Can a Hiatal Hernia Cause Upper Right Abdominal Pain? » Scary Symptoms

Medically reviewed by Santosh Sanagapalli, MD

Right upper abdominal pain is scary because that’s where the liver, pancreas and gallbladder are.

But can a hiatal hernia cause pain in the right upper quadrant of the abdomen?

After all, it would be more reassuring to the sufferer of this pain if it were being caused by a typical hiatal hernia than by liver cancer or pancreatitis.

Many things can cause right upper abdominal pain, including harmless gas bubbles – which can actually be quite painful.

Occasional discomfort in the right upper abdominal area may be caused by muscle spasms or irritated nerves from exercise, or from inflamed cartilage between the ribcage.

Hiatal Hernia and Abdominal Pain

“No, hiatal hernia is not a typical cause of right upper abdominal pain,” says Santosh Sanagapalli, MD, a consultant gastroenterologist, endoscopist and specialist in esophageal disorders.

“There is a much less common type of hiatal hernia that can cause chest and abdominal pain, called a paraesophageal hiatal hernia.

“The pain can be felt in the central chest or in the center of the upper abdomen (epigastric region).

“Such hernias often also cause difficulty swallowing, and are easily diagnosed on endoscopy, CT scan or barium swallow.

“When a paraesophageal hernia is determined to be present and causing such symptoms, it generally needs to be surgically repaired.”

The More Common Hernia

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“The majority of hiatal hernias are asymptomatic, and most patients with hiatal hernias would not even know they have one since they feel well,” says Dr. Sanagapalli.

“The main significance of hiatal hernias is that they predispose to developing GERD (acid reflux) by disrupting and weakening the anti-reflux barrier between the lower esophagus and stomach.

“Therefore, the most common symptoms in patients with a hiatal hernia are heartburn and regurgitation of acidic fluid. Sometimes, chest pain can be a manifestation of GERD in these patients.”

If you’ve been diagnosed with a hiatal hernia and are experiencing recurring pain in the upper right region of your abdomen, this may very well be another – and unrelated – condition, such as gallstones.

Don’t just assume it’s from the hiatal hernia. Have your doctor order tests to investigate possible causes.

Dr. Sanagapalli is a gastroenterologist and director of the Esophageal Disorders Center at St Vincent’s Hospital, Darlinghurst. He performs diagnostic and therapeutic endoscopic procedures, and enjoys providing comprehensive and holistic care to patients with a wide variety of disorders affecting the gastrointestinal tract.

Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.

Hiatus hernia – NHS

A hiatus hernia is when part of your stomach moves up into your chest. It’s very common if you’re over 50. It does not normally need treatment if it’s not causing you problems.

Check if you have a hiatus hernia

You can have a hiatus hernia without knowing and without it being a problem.

With a hiatus hernia you may:

• have a painful burning feeling in your chest, often after eating (heartburn)
• bring up small amounts of food or bitter-tasting fluids (acid reflux)
• have bad breath
• burp and feel bloated
• feel or be sick
• have difficulty or pain when swallowing

These are the symptoms of gastro-oesophageal reflux disease (GORD).

Non-urgent advice: See a GP if:

• your symptoms do not go away after 3 weeks
• your symptoms are very bad or getting worse
• medicines from the pharmacy do not help

Urgent advice: Get advice from 111 now if you have indigestion or acid reflux and:

• you have lost weight for no reason
• swallowing becomes difficult
• you’re being sick (vomiting) frequently
• there’s blood in your sick
• you have pain in your upper tummy

111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need it.

Go to 111. nhs.uk or call 111.

Other ways to get help

Get an urgent GP appointment

A GP may be able to help you.

Ask your GP practice for an urgent appointment.

