A hiatal hernia occurs when the upper part of the stomach pushes or bulges through a small opening in the diaphragm, the muscular wall separating the abdomen from the chest. This opening, known as the hiatus, normally allows the esophagus to pass through and connect to the stomach. While many small hiatal hernias do not cause any noticeable symptoms, larger ones can lead to various forms of discomfort.
Understanding Where Pain Occurs
Pain associated with a hiatal hernia is typically felt in the upper abdomen and chest, particularly behind the breastbone or around the base of the ribcage. This discomfort stems from the stomach’s displacement and irritation.
The pain experienced in these regions often stems from acid reflux, where stomach acid flows back into the esophagus, irritating its lining. This irritation can manifest higher or lower in the chest.
Additionally, the hernia itself can cause pain if it becomes compressed or pinched during activities like bending over, coughing, or lifting heavy objects. The diaphragm, being a muscle, can also be irritated by the hernia, leading to discomfort.
While the query specifically asks about pain in men, the locations of hiatal hernia pain are generally consistent across all individuals, regardless of sex. This is because the underlying anatomical changes and physiological responses to the hernia are universal.
Some individuals may experience referred pain, felt in areas seemingly unrelated to the stomach, such as the upper back (often between the shoulder blades), neck, or shoulders. This occurs because nerves supplying the stomach and diaphragm share pathways with nerves extending to these distant body parts, and pressure from the displaced stomach can contribute to this radiating pain.
Characteristics of Pain and Other Symptoms
The nature of hiatal hernia pain can vary, often described as a burning sensation, especially in the chest, which is characteristic of heartburn. This burning discomfort can frequently occur after eating. Other descriptions of the pain include aching, pressure, or a feeling of fullness in the upper abdomen. Some individuals may also experience a sharp pain.
Beyond pain, hiatal hernias are frequently accompanied by a range of other symptoms, primarily due to gastroesophageal reflux disease (GERD). These include acid regurgitation, where food or liquids flow back into the mouth, often with a sour taste, and difficulty swallowing (dysphagia), sometimes feeling like a lump in the throat. Other digestive symptoms include belching, bloating, and nausea.
A persistent cough, particularly at night, or hoarseness can also occur if stomach acid irritates the windpipe or vocal cords. In some cases, feeling full very quickly after eating only a small amount of food is reported, as the stomach may be compressed.
When to Seek Medical Advice
Anyone experiencing persistent or worsening symptoms suggestive of a hiatal hernia should consult a healthcare professional for proper diagnosis and management. Self-diagnosis is not recommended, as symptoms can overlap with other conditions. A medical evaluation can determine the exact cause of the discomfort and recommend appropriate treatment.
Certain symptoms warrant immediate medical attention:
Severe, sudden, or persistent chest pain, especially if it feels like a heart attack.
Difficulty breathing or shortness of breath, which can occur if the hernia is pressing on the lungs.
Vomiting blood or black, tarry stools, as these can indicate bleeding in the digestive tract.
Inability to pass gas or stool, or severe pain accompanied by retching or vomiting, which could signal a serious complication like a strangulated hernia.
Such situations are medical emergencies requiring prompt intervention.