Hiatus hernia | Health Information | Bupa UK
Below is an article on the topic Hiatus hernia | Health Information | Bupa UK compiled by the editors of Gootoplist.com. Gootoplist - a general information page about useful tips for life
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Expert reviewer, Mr Peter Lamb, Consultant General and Upper Gastrointestinal Surgeon
Next review due October 2023
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.
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:
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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 GP.
You should also see your GP urgently if you’re having difficulty swallowing, or food gets stuck.
If you see your GP, 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 GP 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 GP 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.
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 (PDF, 1.4MB) 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. Use our Food and symptoms diary in the Self-help section above to help identify foods that may cause you problems.
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.
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Barrett's oesophagus is when the cells that line the lower part of your oesophagus get damaged by acid and bile travelling upwards from your stomach.
Fundoplication is an operation to treat gastro-oesophageal reflux disease (GORD) when it can’t be controlled with lifestyle changes and medicines.
Indigestion medicines can be used to relieve pain or discomfort in your upper abdomen (tummy) or chest that may occur soon after meals.
This information is for you if you have indigestion and are considering seeing your doctor.
Reviewed by Pippa Coulter, Freelance Health Editor, October 2020
Expert reviewer, Mr Peter Lamb, Consultant General and Upper Gastrointestinal Surgeon
Next review due October 2023
This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.
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