Hiatus Hernia

What is a hiatus hernia?

A hiatus hernia is when part of the stomach slides through an opening in the diaphragm called the hiatus. The diaphragm is a sheet of muscle that separates your chest from your abdomen (tummy.)

What causes a hiatus hernia?

The exact reasons why a hiatus hernia may develop are not fully understood and they can affect anyone.

They tend to be more common in:

• women
• people who are over 50
• pregnant women
• people who smoke

Symptoms of hiatus hernia

Most hiatus hernias do not cause any symptoms; however they can cause gastro-oesophageal reflux disease (GORD).

GORD occurs when the acid from the stomach goes into the oesophagus (the tube that goes from the mouth to the stomach). This may occur if the hiatus hernia prevents the valve at the bottom of the oesophagus from working properly.

Other symptoms may include:

• heartburn
• chest pain
• problem with swallowing
• unpleasant/sour taste in your mouth
• nausea or vomiting
• a cough/wheezing especially at night

Treatment for hiatus hernia

Treatment for hiatus hernia generally aims to relieve/ease the symptoms of GORD. Lifestyle changes and medication are the preferred treatments. Surgery maybe recommended as an alternative if you have tried other treatments that have not worked or if your symptoms are severe.

Lifestyle advice

• if you are overweight lose excess weight
• eat small meals more often
• try not to eat before you go to bed
• raise the head of the bed
• cut down or stop eating food or drink that make your symptoms worse

Foods that may make symptoms worse

• chocolate
• spicy food
• fatty food
• tomato-based foods
• alcoholic drinks
• drinks that contain caffeine such as coffee and cola

If you are unsure what foods may be causing your symptoms to be worse it might be helpful to keep a food diary so you can recognise which foods to stop eating or reduce intake of them.

Medicines

There are several different medicines available to deal with the symptoms that may be caused by a hiatus hernia, they work in different ways. You should discuss with your GP which medication is most suitable for you.

Surgery

If you have tried other treatments and they have not worked or your symptoms are severe your GP can refer you to a surgeon who will discuss different surgical options with you.

However if a hiatus hernia is not causing any problems it does not usually need to be treated.