What is Hiatus Hernia?
A hiatus hernia happens when part of the stomach moves up through the opening in the diaphragm and into the chest. Some people have no symptoms at all, while others develop reflux-related symptoms.
Symptoms
Common symptoms include heartburn, acid reflux, bloating, feeling or being sick, bad breath, and difficulty or pain when swallowing. Symptoms often feel worse after eating.
Diagnosis
A hiatus hernia is often found when doctors investigate reflux symptoms. The most common test is an endoscopy, and in some cases a barium swallow X-ray may also be used.
Management
Treatment depends on your symptoms. If a hiatus hernia is not causing problems, treatment may not be needed. When symptoms are present, treatment usually focuses on reducing reflux and discomfort.
- Dietary & Lifestyle Modifications
Helpful steps may include eating smaller, more frequent meals, avoiding trigger foods, not eating within 3 to 4 hours of bedtime, raising the head of the bed, losing weight if needed, stopping smoking, limiting alcohol, and trying to reduce stress. - Medications
Medicines may include antacids or alginates for short-term symptom relief, and stronger acid-reducing medicines such as H2 blockers or proton pump inhibitors (PPIs) when needed. - Surgery
Surgery is not needed for most people, but it may be considered if symptoms are severe, ongoing, or do not improve with medicines and lifestyle changes. This is usually done with keyhole surgery, and one common anti-reflux operation is fundoplication.
Outlook
The outlook is generally good. Many people either have no symptoms or can manage symptoms well with lifestyle changes and medication. A smaller number of patients may need surgery if symptoms continue or become more troublesome.