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Paraesophageal Hernia Symptoms

Though most people are familiar with abdominal hernias, hernias can occur in other places. A hiatal hernia happens when the stomach pushes through an opening in the diaphragm, called the esophageal hiatus or diaphragmatic hiatus, and into the chest. A paraesophageal hernias is a type of hiatal hernia where the gastro-esophageal junction remains in place, but part of the stomach is squeezed up into the chest beside the esophagus.

  1. Complications

    • The problem that can happen with a paraesophageal hiatal hernia is that it can become incarcerated or stuck in the diaphragm opening. If this happens it can become strangulated, which means that the blood supply will be cut off. This can result in tissue death in as little as six hours.

    Symptoms

    • Unlike abdominal hernias that announce their presence with bulges in the body, paraesophageal hiatal hernias may not present symptoms. If the hernia does produce symptoms, they can include severe chest pain, radiating chest pain that antacids can't help, difficulty swallowing, stomach pain, indigestion, nausea and vomiting.

    Living with the hernia

    • You may not need surgery for your hernia, but you will need to make some lifestyle changes to minimize the pains. If you have reflux problems, you will need to eat smaller, more frequent meals rather than the typical three large meals a day. Antacids may also help. If the problems persist or become worse, you may need surgery.

    Diagnosis

    • Your doctor will question you about heartburn and chest discomfort. These could be indicators of a hernia particularly if they come after eating a heavy mean or lifting heavy objects. Other risk factors include obesity and smoking. Your doctor will probably run tests, such as a chest x-ray or a barium swallow, to help him determine that you actually have a hernia. The same symptoms can also occur in people with coronary artery disease so the doctor will want to verify that heart disease isn't the problem.

    Treatment

    • If the hernia has become constricted or strangulated, surgery will be required to repair the hernia. The surgery is generally laparoscope. Three small incisions are made. A laparoscope is inserted in one, surgeon's tools in the other. The laparoscope acts as an eye or camera so the surgeon can see where the problem is and repair it by repositioning the stomach and then reinforcing the hiatus.

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