Is esophageal hernia life-threatening?

Esophageal hernia is a relatively serious disease. Patients often experience heartburn and acid reflux. In more serious cases, they may have difficulty swallowing and eating. This disease is also prone to misdiagnosis, for example, it is easy to be misdiagnosed as gastroesophageal reflux. Once a serious situation occurs, it will pose a great threat to the patient's life safety, so it is necessary to receive good and regular treatment in a timely manner.

What is a hiatal hernia?

The human chest cavity and abdominal cavity are separated by a layer of flat muscle called the diaphragm. There is a hole on the diaphragm called the esophageal hiatus. The esophagus passes through the esophageal hiatus on the diaphragm into the abdominal cavity and connects to the stomach. Under normal circumstances, the esophageal hiatus is just large enough to accommodate the passage of the esophagus. The pressure in our abdominal cavity is greater than that in the chest cavity. When the esophageal hiatus is too large, the pressure difference will "suck" a small part of the stomach into the chest cavity, which is called esophageal hiatal hernia.

How does a hiatal hernia develop?

1. Congenital factors of esophageal dysplasia. 2. The structure of the esophageal hiatus, such as muscle atrophy or weakened muscle tension. 3. Acquired factors that cause long-term increased abdominal pressure, such as pregnancy, ascites, chronic cough, habitual constipation, etc., can cause the stomach to herniate into the diaphragm and form a hiatal hernia. 4. Hiatal hernia after surgery, such as surgery on the upper stomach or cardia, which destroys the normal structure can also cause hernia.

What are the causes of hiatal hernia?

Overeating, constipation, obesity, bending over, tight belts, pregnancy, severe coughing, lifting heavy objects, smoking, drinking, etc.

What are the symptoms of hiatal hernia?

Except for some congenital patients, most hiatal hernias occur in middle-aged and elderly patients. Patients with smaller hiatal hernias may have no symptoms in the early stages, or may only experience mild discomfort such as fullness and chest tightness after eating, which can usually be relieved on their own.

Patients with hiatal hernia may be asymptomatic or have mild symptoms, and the severity of their symptoms has nothing to do with the size of the hernia sac or the severity of esophageal inflammation. In short, the symptoms of patients with hiatal hernia can be summarized into the following three aspects:

1. Gastroesophageal reflux symptoms

Professor Wu Jimin said that typical symptoms are heartburn, acid reflux, belching, chest pain, and acid vomiting; sometimes there are some atypical manifestations such as paroxysmal cough, hoarseness, and foreign body sensation in the throat. In fact, these are all manifestations of acid reflux into the esophagus. In severe cases, esophageal reflux into the trachea may also cause asthma and aspiration pneumonia.

As the disease progresses, the hernia gradually grows larger and causes more obvious gastroesophageal reflux symptoms. At this time, the stomach of the patient with hiatal hernia is like a vinegar bottle without a cap. Gastric acid will overflow if shaken and can easily reflux into the esophagus and cause various esophageal reflux symptoms.

2. Symptoms related to complications

(1) Bleeding: Hiatal hernia may bleed sometimes, mainly due to esophagitis and hernial sac inflammation. Most of the bleeding is chronic and small amounts, which may cause anemia. (2) Reflux esophageal stenosis: Among patients with reflux symptoms, a small number develop organic stenosis, resulting in symptoms such as dysphagia, dysphagia, and vomiting after eating. (3) Hernia sac incarceration: commonly seen in paraesophageal hernia. If a patient with hiatal hernia suddenly experiences severe upper abdominal pain accompanied by vomiting, is completely unable to swallow, or has heavy bleeding at the same time, it indicates acute incarceration.

3. Hernia sac compression symptoms

When the hernia sac is large and compresses the heart, lungs, and mediastinum, it may cause symptoms such as shortness of breath, palpitations, cough, and cyanosis. When the esophagus is compressed, esophageal stagnation or dysphagia may be felt behind the sternum.