What Are the Symptoms of a Sliding Hiatal Hernia?

Approximately 40 percent of Americans have a sliding hiatal hernia, according to 2006 information from the Merck Manual. The esophagus--the tube that runs from the mouth to the stomach--passes through an opening in the diaphragm, the sheet of muscle that separates the chest from the abdominal cavity. If the opening or hiatus is too large, part of the stomach and the connection between the stomach and esophagus may protrude through the diaphragm into the chest cavity. This condition, called a sliding hiatal hernia, may cause symptoms that interfere with swallowing, eating and activities of daily life.

A man is experiencing severe heartburn. (Image: Lisa F. Young/iStock/Getty Images)

Heartburn and Indigestion

Some patients with a sliding hiatal hernia experience indigestion and heartburn related to food and stomach acid backing up in the esophagus, according to the Merck Manual. They may complain of pain behind the breast bone or a squeezing pain in the chest similar to the pain of coronary artery disease. Pain may also occur in the neck, face or throat. Discomfort occurs most often after a meal or when lying down. Discomfort may be relieved by simple measures such as raising the head of the bed on blocks to limit reflux, wearing loose clothing, and avoiding fatty or acidic foods. Lifestyle changes such as losing weight and quitting smoking are also helpful. Medication that blocks acid production, called proton pump inhibitors, may provide relief as well.


Patients with sliding hiatal hernias may have a sour or bitter taste in the mouths and an increase in saliva production, both due to regurgitating stomach contents, according to the Merck Manual. Regurgitation can also cause burping, vomiting or a feeling that acid is backing up into the throat, according to the University of Maryland Medical Center.

Difficulty Swallowing

Reflux of acid and stomach contents into the esophagus can cause difficulty swallowing, a condition called dysphagia, according to the University of Maryland Medical Center. Patients may feel that something is trapped in the throat or, in extreme cases, may choke on their food. Other symptoms involving the throat may include a dry cough, hoarseness, a need to clear the throat, hiccups or a sore throat that does not go away. Throat issues may be related to damage to the esophagus from stomach acids or temporary muscle spasms.

Abdominal Discomfort

Some patients complain of pain in the upper part of the abdomen and feeling unusually full, a condition called dyspepsia, according to the University of Maryland Medical Center. This condition can occur with heartburn and indigestion or on its own. Bloating and belching may also be present, according to Aurora Health Care. Severe nausea and vomiting, or an inability to have a bowel movement, require immediate medical attention as they may indicate a bowel obstruction or strangulated hernia.

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