clinical features

Last reviewed 06/2021

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)

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