Treatment for a hiatus hernia

Broadly, treatment follows these steps:

1. Change your eating habits, for example, eat smaller, more frequent meals and do other things to help with the symptoms of GORD.
2. If you smoke, try to give up, as it can irritate your digestive system and make your symptoms worse.
3. Buy medicines from the pharmacy (ask the pharmacist what you should take to help with the symptoms of GORD).
4. If medicines from the pharmacy and changing your eating habits do not help, see a GP, who can prescribe stronger medicines.
5. If stronger medicines do not work, a GP can send you for further tests to find out if your symptoms are caused by a hiatus hernia. They might also prescribe medicines for long-term GORD.
6. A GP might refer you to a specialist to check if you need surgery. This usually only happens if other treatments have not worked and you keep having very bad symptoms.

Surgery for a hiatus hernia

Keyhole surgery (also called a Laparoscopy) is usually used for a hiatus hernia. This involves making small cuts in your tummy (abdomen).

It’s done under general anaesthetic, so you’ll be asleep during the operation.

After surgery, it usually takes:

• 2 to 3 days to go home
• 3 to 6 weeks to go back to work
• 6 weeks before you can eat what you want
• a few months to recover from side effects like bloating, burping, farting and difficulty swallowing

There’s a small risk (about 1 in 100) that your side effects will not go away and you’ll need more surgery.

What causes a hiatus hernia

It’s not clear what causes a hiatus hernia. Anyone can have one, but it’s more common if you’re over 50, pregnant or overweight.

Page last reviewed: 01 April 2021
Next review due: 01 April 2024

Why does a hernia occur and how to cure it?

It is commonly believed that hernias are caused by exercising too intensely or by lifting weights. In this article, we will understand what a hernia is and what factors actually provoke its appearance.

Contents

• What is a hernia?
• Hernia symptoms
• Causes of hernia
• Diagnostics
• Treatment

Atlas has been researching DNA since 2013. We create opportunities for health management, relying only on scientifically proven facts.
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What is a hernia?

A hernia is a protrusion through a hole in the tissues of an internal organ from a cavity that it normally occupies.

The organ may protrude under the skin, into spaces between muscles, or into body cavities.

Source: wikipedia

There are many types of hernias. They are classified depending on the location. The following are most common:

1. Inguinal hernia is a protrusion of the peritoneum (the thin membrane covering the inner walls of the abdominal cavity) into the inguinal canal. In this case, the peritoneum forms the so-called “hernial sac”, into which organs from the abdominal cavity can enter. Inguinal hernia is much more common in men (27% risk), but women can also be affected (3% risk).
2. Femoral hernia , unlike inguinal hernia, is more common in women, especially pregnant or obese patients. The main difference between a femoral hernia and an inguinal hernia is its location. It is located below the inguinal ligament, in the area of ​​the femoro-inguinal fold. Inguinal hernia, on the contrary, is located above the inguinal ligament.
3. Umbilical hernia – protrusion of part of the small intestine through the structures of the umbilical ring. This hernia is common in infants, but also affects overweight women or those who have had multiple pregnancies.
4. Hiatal hernia or hiatal hernia. In this case, part of the stomach exits through a hole in the diaphragm, the thin layer of muscle that separates the chest from the abdomen.
5. Herniated disc is a protrusion of the nucleus of the intervertebral disc into the spinal canal. The intervertebral disc consists of an inner part – the nucleus of a gelatinous consistency – and an outer part – a dense fibrous ring. With a hernia of the spine, the integrity of the fibrous ring is violated, due to which part of the nucleus comes out.

The most common types of hernias are listed above, but there are others : postoperative, epigastric (when organs protrude between the sternum and navel), hernias of the Spigelian line of the abdomen (protrusion of organs just below the navel, to the right and left of it), muscular hernias .

Symptoms of a hernia

As a rule, a hernia is clearly visible : it is a bump or “bump” on the body, and sometimes it can be “set”, that is, pressed back, and in some cases it can disappear when the patient lies down .

The hernia reappears when coughing, laughing, straining during bowel movements or physical activity.

