(See also Overview of Esophageal and Swallowing Disorders.)
There are 2 main types of hiatus hernia:
Hernias may also occur through other parts of the diaphragm (see Diaphragmatic Hernia).
A sliding hiatus hernia is common and is an incidental finding on x-ray in > 40% of the population; therefore, the relationship of hernia to symptoms is unclear. Although most patients with GERD have some degree of hiatus hernia, < 50% of patients with hiatus hernia have GERD.
Most patients with a sliding hiatus hernia are asymptomatic, but chest pain and other reflux symptoms can occur. A paraesophageal hiatus hernia is generally asymptomatic but, unlike a sliding hiatus hernia, may incarcerate and strangulate. Occult or massive gastrointestinal hemorrhage may occur with either type.