11 Hiatal Hernia Symptoms

2. Chest Pain

You may feel chest pain with a hiatal hernia when part of your stomach moves upward through the diaphragm and presses against your chest. This pain often feels like pressure, tightness, or burning in the center of the chest.

The discomfort can be mild or severe and may occur after eating, bending over, or lying down. Some people describe it as a dull ache behind the breastbone, while others feel discomfort that starts in the upper stomach and moves upward.

Chest pain is often accompanied by other symptoms such as a sour taste in the mouth, bloating, or difficulty swallowing. Unlike heart-related chest pain, discomfort linked to a hiatal hernia often improves when sitting upright or using antacid-type medicines.

3. Reflux

Reflux occurs when stomach acid moves upward into the esophagus, the tube that connects your mouth to your stomach. This backflow can cause a burning sensation in the chest, commonly known as heartburn. When a hiatal hernia is present, part of the stomach pushes through the diaphragm, increasing pressure and making reflux more likely.

Symptoms may include a sour or bitter taste in the mouth, regurgitation of food or liquid after eating, and discomfort when bending over or lying down. Some people also experience a sore throat or a cough that worsens at night.

Reflux can range from mild to uncomfortable and often becomes more noticeable after large meals or after eating certain foods, such as fried foods, chocolate, or citrus. Medicines that reduce or block stomach acid, including antacids or acid-suppressing medications, can ease discomfort but do not correct the hernia itself.

4. Difficulty Swallowing

You may notice that swallowing feels harder than usual with a hiatal hernia. This happens when part of the stomach bulges through the diaphragm and presses on the lower esophagus, making it harder for food to move down smoothly.

Some people feel as though food gets stuck in the chest or throat, especially when eating solid or dry foods, and may need to drink liquids between bites to help swallowing. Difficulty swallowing, also called dysphagia, can also be linked to acid reflux. When stomach acid flows back into the esophagus, it can irritate the lining and cause swelling, which narrows the passage and increases discomfort.

Eating smaller meals, chewing food thoroughly, and avoiding foods that trigger reflux, such as fried or spicy foods, can help reduce pressure on the esophagus. Antacids and other acid-reducing medications can help relieve irritation and enhance comfort.

5. Difficulty Moving

You might not expect a hiatal hernia to affect movement, but when part of the stomach pushes upward through the diaphragm, it can create pressure in the chest and upper abdomen. This pressure may cause pain, tightness, or a burning sensation.

Bending, lifting, twisting, standing up quickly, or lying flat may increase pressure and trigger symptoms. Some people also find that stretching or intense movements make it harder to take a deep breath.

Activities like exercise, heavy lifting, or sudden movements can become uncomfortable, particularly when they involve the abdominal muscles. Over time, some individuals may limit movement or avoid certain activities to prevent discomfort or pain.

6. Vomiting Blood

Vomiting blood can occur in some people with a hiatal hernia, especially when ongoing acid reflux irritates the lining of the esophagus or causes small tears. Repeated exposure to stomach acid can inflame the lower esophagus and cause tiny blood vessels to break, leading to streaks or clots of blood in vomit.

The appearance of the blood can vary. It may look bright red when bleeding is recent, or dark and grainy, resembling coffee grounds, if it has been exposed to stomach acid for a longer time. Vomiting blood may also follow frequent or forceful vomiting, which places extra strain on the tissues of the throat and chest. Because this symptom can signal internal bleeding, vomiting blood should always be treated seriously.

7. Black Stools

Black or tarry stools can be a sign that blood has mixed with stool during digestion. This usually happens when bleeding occurs in the upper digestive tract, such as the esophagus or stomach. As blood passes through the intestines, stomach acid changes its color, which causes the stool to appear black.

In people with a hiatal hernia, ongoing irritation from stomach acid can damage the lining of the esophagus. If the tissue becomes inflamed or develops small sores, small amounts of bleeding may occur. When this happens repeatedly over time, it can lead to dark stools. You may also notice a strong, unpleasant odor, which is common when blood is present in stool.

Some people may feel unusually tired or weak if bleeding continues, because the body is losing red blood cells. However, not all black stools are caused by bleeding. Dark-colored foods such as black licorice and supplements like iron can also darken stool.

8. Tiredness and Fever

You might feel more tired than usual if you have a hiatal hernia. Ongoing heartburn, chest discomfort, and disrupted sleep can gradually wear your body down. When acid reflux interferes with your rest at night, sleep may feel less refreshing, which can leave you feeling drained the next day.

Tiredness can also be linked to eating difficulties. If meals often trigger reflux, nausea, or discomfort, you may begin eating less, which can reduce your overall energy levels. In some cases, your body may also use more energy trying to manage ongoing digestive discomfort after meals. A mild fever is not a typical symptom of a hiatal hernia on its own. However, irritation or inflammation in the esophagus caused by frequent acid reflux can sometimes lead to a low-grade fever.

9. Passing Out

In rare cases, pain linked to a hiatal hernia can become intense enough to cause fainting. This may happen when severe pain overstimulates the vagus nerve, which helps regulate breathing, heart rate, and blood pressure.

When this response is triggered, blood pressure can drop suddenly, leading to lightheadedness or loss of consciousness. This type of fainting is called vasovagal syncope and can also occur in other situations, such as during extreme stress or at the sight of blood. Some people report feeling sudden, overwhelming pain before passing out.

After regaining consciousness, individuals may notice lingering symptoms such as weakness, difficulty moving comfortably, acid reflux, nausea, or vomiting. Because fainting can signal a serious reaction, any episode of passing out should be taken seriously and evaluated by a medical professional.

10. Insomnia

You may find it harder to fall asleep or stay asleep when you have a hiatal hernia. Discomfort from heartburn or acid reflux often becomes worse when you lie flat, which can lead to tossing and turning and broken sleep.

Some people also notice nighttime coughing, chest discomfort, or a sour taste in the mouth. Lying flat makes it easier for acid to rise, while keeping the upper body slightly elevated can help reduce reflux. Using a wedge pillow or raising the head of the bed may help limit nighttime symptoms.

Eating large meals close to bedtime can worsen symptoms. Late-night snacking, caffeine, alcohol, and spicy or fatty foods may also increase reflux and make sleep more difficult. Ongoing sleep problems can leave you feeling tired and less focused during the day.

11. Risk Factors

You are more likely to develop a hiatal hernia as you get older. As time passes, the muscles supporting the diaphragm weaken, allowing part of the stomach to push upward more easily. This helps explain why many people diagnosed with a hiatal hernia are over the age of 50. Increased pressure inside the abdomen can also raise the risk.

This pressure may come from obesity, pregnancy, or frequent heavy lifting. Ongoing coughing or repeated straining during bowel movements can also increase abdominal pressure enough to affect the diaphragm. Some people are born with a larger-than-normal opening in the diaphragm, which allows the stomach to move upward more easily.