Many people wonder if they can feel a hiatal hernia with their fingers. A hiatal hernia cannot typically be felt from outside the body. This is because it involves an internal organ, specifically a part of the stomach, moving through an opening in the diaphragm. The diaphragm is a muscle located deep within the body, separating the chest from the abdomen.
Understanding Hiatal Hernias
A hiatal hernia occurs when a portion of the stomach pushes upward through an opening in the diaphragm, known as the esophageal hiatus, into the chest cavity. The diaphragm is a muscular barrier separating the abdominal and chest cavities. Normally, the esophagus passes through this hiatus to connect to the stomach. With a hiatal hernia, the top part of the stomach bulges through this opening.
There are two main types of hiatal hernias. The most common is a sliding hiatal hernia, accounting for up to 95% of cases, where the stomach and the section of the esophagus that joins it periodically slide up into the chest through a widened hiatus. The other type, a paraesophageal hiatal hernia, involves a part of the stomach pushing up through the hiatus alongside the esophagus, forming a bulge. While sliding hernias are more frequent, paraesophageal hernias can sometimes be more concerning due to potential complications.
Recognizing Symptoms and Seeking Care
Since a hiatal hernia cannot be felt externally, recognizing its symptoms is key to identifying a potential issue. Many people with small hiatal hernias experience no symptoms. When symptoms do occur, they are often associated with the backflow of stomach acid into the esophagus, known as gastroesophageal reflux disease (GERD). Common symptoms include heartburn (a burning sensation in the chest often worse after eating or lying down) and regurgitation of food or liquids.
Other signs can include chest or abdominal pain, trouble swallowing, and feeling full soon after eating. Nausea, burping, or shortness of breath may also be present. If these symptoms are frequent, severe, or do not improve with over-the-counter medications, consult a healthcare provider. Seek immediate medical attention for severe chest pain, a rapid heart rate, or bloody stools, as these could indicate a more serious complication.
How Hiatal Hernias Are Diagnosed
Healthcare professionals use specific medical procedures to accurately diagnose a hiatal hernia, as it cannot be detected by touch. One common method is an X-ray of the upper digestive system, often performed after the patient drinks a liquid containing barium. This barium coats the lining of the esophagus and stomach, allowing them to be clearly seen on X-ray images and revealing any part of the stomach that has bulged through the diaphragm.
Another diagnostic tool is an upper endoscopy, also known as esophagogastroduodenoscopy (EGD). During this procedure, a thin, flexible tube with a camera is guided down the throat to visualize the esophagus, stomach, and the initial part of the small intestine. This allows the doctor to observe the hernia, assess its size, and identify any related complications like inflammation. Esophageal manometry may also be used to measure muscle contractions and pressure within the esophagus, which can help assess its function and identify abnormalities.