Hiatal & Paraesophageal Hernias

A hiatal hernia occurs when part of the upper stomach moves into the chest area. A paraesophageal hernia refers to larger portions of the stomach or even other parts of the bowel that are pushed up into the chest. Typically, your stomach sits below your diaphragm, but in hiatal and paraesophageal hernias, it can be found above the diaphragm.

Hiatal and paraesophageal hernias usually do not cause symptoms, but they can significantly increase your risk of having reflux. Some associated symptoms are:

• Heartburn: a burning feeling in the chest
• Regurgitation: when acidic foods back into the mouth or throat
• Trouble swallowing
• Chest pain
• Changes in voice or sore throat
• Unexplained cough

Hiatal and paraesophageal hernias are usually diagnosed with an EGD or upper endoscopy, where a flexible camera is used to evaluate the esophagus and stomach. Sometimes they are incidentally found on X-rays, CT scans, or MRIs.

Small hiatal hernias are common and typically do not need to be treated, but the associated heartburn can be treated. Larger hiatal hernias or paraesophageal hernias are typically treated with surgical repair. Surgery will not only improve the hernia but usually improves the symptoms of reflux.