Other symptoms of a hernia include:

• swelling (for example, in an inguinal hernia – in the groin or scrotum),
• constant pain at the site of the protrusion,
• pain when lifting weights,
• feeling full stomach or bowel obstruction.

It is important to note that hiatal hernia (hiatal) may not be visible externally – there are no “bumps” or bulges on the body. Instead, symptoms may include heartburn, indigestion, difficulty swallowing, belching, or chest pain.

In the case of a herniated disc, the main symptom is pain .

Hernia pain usually occurs in the cervical or lumbar spine, and only on one side of the body. The pain may radiate to the leg (up to the foot) or to the shoulder and arm.

Also possible are numbness and tingling in the arms and legs, as well as loss of physical strength (up to the point that a person may start to stumble).

In addition, a hernia may be accompanied by a complication – pinching . This is a compression of the internal organ in the hole through which it protruded.

Pinching can lead to circulatory problems and, consequently, tissue necrosis. This complication requires urgent surgical intervention.

Symptoms of infringement:

• sharp and rapidly increasing pain,
• nausea,
• vomiting,
• inability to empty the bowels.

The hernia itself can become hard. These symptoms are a reason for immediate medical attention.

Causes of hernias

Due to the variety of types of hernias, it is impossible to form a single list of causes of their occurrence. In general, the appearance of a hernia requires the presence of predisposing factors and conditions that directly lead to rupture of muscles and tissues and, as a result, protrusion of the organ.

Predisposing factors include:

1) Genetics . Scientists have found that the predisposition to certain types of hernias is inherited. These include, for example, an inguinal hernia or a hernia of the spine.

Genetic variants in the WT1, EFEMP1, EBF2 and ADAMTS6 genes are associated with the risk of inguinal hernia.

The WT1 and EFEMP1 genes regulate the work of enzymes that break down collagen and elastin, the main components of connective tissue that provide its strength and elasticity.

A gene ADAMTS6 promotes the formation of collagen from its precursor procollagen.

The Atlas Genetic Test can identify combinations of gene variants that increase the risk of inguinal hernia.

Mutations in the ZFPM2, SOX7, GATA6, MYRF, NR2F2, KIF7, GLI3, PBX1, SLIT3, ROBO1, GPC3, NDST1, FREM1, FRAS1, FREM2 genes are associated with the risk of diaphragmatic hernia.

2) Increased physical activity . We are talking about regular intense sports or physical labor, which damage and weaken muscles, accelerate the destruction of intervertebral discs.

3) Age . Although a hernia can occur at any age (for example, umbilical hernias are common in infants), the risk of developing some types of hernia increases as a person ages.

For example, inguinal hernias most often appear either before the age of one year or after the age of 55.

In general, the older a person, the weaker his muscles, and therefore, the higher the likelihood of damage and rupture.

4) Overweight or underweight .

5) Adverse lifestyle factors : smoking, alcohol abuse.

However, there are not enough predisposing factors to cause a hernia. In order for a gap to appear in a muscle or other tissue (already weakened for the reasons listed), a certain “push” is needed.

Such an event could be a sudden increase in load or pressure on the affected organ, such as heavy lifting, prolonged diarrhea or severe coughing.

Diagnosis

Usually a doctor can make a diagnosis based on the examination of the patient.

If necessary, to confirm the diagnosis or to better understand the condition of the hernia, the specialist may prescribe additional examinations:

• ultrasound,
• computed tomography,
• magnetic resonance imaging (in case of a herniated disc).

Hernia treatment

Hernia cannot go away on its own, so the only way to get rid of it is surgical treatment.

Hernia removal can be done either by traditional surgery or by laparoscopy, a minimally invasive surgery performed through a small incision using special instruments.

However, surgery is not always necessary. If the hernia is small and “does not grow”, and there are no pinched internal organs, then the doctor may advise you to simply observe it. In this case, it is important to really monitor the condition of the hernia and, if there are signs of deterioration, contact a specialist again.

