In many cases, hiatus hernia does not cause any symptoms. The most frequent symptom is retrosternal or epigastric distress. Other symptoms include belching, fullness in the upper abdomen, and regurgitation. Complications include hemorrhage, esophagitis and stricture of the esophagus. Surgical treatment should be used only in cases in which complications are a serious problem or in cases in which the patients do not respond to adequate medical treatment.