The diaphragm is composed of paired muscles that separate the abdominal cavity from the chest cavity. By contracting and relaxing, the diaphragm changes the volume and the pressure within the chest. This facilitates air passing into and out of the lungs. The esophagus penetrates the diaphragm and then enters the stomach. The opening through which it passes, or hiatus, may become stretched or weakened. This may cause the stomach acid or stomach contents to flow backwards into the esophagus. This causes irritation in the esophagus. In addition, a portion of the stomach, or occasionally other organs, may protrude into the chest cavity.
Causes of Hiatal Hernia
Hiatal hernia is thought to be caused by weakening of the tissues which anchor the gastroesophageal junction and the diaphragm. Increased abdominal pressure, obesity and trauma may be contributing factors.
Signs and Symptoms of Hiatal Hernia
Hiatal hernias frequently do not produce any symptoms. When they do cause symptoms, they usually develop within 1 hour or more after eating. typically, they may produce heartburn, belching, or regurgitation. Sometimes there may be difficulties swallowing or painful swallowing. At times, the pain may be confused with heart attack symptoms. Irritation of the esophagus can lead to bleeding. Anemia may develop, with weakness, rapid heart beat, shortness of breath and exercise intolerance.
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