Is a paraesophageal hernia dangerous?

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Paraesophageal vs. sliding hiatal hernia

In the common sliding hiatal hernia, the top of the stomach slides up through the diaphragm along with the end of the esophagus. In a paraesophageal hernia, part of the stomach, and sometimes other organs, pushes up beside the esophagus into the chest. Paraesophageal hernias tend to be larger and are more likely to cause problems.

Common symptoms

• Chest or upper-belly pressure or pain after eating
• Feeling full quickly, bloating, nausea or vomiting
• Food sticking or trouble swallowing
• Shortness of breath after meals
• Anemia (low blood count) from slow bleeding in the stomach

Some people have no symptoms at all.

How it is treated

Not every paraesophageal hernia needs an operation right away. Dr. Tufts weighs your symptoms, the size of the hernia and your overall health. When repair is recommended, it is done with minimally invasive surgery: the stomach is returned to the abdomen, the opening in the diaphragm is tightened, and an anti-reflux wrap is usually added. Recurrent paraesophageal hernias are primarily repaired with the Da Vinci robotic system.

When to see a surgeon

• A paraesophageal or large hiatal hernia on a CT scan, X-ray or endoscopy
• Pressure, fullness, vomiting or trouble swallowing after meals
• Unexplained anemia

Get urgent care: Go to the emergency room for sudden severe chest or upper-belly pain, retching without bringing anything up, being unable to keep anything down, or vomiting blood.

Learn more: Hiatal & paraesophageal hernia guide (with illustrations) · Reflux & hiatal hernia overview

Talk with Dr. Tufts

Dr. Tufts is a minimally invasive and endoscopic general surgeon. To have your symptoms evaluated or talk through your options, call (941) 391-5102 to schedule a visit at Charlotte Harbor Surgical, 4245 Kings Hwy, Unit A, Port Charlotte, FL 33980. We see patients from Port Charlotte, Punta Gorda, North Port, Englewood, Cape Coral and North Fort Myers and across Southwest Florida.

Written and medically reviewed by Dr. Matthew Tufts, MD, FACS, a board-certified minimally invasive and endoscopic general surgeon in Port Charlotte, FL. Last reviewed 2026-11-11.

This page is general information, not medical advice. Every patient is different. Dr. Tufts will review your history, exam and test results with you and explain the options, benefits and risks that apply to you.