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Forum Name: Gastroenterology Topics

Question: Hiatal Hernia


 cjpett - Mon Jul 26, 2010 7:36 am

Hi, I am a 25 yr old female and I think I might have a hiatal hernia. I have had nausea for the past 4 months with no vomiting. It is pretty much constant and it feels like I have something stuck in the back of my throat or like I am being choked but from the inside. I haven't felt any heartburn, but I also have moderate upper abdominal pain and it hurts when I press right underneath my sternum. Also I've been feeling some chest pain and sometimes I feel pain in my ear (not sure if that's related). If I'm right about the hernia, I think it was caused by the fact that I had been bloated for a few months prior due to a complex ovarian cyst and the bloating pushed my stomach into my esophagus. This was around the time I started to feel the nausea. Should I go see my doctor? Is there anything I can take OTC or try on my own to fix the problem?
 Dr.M.Aroon kamath - Sat Sep 04, 2010 10:02 am

User avatar Hi,
Your symptoms are not "typical" for a hiatus hernia.
What you are describing is similar to a "Globus" sensation (Globus phryngeus). This may be defined as a persistent or intermittent sensation of foreign body or a lump in the throat for at least 12 weeks.

Other symptoms which may co-exist are..
- discomfort in the ear,
- a Gagging sensation,
- difficulty in swallowing (Repeated swallowing does not usually resolve the sensation), &
- muffling of the voice.

"globus sensation" is often caused by causes outside the throat.

It can be either
- organic, or
- psychologic, psychiatric or stress related.

The contributions of organic and the non-organic causes to the symptomatology in an individual case is difficult to quantify.

Some of the the more common organic causes are..
- gastroesophageal reflux disease (GERD),
- upper esophageal sphincter (UES) abnormalities,
- drug induced esophagitis,
- extremely enlarged tonsils,
- epiglottic masses,and
- enlargement of the uvula (infection, allergic reactions, reflux induced, or even due to severe snoring).

Apart from globus sensation, the other cause which needs to be excluded is what is known as "Panic attacks". Panic attacks are manifested by an acute anxiety coupled with an intense physiological response. An affected person may feel close to death and extremely frightened.This may occur as an isolated occurrence or may be recurrent. Duration also varies.

You will certainly need an upper GI endoscopy to begin with. Other tests such as a 24-hr pH study and an electrocardiography may also be considered.
Good luck!

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