A hiatus hernia, or hiatal hernia,is when part ofthe stomach squeezes up into the chest through an opening ("hiatus") inthe diaphragm.

The diaphragm is a large, thin sheet of musclebetween the chestand the abdomen (tummy).

Hiatus hernia and heartburn

A hiatus hernia itself rarelyhas any noticeable symptoms. However, it can cause a problem called gastro-oesophageal reflux disease (GORD) .

GORD is where stomach acid leaks into the oesophagus (the tube that carries food to the stomach). It can occur if a hiatus hernia prevents the valve at the bottom of the oesophagus from working properly.

Your oesophagus can becomeseverely irritated, because it's not protected against stomach acid. This can cause symptoms such as heartburn, chest pain , an unpleasant sourtaste in your mouth, and swallowing problems ( dysphagia ).

You should see your GP if you have frequent and severe symptoms of GORD .

What causes a hiatus hernia?

It's not exactly clear what causes hiatus hernia, but it may be the result of the diaphragm becoming weak with age, or pressure on the abdomen.

Hiatus hernia can sometimes occur in newborn babies if the stomach or diaphragm doesn't develop properly.

Who's affected

Hiatus hernia can affect anyone, but it's more common in people who are:

  • over 50 years of age
  • overweight
  • pregnant

It's estimated that a third of people over 50 have a hiatus hernia.

There's also arare type of hiatus hernia that affects newborn babies, whichis caused by a congenital defect of the stomach or diaphragm. Congenital means that it is present from birth.

Types of hiatus hernia

There are two main types of hiatus hernia. They are:

  • sliding hiatus hernias hernias thatmove up and down, in and out of the chest area (more than 80% of hiatus hernias are of this type)
  • para-oesophageal hiatus hernias also called rolling hiatus hernias, where part of the stomach pushes up through the hole in the diaphragm next to the oesophagus (about 5-15% of hiatus hernias are of this type)

These pagesmainly focus on sliding hiatus hernias. They can usually be diagnosed using an X-ray or an endoscopy , where a long, thin flexible tube with a light and video camera at one end is used to examine the inside of the body.

Surgery is usually only recommended as an alternative to long-term medication or if other treatments haven't worked.

Lifestyle advicemay include:

  • eating smaller, more frequent meals, rather than three large meals a day
  • avoiding lying down (including going to bed) for three hours after eating or drinking
  • removing any foods or drinksfrom your dietthat make your symptoms worse

If a hiatus hernia isn't causing any noticeable problems, it doesn't usually need to be treated.

Surgery is used to repair a para-oesophageal hiatus hernia if there's arisk of serious complications.


Further problems

It's rare for a hiatus hernia to cause complications,but long-term damageto the oesophaguscaused byleaking stomach acid can lead toulcers, scarring and changes to the cells of the oesophagus,which can increase your risk of oesophageal cancer .


Content supplied by the NHS Website

Medically Reviewed by a doctor on 4 Jan 2017