Is a hiatus hernia associated with severe pain?

GERD: A hiatal hernia is often associated with gastro-esophageal reflux disease (gerd). This can be associated with severe "heartburn", especially after bending over, lying down or after eating some foods.

Sometimes: Large hiatal hernias can cause severe pain in the lower chest and upper abdomen. The pain is crampy, and often described as a pressure sensation like there is a balloon inside that is trying to burst. It is typically worse after meals. If this is progressive, you need to see a general surgeon with experience in laparoscopic hiatal hernia repair soon to avoid complications of the hernia itself.