Most hiatal hernias are of the so-called "sliding" type, in which the junction of the esophagus and stomach and part of the stomach protrude into the chest. The junction may reside permanently in the chest, but often it juts into the chest only during a swallow. These hernias can and most often do occur without producing symptoms at all. When they do produce symptoms, they are the typical symptoms of gastroesophageal reflux disease (GERD). Heartburn, regurgitation, and nausea are common symptoms. Other symptoms can include chest pain or burning and difficulty swallowing. A bloated feeling after meal consumption and shortness of breath sometimes occur.
Causes of hiatal hernias
There are different causes of hiatal hernias. A decrease in abdominal muscle tone and increased pressure within the abdominal cavity may lead to a hiatal hernia. Thus, people who are obese and pregnant women are at an increased risk for developing a hiatal hernia. Repetitive coughing, vomiting, or constipation with excessive straining during bowel movements both increase the intra-abdominal pressure and may contribute to the development of a hiatal hernia. Ascites, an abnormal collection of fluid in the abdominal cavity, also is associated with the development of a hiatal hernia.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.
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