Your oesophagus connects to your stomach by passing through a gap in your diaphragm called the hiatus. A hiatus hernia develops when part of your intestines, usually the stomach, squeezes through this hole.
A hiatus hernia can affect the diaphragm’s ability to stop stomach acid escaping into your oesophagus (gullet), triggering acid reflux. This can cause heartburn and, in some cases, gastro-oesophageal reflux disease (GORD).
Having a hiatus hernia is very common and can affect anyone at any age, although it’s more likely if you’re older. It’s estimated that one in three people over the age of 50 has a hiatus hernia. You’re also more likely to develop a hiatus hernia if you’re overweight or pregnant.
In many cases, a hiatus hernia requires no treatment – simple lifestyle changes can relieve any symptoms. However, sometimes hiatus hernia medication or surgery may be necessary.
A hiatus hernia is often symptomless and won’t give you any problems.
If symptoms do occur, the most common is heartburn. Other hiatus hernia symptoms include:
Occasionally, heartburn caused by a hiatus hernia can trigger severe chest pain. It can be difficult to distinguish chest pain associated with a hiatus hernia from a heart attack, so if you do have chest pain, seek medical attention immediately.
If your hiatus hernia symptoms continue for over three weeks and over-the-counter medication isn’t helping, see your GP.
Your GP will discuss your symptoms and your general health. Your GP may refer you to a gastroenterologist (a consultant specialising in the digestive system) for further assessment and treatment.
The tests you may need include:
It’s unclear what the causes of a hiatus hernia are, but it may be:
There are several ways you can help relieve hiatus hernia symptoms. These include:
Over-the-counter medications such as antacids may successfully relieve your hiatus hernia symptoms, especially heartburn. Alternatively, your GP or consultant may prescribe a short course of medication to suppress or reduce the production of stomach acid.
If lifestyle changes and medication are unsuccessful and your symptoms are very severe, your GP or consultant may suggest surgery. A hiatus hernia operation is usually done as keyhole (laparoscopic) surgery and has a good success rate. However, further surgery may be required if the hiatus hernia returns.