The hiatus is a natural opening that allows the esophagus to enter the abdomen as it descends from the chest. Hiatal hernias occur when abdominal contents such as the stomach push through this opening by compressing against or squeezing alongside the lower esophagus.
Hiatus hernias may contribute to gastroesophageal reflux disease (GERD), but also may affect swallowing or cause other symptoms.
Non-GERD symptoms of Hiatal Hernia may include:
- Difficult or painful swallowing
- Chest pain
- Shortness of Breath
- Certain stomach ulcers called Cameron’s ulcers
How is Hiatal Hernia Diagnosed?
An upper GI X-ray or endoscopy can identify a hiatal hernia and characterize its severity in most cases. Most are small and do not pose risk to patients. Certain hiatal hernias called paraesophageal hernias do carry a small chance of a sudden dramatic twisting of the stomach that could require emergency surgery.
When Should a Hiatal Hernia be Treated Surgically?
Small hiatal hernias associated with GERD do not change the indications for surgery. Therefore, the standard treatments for GERD still apply. However, large hiatal hernias that cause swallowing difficulties, ulcers or worsening of respiratory conditions, as well as paraesophageal hernias, should be assessed by gastroenterologists or surgeons who are able to help you compare the risks of the hernia to the risks of corrective surgery.