What symptoms do hiatal hernias cause?
The vast majority of hiatal hernias are of the sliding type, and most of them are not associated with symptoms. The larger the hernia, the more likely it is to cause symptoms. When hiatal hernias produce symptoms, they almost always are those of gastro-esophageal reflux disease (GERD) or its complications. This occurs because the formation of the hernia often interferes with the barrier (lower esophageal sphincter) which prevents acid from refluxing from the stomach into the esophagus. Additionally, it is known that patients with GERD are much more likely to have a hiatal hernia than individuals not afflicted by GERD. Thus, it is clear that hiatal hernias contribute to GERD. However, it is not clear if hiatal hernias alone can result in GERD. Since GERD occurs in the absence of a hiatal hernia, factors other than the presence of a hernia can cause GERD. How does a hiatal hernia cause GERD? Normally, there are several mechanisms to prevent acid from flowing backwards (refluxing) up into
