Symptoms of a Paraesophageal Hiatal Hernia

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A general hiatal hernia is defined as the condition that occurs when the upper section of a patient's stomach squeezes through an opening in the diaphragm and ends up in the chest area.

A paraesophageal hiatal hernia is a more rare and more complicated affliction that occurs when the upper section of a patient's stomach is pushed through the diaphragm into the chest area and becomes lodged beside the oesophagus. Most of the time paraesophageal hiatal hernias do not cause obvious symptoms until the situation is severe and immediate medical attention is necessary.


It is unlikely that a patient will recognise a paraesophageal hiatal hernia unless the hernia is already causing severe internal damage. Possible symptoms of a problematic paraesophageal hiatal hernia include sudden severe chest pain, ongoing chest pain that is not made better by taking an antacid pill, trouble swallowing, abdominal pain, indigestion, nausea and vomiting.


Paraesophageal hiatal hernias can pose two major threats to a patient's health, incarceration or strangulation. Incarceration is when the hernia is tightly stuck beside the oesophagus is such a way that it is being repeatedly squeezed. When this condition occurs, the patient will be in tremendous pain until surgery is performed to fix the condition. The second complication, strangulation, is the more serious problem of the two. Strangulation is when the paraesophageal hiatal hernia is positioned in a way that cuts off circulation and blood supply. This condition can cause death to the tissues that are impacted by the decreased blood circulation.


When symptoms of a paraesophageal hiatal hernia appear and a doctor confirms this diagnosis, a special type of surgery called a laparoscopic procedure may be performed. A laparoscopic procedure utilises a very thin instrument with a minuscule camera attached to enter the patient's stomach through a small incision. The surgeon uses this tool to reposition the patient's stomach to remove the pressure on the paraesophageal hiatal hernia. The small size of the tool used makes the procedure for treating a paraesophageal hiatal hernia less intrusive than many other surgical operations.


If you are at the stage where symptoms of a possible paraesophageal hiatal hernia are appearing, it is crucial that you seek medical attention and receive a definitive diagnosis as soon as possible. The sooner your doctor can positively diagnose this condition, the sooner you can receive treatment and hopefully avoid extensive tissue death. Your doctor will most likely use a chest X-ray or esophagoscopy to diagnose your paraesophageal hiatal hernia. An esophagoscopy can be uncomfortable because a tube is inserted down the throat, so patients are encouraged to have anaesthesia for this diagnostic procedure.


Paraesophageal hiatal hernias cannot always be prevented. However, you can significantly decrease your risk of developing a paraesophageal hiatal hernia by having a healthy body weight, not smoking and avoiding heavy lifting. A diet that is high in fibre may also help to prevent against the formation of paraesophageal hiatal hernias.


Not all patients with a paraesophageal hiatal hernia require treatment. Most of the time, a paraesophageal hiatal hernia will never show any symptoms and will not negatively affect the patient's lifestyle and overall health. In fact, only 5% of people with a paraesophageal hiatal hernia ever require surgery. If you are diagnosed with a paraesophageal hiatal hernia, there is always the potential for symptoms to come to the forefront, but it is unlikely that you will require surgical treatment.


When most of us hear the term hernia, we cringe inside because the word is associated with extreme pain. While some large hernias can indeed cause a great deal of discomfort, most hernias are very manageable with medication and never require invasive medical treatment. Many people also have the misconception that all hernias are a result of excessive heavy lifting. Again, this is entirely untrue. In most cases, paraesophageal hiatal hernias simply cannot be prevented and, when they do occur, heavy lifting is only one of several possible causes.