Learn about what is a hiatal hernia, various medical symptoms of a hiatal hernia such as chronic epigastric pain, hernia reflux, etc., whether symptoms of hiatal hernia include back pain or not, and fix hiatal hernia through correction or pulling of stomach, surgery, etc. in this article.

What is a hiatal hernia?

Hiatal hernia is a type of hernia where the abdominal wall presses against the esophageal hiatus - the opening in the diaphragm which the esophagus enters the abdominal cavity - causing a part of the stomach protrudes above the diaphragm. The esophageal hiatus along with the lower esophageal sphincter functions as a valve to ensure that the food from the stomach does not return back to where it came and prevent the content of the stomach from passing into the esophagus. If the muscles get weak and the abdominal pressure increases, the hiatus will stretch so much that the content of the abdomen or the upper part of the stomach will poke through the esophageal hiatus thus causing hiatal hernias.

Risk factors

Hiatal hernia affects both men and women equally. Although it can happen at any age, the disorder has the highest occurrence in elderly people. Hiatal hernias are also common in obese people and in people who often endure extreme physical effort (weight lifting).

Medical symptoms of a hiatal hernia

Small hiatal hernias

In the early stages, most hiatal hernia cases don’t show any obvious medical symptoms thus usually it is found out when one visit the doctor for a routine check. But as the disease progresses symptoms are starting to appear. Among these there is heartburn, chest pain, abdominal pain, vomiting, nausea, gas, bad breath, acid reflux and rarely some infections. These medical symptoms of a hiatal hernia usually intensifies when leaning forward, straining, lifting heavy objects and during pregnancy. Symptoms such as heartburn, vomiting and nausea from the hiatal hernia tend to become worse after meals.

Large hiatal hernias

In rare cases, the hiatal hernia may get worse when the content of the stomach that thrusts into the chest cavity become strangulated or impair the blood supply to the stomach, resulting in the death of part of the stomach. Several large hiatal hernia symptoms include difficulty swallowing, belching, esophagus disruption, heartburn, nausea, chronic chest pain, chronic epigastric pain, etc.

Does symptoms of hiatal hernia include back pain?

Well, medically hiatal hernia shouldn’t cause any back pain at all but in several cases, hiatal hernia did include back pain. In these cases, the most possible reason of the back pain is when a swollen esophagus - because of the arising of acids - touches the spine. The esophagus is located closely to the spine thus any swelling of the esophagus may cause the esophagus to touch the spine and lead to back pain. This is why some patients of large hiatal hernia might complain about their back pain.

These medical symptoms of a hiatal hernia occur because of the reflux of the abdominal content inside the esophagus. In addition, hiatal hernia has parsyntoms that are multifactorial, like esophagitis and peptic ulcer. In worse cases chest infection appears in the hernia. 

Type of hiatal hernias

  • Sliding hiatal hernia, where the hernia occurs in the area above the diaphragm Sliding hernia is a very common type of hiatal hernia. It´s not dangerous, but it may cause reflux esophagitis, which was noticed in any people that suffer from hiatal hernia. Some of them were also suffering Barrett’s esophagus due to the hernia. Barrett’s esophagus may present dysphagia or reflux symptoms.
  • Paraesophageal hiatal hernia, where the hernia occurs in the area below the diaphragm Paraesophageal hernia may present several medical symptoms of hiatal hernia such as incarcerations or more acute epigastric pain, because of strangulation. This type of hernia is not very common but it is dangerous, life threatening probably. Occasionally complications like stomach strangulation appear but in most cases this does not happen.

Diagnosing hiatal hernia

When doctors suspect the presence of hiatal hernia in patients, they usually perform additional tests in order to confirm the clinical diagnose. Hiatal hernia can be revealed by X-ray scans, MRI (magnetic resonance imaging) and computerized tomography. Nowadays, the disorder can be quickly diagnosed with the means of a laparoscope.

Treatment of hiatal hernia

Unlike other types of hernia (e.g. infant umbilical hernia, epigastric hernia, etc.), this disorder rarely needs surgery correction for pulling the stomach and fix the hiatal hernia. In fact, in many cases hiatal hernia doesn’t require any medical treatment at all.

Surgery for less severe or uncomplicated hiatal hernia is not needed since it can be effectively treated by making lifestyle improvements. Following a recommended diet for hiatal hernia patient and a healthy eating schedule have showed to be very effective ways of correcting hiatal hernia. Also, patients of hiatal hernia are advised to avoid weight lifting and straining in order to prevent complications. Some doctors may suggest the patients to try to lose some weight and not to wear tight clothes too. When patients diagnosed with hiatal hernia complain about unpleasant sensation of various medical symptoms of the hiatal hernia such as heartburn, doctors usually prescribe antacids or other appropriate medications.

Correction treatment to pull the stomach or fix hiatal hernia through surgery is only needed for patients with more severe, complicated types of hiatal hernia. Recovery after hernia surgery: the surgical intervention is safe and quick, allowing patients to recover totally within a few days after the surgery.

Although hiatal hernia is very common, it is one of the least threatening types of hernia and in many cases the disorder disappears on itself. However, if the medical symptoms caused by hiatal hernia are persisting or very intense, it is best to inform your doctor about this.