For example, an inguinal or femoral hernia that is not removed in time can lead to a number of complications and can lead to intestinal entrapment. Because of this, its blood supply is disrupted and obstruction occurs – in this case, emergency hospitalization and surgery will be required.

More similar blog articles Atlas:

• Osteochondrosis: where does it hurt and how to treat it?
• Osteoporosis: how and why do bones become brittle?

• Cleveland Clinic, Hernia, 2018
• WebMD, Understanding Hernia – the Basics, 2021
• Frontiers in Surgery, Etiology of Inguinal Hernias: A Comprehensive Review, 2017
• National Health Service, Hernia, 2019
• Mayo Clinic, Herniated disk, 2019

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On our website in the section Home / Applicants / Applicants (specialist / bachelor / master) there is a video that details the rules for admission to Ryazan State Medical University.

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We invite you, dear applicants, to take intensive courses to prepare for the entrance exams, conducted by the university itself.

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Ryazan State Medical University student winner of the All-Russian Festival of Youth Science “Springboard to Science – 2023”

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RyazGMU employees were awarded honorary titles
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Presentation of diplomas of education
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Environmental Initiative
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WE TELL YOU WHO IS ALREADY AVAILABLE ONLINE PAYMENT FOR TRAINING IN RYAZGMU

Now all students of the FDPO RyazGMU can pay for training without leaving their homes. You can pay online and without commission using the new service pay.rzgmu.ru

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TRAINING UNDER THE PROGRAM “NURSING IN PEDIATRICS” IS COMPLETED
On February 16, the 144-hour advanced training program “Nursing in Pediatrics” ended. During the training, nurses in the Ryazan region improved their knowledge and skills in nursing care for a healthy and sick child with infectious and somatic pathology, prevention of somatic and infectious pathology in childhood in accordance with the regulatory framework, professional standards and clinical recommendations.

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BASIC EMERGENCY FIRST AID COURSE

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INTESTINAL OBSTRUCTION IN CHILDREN OVER THE NEWBORN PERIOD

Dear Colleagues! We invite you to the scientific and educational school “Intestinal obstruction in children older than the neonatal period”, which will be held on June 23, 2023. The event will discuss topical issues of diagnosis, treatment and tactics of the surgeon in intestinal obstruction in children.

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SCIENTIFIC AND PRACTICAL CONFERENCE
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I Congress of Therapists of the Central Federal District
8-9June at the Ryazan State Medical University will host a forum focused on practical healthcare professionals. The organizers are RNMOT, the Ministry of Health of the Ryazan Region and the Ryazan State Medical University.

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In June, the second cycle of training “Fundamentals of Kinesiology Taping” starts
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Physical and Rehabilitation Medicine in Pediatrics
On June 3, 2023, the University will host the Interregional Scientific and Practical Conference “Physical and Rehabilitation Medicine in Pediatrics”. Beginning at 10.00 in the hall of the Academic Council, at the address: Ryazan, st. Vysokovoltnaya, d. 7, bldg. 1, 4th floor.

05/25/2023

Mental health service: achievements and prospects
We invite you to take part in the IX Interregional Scientific and Practical Conference “Mental Health Service: Achievements and Prospects. Dedicated to the 135th anniversary of the Ryazan Regional Clinical Psychiatric Hospital. N.N. Bazhenov”, which will be held on June 2, 2023 on the basis of the Ryazan Regional Clinical Psychiatric Hospital. Bazhenova N.N.

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WE INVITE YOU TO READ THE PROGRAM OF THE CONFERENCE “TOPICAL ISSUES OF THERAPY AND GENERAL MEDICAL PRACTICE”

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To the attention of graduates, students and residents!
The annual large-scale event at the Ryazan Medical University – Job Fair 2023 – will be held on Tuesday, May 23 at 11 am in the foyer of the first and second floors of the medical and preventive building (Vysokovoltnaya st.