Signs & symptoms of a hiatal hernia

Adam Ciesielski/

A hiatus hernia, also often referred to as a hiatus hernia, is a hernia of the upper gastrointestinal region. It's caused when an upper portion of the stomach tears through a portion of the diaphragm and breaks into the thorax.

A hiatus hernia can promote discomfort in individuals and may also pose significant health risks.

Acid Reflux

A hiatus hernia involves a tear in the lining of the diaphragm, the tissue that physically separates the abdomen and thorax. The stomach can then move up into the diaphragm along with the lower esophageal sphincter. Normally, the sphincter keeps the stomach's digestive acids from travelling back up the digestive tract. With a hernia, the acid may surge upward and cause gastro-oseophageal reflux (GER) and gastro-oseophageal reflux disease (GERD). Common symptoms of GERD and GER include a burning sensation in the chest, as well as a sour flavour in the back of the mouth. This is the most common sign or symptom of a hiatus hernia, though the hernia itself typically goes undiagnosed unless individuals have severe GER or GERD that requires a closer examination.

Chest Pain

The movement of internal organs due to the weakening of muscle tissue caused by the hiatus hernia can create physical chest pain. The pain is typically a dull ache in the chest. However, some sufferers of a hiatus hernia may experience a sharper pang in the chest.

Nausea and Appetite

As the hiatus hernia grows, more of the stomach organ can move upwards in the chest. This can cause health symptoms related specifically to the stomach. Some individuals may experience varying levels of nausea. Other individuals may notice changes in their appetites, including an increased appetite or a reduced sensation of hunger. In cases of extremely large hernias, individuals may find it difficult or painful to swallow food.

Breathing Problems

Due to the hernia pushing into the diaphragm, an uncommon but not unheard of symptom is a difficulty breathing. This can feel like a tightness in the chest akin to the sensation caused by asthma. Unlike asthma, individuals who take steroid medications for asthma will likely not notice a significant reduction in breathing problems because the hernia will not react to the steroids.


Typically, a hiatus hernia is treated for its symptoms rather than the actual hernia. Small to mild hernias are usually symptom-free and are not noticed by the individual. If there are symptoms, physicians will often prescribe medications for these symptoms to ease the pain and discomfort of the patient. Only in severe cases will individuals be operated upon to remove the actual hernia. Common medications prescribed to cure symptoms include over-the-counter non-prescription antacids such as Tums, or prescription medications such as proton pump inhibitors to treat GERD caused by a hernia.