases Information Clearinghouse reports that in rare cases of GERD, infants may stop growing normally because they are spitting up so much food that they cannot obtain the proper nutrition needed to grow well.
Difficulty Swallowing
According to MedlinePlus, an infant with a paraesophageal hiatal hernia may have difficulty swallowing food or liquid. The Harvard Medical School-affiliated website InteliHealth warns that this is a dangerous symptom, because it suggests that the part of the stomach that has come up--herniated--through the opening in the diaphragm is being "strangulated" and is losing its blood supply. This is an emergency situation; an infant who is showing symptoms of hiatal hernia strangulation should receive immediate medical attention.
References
- MedlinePlus: Anti-reflux surgery--children
- National Digestive Diseases Information Clearinghouse: Gastroesophageal Reflux in Infants
- "UpToDate"; Hiatus Hernia; Peter Kahrilas; March 2010
- "Current Diagnosis and Treatment: Pediatrics;" William Hay et. al.; 2009
- InteliHealth: Hiatal Hernia
