Paraesophageal Hernia Symptoms

Paraesophageal hernia symptoms occur as a result of part of the stomach being pushed up beside the esophagus into the chest. The gastroesophageal junction stays in place, however. At all times, this type of hernia will stay within the chest and complications are possible. The symptoms associated with this condition will vary among those with this condition, however, many patients do not have any symptoms. Most are manageable, however.
Chest Pain
With this type of hernia chest pain can occur. This pain may be severe and sudden, sometimes resembling a heart attack. The pain may also radiate. Antacids are often ineffective in relieving this pain. Over-the-counter pain medications are often ineffective as well. The key to the chest pain is avoiding it in the first place by avoiding foods and activities that may trigger this pain and other symptoms.
Indigestion
Indigestion and heart burn may be experienced by those with this condition. It occurs as a result of stomach acids “backing up” into the esophagus. Over-the-counter antacids are effective in relieving these symptoms for many patients. If a patient does not experience relief from these, prescription medication, such as Nexium, may be beneficial.
Trouble Swallowing
Some patients may have difficulty swallowing. If this occurs a procedure may be necessary to widen the esophageal tract. This procedure is typically done via endoscopy and with balloons, such as a balloon endoscopy.
Stomach Symptoms
Since the stomach is directly involved, a few different paraesophageal hernia symptoms may involve the stomach. Stomach pain can occur. Some patients experience this right after eating and there really is not much that can be done except to eat slowly and not eat too much. Nausea and vomiting may occur and may be relieved with medications, both over-the-counter and prescription depending on severity and patient response to the treatment. Retching may also occur.
Incarceration
This is considered a complication instead of a symptom. It occurs when the hernia is being squeezed and is stuck. It may result in strangulation. Pain is common, as is nausea and vomiting. Surgery is necessary when this complication occurs.
Strangulation
A strangulated hernia is also considered a complication instead of a symptom. This often occurs after incarceration. When strangulation occurs, tissues die due to lack of a blood supply. Strangulation causes constant pain, and sometimes tenderness, nausea, and vomiting. Patients may seem ill and a fever may occur. If a patient experiences this, emergency surgery must be performed to correct it, to relieve the strangulation, and to restore blood flow. Surgery is often done laparoscopically.
Resources
The DAVE Project. (2010). Endoscopic Repair of a Type II Paraesophageal Hernia with Mesenteroaxial Volvulus. Retrieved on January 10, 2011 from The DAVE Project: https://thedaveproject.org/ViewFilms.cfm?Film_id=868
Qureshi, W.A. MD. (2009). Hiatal Hernia. Retrieved on January 10, 2011 from eMedicine: https://emedicine.medscape.com/article/178393-overview
Image Credits
CT Scan: Hellerhoff – Wikimedia Commons