A hiatus hernia is when part of your stomach slides upwards into your chest, which can cause symptoms such as heartburn. You don’t necessarily need any treatment for a hiatus hernia, but if it’s causing any problems there are lots of things that can help.
How a sliding hiatus hernia forms
Usually, your stomach sits completely below a sheet of muscle, called your diaphragm. This separates your chest from your abdomen (tummy). There’s an opening in your diaphragm called a hiatus. Your oesophagus (the tube that carried food from your mouth to your stomach) passes through the hiatus. A hiatus hernia usually develops when part of your stomach slides up through this opening and into your chest.
A hiatus hernia doesn’t always cause problems. But it may allow acid from your stomach to travel the wrong way, back up your oesophagus. This is called gastro-oesophageal reflux disease (GORD), or acid reflux, and this is what causes your symptoms.
There are two main types of hiatus hernia.
You can also have a mixed hiatus hernia, which is a combination of these types. These can become very large and include a lot of your stomach. You’re more likely to need surgery for this type.
Hiatus hernias are very common. Up to half of the population may have one, although it’s hard to say for sure, as many people don’t have symptoms. There are certain factors that make you more likely to develop a hiatus hernia. These include:
Many people with a hiatus hernia don’t have any symptoms.
But, if you have a sliding hiatus hernia, you may develop gastro-oesophageal reflux disease (GORD). This is when acid from your stomach travels back up your oesophagus. Symptoms of GORD can include:
You may notice certain things cause a flare-up of your symptoms, such as particular foods, drinking alcohol or feeling stressed. See the self-help section below for more information.
You can usually manage symptoms like these yourself, without needing to see a doctor. But if your symptoms don’t go away with over-the-counter medicines and lifestyle changes, or your symptoms are severe or getting worse, see your doctor.
You should also see your doctor urgently if you’re having difficulty swallowing, or food gets stuck.
If you see your doctor, they’ll ask about your symptoms, how they affect you and what could be triggering them. They may also ask about your family history, and examine you too. Your doctor can let you know things you can try to help improve your symptoms, without the need for tests.
If these measures haven’t worked or your doctor has any concerns about your symptoms, they may refer you to a gastroenterologist for further investigation and assessment. A gastroenterologist is a doctor who specialises in conditions of the digestive system. Your gastroenterologist may recommend you have some of the following tests.
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There’s a lot you can do yourself to ease the symptoms of a hiatus hernia, and to help stop them from happening again.
Try printing and filling out the food and symptoms diary below to help you identify foods that cause you problems.
Treatment for hiatus hernia depends on how severe your symptoms are and how much they’re bothering you. You won’t usually need treatment for a hiatus hernia at all if it’s not causing you any problems.
If you do get symptoms, making changes to your lifestyle and taking medicines can help to ease them, but they won’t cure your hiatus hernia.
There are lots of indigestion medicines that can ease the symptoms of heartburn when they happen. You can buy many of these without a prescription, but some need to be prescribed by a doctor. Ask your pharmacist for advice if you need it.
Medicines which may be used to treat the symptoms of a hiatus hernia include the following:
If medicines aren’t controlling your symptoms, they’re causing side-effects or you don’t want to carry on taking them long term, speak to your doctor. They may suggest you see a specialist surgeon to consider an operation.
If you have a rolling or a mixed hiatus hernia and have pain or vomiting after eating, then your doctor should also refer you to a specialist surgeon to consider an operation.
The most common surgical treatment for a hiatus hernia is an operation called a fundoplication. This is often done as a keyhole (laparoscopic) procedure, but sometimes you may need open surgery. It involves repairing your hiatus hernia and wrapping the top part of your stomach around your lower oesophagus (the tube that carries food from your mouth to your stomach). This can help to control your symptoms as well as reduce your hiatus hernia.
Occasionally, a hiatus hernia can lead to more serious problems.
Occasionally, if your hiatus hernia keeps letting stomach acid come up into your oesophagus, it can lead to more serious complications. These include the following.
If you have a rolling hernia, the part of your stomach which has gone up into your chest can become trapped by the diaphragm, cutting off the blood supply. This is called a strangulated hernia and causes severe pain. If this happens, it is an emergency and you’ll need an operation immediately.
Heartburn isn’t always related to having a hiatus hernia. There are lots of other things that can trigger the symptoms of heartburn, such as:
Most people who have a hiatus hernia don’t have any serious problems. If your symptoms respond well to medicines, it’s not always necessary to have any tests to find out.
Many people who have a hiatus hernia have no symptoms. However, if you have symptoms such as heartburn, you may find that avoiding certain foods helps prevent these.
There’s no clear scientific evidence about which foods make symptoms of hiatus hernia worse. However, doctors often recommend that you try avoiding:
You may already be aware that some of these or other foods trigger your symptoms.
Try eating small meals only and avoid eating for a few hours before sleeping. And remember that even if you cut out some foods, it’s important to keep eating a healthy balanced diet.
The information and/or article is solely the contribution of Bupa, (hereinafter referred to as “Bupa UK”) a United Kingdom (UK) based healthcare services expert and is based on their experiences and medical practices prevalent in UK. All the efforts to ensure accuracy and relevance of the content is undertaken by Bupa UK. The content of the article should not be construed as a statement of law or used for any legal purpsoe or otherwise. Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited) (hereinafter referred to as “the Company”) hereby expressly disown and repudiated any claims (including but not limited to any third party claims or liability, of any nature, whatsoever) in relation to the accuracy, completeness, usefulness and real-time of any information and contents available in this article, and against any intended purposes (of any kind whatsoever) by use thereof, by the user/s (whether used by user/s directly or indirectly). Users are advised to obtain appropriate professional advice and/or medical opinion, before acting on the information provided, from time to time, in the article(s).
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