hiatal hernia : Complications

Some large hiatal hernias create friction that causes lesions in the upper stomach. If severe, these lesions can bleed and lead to iron deficiency anemia from chronic blood loss.

Other hernias become so large that one-third or more of the stomach protrudes through the diaphragm, putting extra pressure on the diaphragm or lungs. And occasionally, the part of the stomach that protrudes into the chest cavity becomes twisted or cuts off blood flow to the rest of the stomach, producing severe chest pain and difficulty swallowing. If this occurs, see your doctor without delay. You may require immediate surgical repair of the hernia.

The most common complication of hiatal hernia is probably gastroesophageal reflux disease (GERD). At one time it was thought that hiatal hernias caused most cases of GERD. Now doctors believe that only larger hiatal hernias play a role. Recurrent GERD itself can lead to complications, including:

Difficulty swallowing. Stomach acid backing up into your esophagus can cause inflammation and scarring. This narrows your esophagus, making it hard for you to swallow.
Barrett's esophagus. Occasionally, people with gastroesophageal reflux develop Barrett's esophagus from repeated, long-term exposure to stomach acid. In this condition, cells similar to those in the stomach lining develop in the lower esophagus. If you have Barrett's esophagus, you're at increased risk of developing esophageal cancer. A doctor who specializes in stomach and intestinal problems (gastroenterologist) can advise you how best to manage the condition to lessen this risk.
Esophageal cancer. Most people with Barrett's esophagus don't develop esophageal cancer, but for those who do, the prognosis is often poor. An esophageal tumor makes swallowing increasingly difficult and for some people, eventually impossible.


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