When an internal body part pushes into another area of the body, it is called a hernia. When the stomach moves up through the diaphragm – as in a hiatal hernia – and distorts the esophagus, it is called a paraesophageal hernia. Paraesophageal hernias will increase in size over time, and may involve the entire stomach and other organs, like the colon or small bowel, bulging into the chest cavity. If they become twisted, the blood supply to the stomach can be interrupted, necessitating immediate treatment.
Signs and symptoms of a paraesophageal hernia can include:
Based on your medical history and your signs and symptoms, your doctor may suspect a hernia and refer you to a gastroenterologist. Tests and procedures used to diagnose a paraesophageal hernia include:
Paraesophageal hernias may be initially treated with medication or lifestyle changes. If it is confirmed that you have a paraesophageal hernia, you should be assessed by a surgeon.
Dietary and Lifestyle Changes
Your doctor will review your symptoms with you and may recommend that you:
Surgery
When medications do not relieve heartburn and acid reflux, or if complications such as severe inflammation or narrowing of the esophagus arise, surgery may be required. Virginia Mason’s esophageal surgery team members are experts in repairing paraesophageal hernias, and will use the most current evidence to guide you in understanding which surgical approach is best for you, including the possibility of minimally invasive surgery. The aims of surgery may include pulling your stomach back down into your abdomen, decreasing the size of the opening in your diaphragm, reconstructing an esophageal sphincter or removing the hernia sac.
To schedule an appointment with Virginia Mason's thoracic surgeons call (206) 341-1905.