Paraesophageal hernias are relatively rare, involving less than 1 percent of all hiatal hernias. These hernias occur when the stomach rotates up through the diaphragm to lie within the chest beside the esophagus. Over time these hernias can reach massive proportions.
Paraesophageal hernias may produce a wide variety of symptoms, including heartburn and regurgitation, difficulties with swallowing food, bloating and pain after meals, and bleeding from the stomach resulting in chronic anemia. They can also affect a patient’s respiratory status, causing shortness of breath during normal activities.
Because these hernias evolve over a long period of time and may not cause problems until the patient is older, symptoms are often attributed to aging, rather than to the underlying paraesophageal hernia. Many physicians are unaware of the clinical and quality-of-life impact these hernias can have on patients. In addition, the distinction between standard hiatal hernias and paraesophageal hernias is not well understood by most patients or their doctors.
