In most cases, the condition progresses without symptoms (circa 60% of cases). However, the following symptoms and complaints may indicate a hiatal hernia (diaphragmatic hernia):
Axial hiatal hernia (displacement of cardia (gastric inlet) and fundus (“base of the stomach“) portions into the thorax/chest)).
- Mostly asymptomatic, i.e., no symptoms.
- Reflux symptoms (heartburn, regurgitation of gastric contents (backflow of food pulp from the esophagus into the mouth), acid or nonacid regurgitation, retrosternal pain (pain behind the breastbone; this occurs mainly when lying down), epigastric pain (upper abdominal pain)) (incidence: 10%)
- Esophagitis (esophagitis), which can lead to chronic bleeding (→ iron deficiency anemia / anemia due to iron deficiency), possibly also emergence of stenoses (narrowing) due to severe inflammation.
Paraesophageal hernia (displacement of fundal parts past the esophagus (= paraesophageal) into the thoracic cavity; normal location of the cardia) [3 stages].
- Asymptomatic
- Uncomplicated: Belching, dysphagia (difficulty swallowing), bloating, pressure in the cardiac region, possibly epigastric pain.
- Complicated: chronic bleeding, erosions (epithelial defects confined to the mucosa), ulcers (ulcers), incarcerations (entrapment of tissue) → iron deficiency anemia.
Possible other symptoms
- Tachycardia (heartbeat too fast: > 100 beats per minute) or angina attacks (chest tightness) occurring mainly after eating.
