Symptoms of hiatal hernia, these two are the most obvious

Hiatal hernia is common in obese multiparous women. Patients will experience esophageal pain, especially after meals or before going to bed at night when the pain will be more intense. They will also have symptoms of hiccups, nausea, and acid reflux, and should be treated as soon as possible.

1. Pain : Pain is the most common symptom, which usually occurs 0.5 to 1 hour after eating or at bedtime. It may be mild burning pain or severe burning pain. It is mostly located behind the sternum (middle or lower 1/3), under the xiphoid process or in the bilateral hypochondrium, and may radiate upward to between the two shoulder blades on the back, accompanied by belching or hiccups. It often varies with body position. Supine position, bending over, squatting, coughing, right side lying or forceful inhalation after a full meal can induce or aggravate the pain, while standing, semi-recumbent position, walking, vomiting food or belching can relieve the pain. It can usually be relieved on its own within 1 hour. Patients with a long course of illness gradually master the pain pattern and know how to relieve their own symptoms, but cannot completely eliminate the discomfort. Some foods such as peppers, onions, acidic or alkaline foods, rough and hard foods, etc. are prone to induce or aggravate the pain.

The causes of pain are mostly related to reflux of gastric acid irritating the esophageal mucosa to cause esophagitis, esophageal spasm and herniated stomach pulling the diaphragmatic muscle fibers. Studies have found that pain only occurs when the normal esophagus is dilated to a diameter of 3-4 cm with a balloon, while the esophagus with inflammation and allergies can induce pain as long as it is slightly dilated. Since this disease is often accompanied by esophagitis, esophageal stenosis and peresophagitis, eating can cause the esophagus above the food bolus to dilate and produce very severe pain. The most severe pain is caused by the third contraction or spasm. Patients often describe a feeling like a clenched fist pressing into the chest. In addition to the spasmodic pain caused by the swallowing action when eating, reflux can also occur. The esophageal muscle pain is spasmodic or knife-like pain, and is distributed in the same area as the burning pain behind the sternum. In very rare cases, it can radiate to both upper limbs.

2. Burning pain behind the sternum, acid reflux, hiccups and nausea: Mainly caused by gastroesophageal reflux, it often occurs in the supine position. Its typical symptoms are burning pain behind the sternum, acid reflux and nausea. Some people have reported 2

The symptoms and complication rates of 178 patients with gastroesophageal reflux and hiatal hernia were as follows: burning pain behind the sternum 85%, postural aggravation 81%, dysphagia 37%, regurgitation 23%, nausea and vomiting 21%, hoarseness 12%, sore throat 3%; angina-like pain 3%, arm-shoulder pain 8%, neck and ear pain 3%; cough 47%, hemoptysis 13%, upper gastrointestinal bleeding 12%, bronchitis 35%, pneumonia 16%, asthma and wheezing 16%, aspiration 8%, shortness of breath 13%.

1. Burning pain behind the sternum: It is caused by acidic reflux irritating the esophageal mucosa. It is mostly located in the upper abdomen or behind the sternum and may be accompanied by a burning sensation. It is related to the acidity of the reflux and the sensitivity of the esophageal mucosa. The burning pain behind the sternum is not only related to gastroesophageal reflux, but also to the acidity of the diet. Beverages with a pH value below 4.0 (such as lemon juice, orange juice, grape juice, pineapple juice, etc.) can cause burning pain behind the sternum. Drinking white wine, strong coffee or hot water, and eating onions, garlic or peppers can also cause burning pain behind the sternum. If there is dull pain, tingling or colic at the same time, the possibility of esophagitis should be considered.

Tolerance varies greatly among individuals, and the intensity is not always related to the extent of organic lesions. Some patients complain of painful burning pain behind the sternum but only have mild or no esophageal inflammation.

2. Reflux and acid reflux: Reflux often occurs before the burning pain or burning sensation behind the sternum. The refluxed material usually does not contain food and is mainly composed of gastric acid secretions. It usually refluxes to the lower esophagus, and a few can reflux into the pharynx or flow into the mouth.

3. Regurgitation: It refers to the reflux of food in the stomach into the oral cavity under the action of a series of complex involuntary and voluntary muscle reflexes, causing swallowing action and then swallowing or spitting out, leaving a sour or bitter taste in the pharynx and mouth, causing bad breath and damage to taste. Regurgitation occurs suddenly and relatively passively. A full meal, exertion or change of body position can cause nausea. Patients are often unable to do work that requires bending, lifting, etc. Regurgitation often occurs unconsciously during sleep at night. Coughing or even suffocation may occur when liquid enters the throat. After waking up, the patient can see gastric juice or bile on the pillow, and has sore throat, hoarseness, cough or the smell of vomit in the mouth.