The anatomical relation between the diaphragm and the Lowe Esophageal Sphincter LES prevents the gastric acids to come up into the esophagus (reflux). When the upper part of the stomach prolapses through the diaphragm (where the esophagus pass into the abdomen (esophageal hiatus- opening) into the chest, the condition is known as hiatal hernia.
In this condition people will experience one or more of these symptoms, chest pain, especially at night while lying down, swallowing problems and GERD with or without heart burn.
The size of a hiatal hernia and the severity of the symptoms are not correlated. The presence of hitaus hernia aggravates the GERD condition. Acid reflux causes severe pain and discomfort in the chest.
Esophagitis is a known complication of GERD and can lead to esophageal spasm, that can alone give similar clinical picture.
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