What Does a Hiatal Hernia Attack Feel Like?

A hiatal hernia, a tear or defect in the diaphragm that lets the stomach intrude into the chest cavity, may cause heartburn, cramps, occasional vomiting or trouble breathing.

A hiatal hernia occurs when the upper part of the stomach protrudes into the chest cavity through a defect in the diaphragm. In severe cases, the entire stomach can protrude into the chest cavity and cause serious problems with digestion and breathing.

There are two types of hiatal hernias:

• Sliding hernia 
  • The most common type of hiatal hernia
  • Occurs when the top of the stomach and the lower part of the esophagus squeeze up into the space above the diaphragm
• Paraesophageal hernia 
  • Not very common
  • Occurs when the top of the stomach squeezes up into the space above the diaphragm
  • Can be serious if the stomach folds up on itself
  • Can also cause bleeding from the stomach or trouble breathing

Most small hiatal hernias cause no symptoms. Moderate sized hiatal hernia symptoms include:

• Nausea
• Occasional vomiting or retching
• Abdominal cramps
• Gastroesophageal reflux disease (GERD)
  • Heartburn
  • Burning in the throat or an acid taste in the throat
  • Stomach or chest pain
  • Difficulty swallowing
  • Raspy voice 
  • Sore throat
  • Unexplained cough
• Bleeding from the stomach
• Trouble breathing

A hiatal hernia attack is a worsening of symptoms. 

Large hiatal hernias can become life-threatening emergencies if they twist or become obstructed.

Causes of a hiatal hernia include: 

• Increased pressure inside the abdominal cavity 
  • Forceful coughing
  • Heavy lifting
  • Chronic constipation and straining during bowel movements
  • Repetitive vomiting
• Being born with an unusually large hiatus
• Obesity
• Injury or trauma to the area such as force from a seatbelt during a motor vehicle accident

Hiatal hernias are diagnosed with a patient history and physical examination, along with tests such as: 

• Ultrasound
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI) scan
• Barium X-ray
• Endoscopy

Treatment for hiatal hernias includes lifestyle changes, medications, or surgery. 

Lifestyle modifications used to treat symptoms of hiatal hernia include: 

• Eat meals at least three to four hours before lying down
• Eat moderate to smaller portions 
• Limit foods that are fatty or acidic, foods and beverages that contain caffeine, and alcoholic beverages
• Lose weight if overweight/maintain a healthy weight
• Sleep in a slightly elevated position
• Don’t smoke

Medications used to treat symptoms of hiatal hernia include: 

• Antacids 
• Antihistamines

Types of surgery used to repair a hiatal hernia include: 

• Open surgery
  • An incision is made where the hernia is located
  • The protruding tissue is pushed back into place 
  • A mesh may be implanted for additional support
• Laparoscopic surgery 
  • Similar to open surgery, except small incisions are made so surgical tools can be inserted to perform the procedure
• Robotic hernia repair
  • Similar to laparoscopic surgery with small incisions 
  • A surgeon operates surgical instruments from a console