Clinical features
Many are patients are asymptomatic.
There are no specific symptoms for hiatus hernia. Clinical features, where present, may include:
- gastroesophageal reflux disease (GERD):
- due to incompetence of the cardiac sphincter
- 'heartburn' after meals that is made worse by stooping or lying down
- studies in Western countries have reported that over half of patients (50% to 94%) with reflux esophagitis had concomitant hiatal hernias (prevalence of hiatal hernia in the control subjects were 13% to 59%)
- regurgitation of food at night, leading to aspiration pneumonia
- dysphagia
- in part caused by reflux but also due to inefficient peristalsis resulting from movement of the hernia upwards as the oesophagus contracts
- duodenal or gastric ulcer
- Saint's triad - a sliding hiatus hernia is associated with gallstones and diverticular disease
- nausea and vomiting are common in children but not in adults
- waterbrash
- children may present as failure to thrive, and with anaemia (1)
Reference:
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