You can have a hiatus hernia without knowing and without it being a problem.
With a hiatus hernia you may:
- have a painful burning feeling in your chest, often after eating (heartburn)
- bring up small amounts of food or bitter-tasting fluids (acid reflux)
- have bad breath
- burp and feel bloated
- feel or be sick
- have difficulty or pain when swallowing
These are the symptoms of gastro-oesophageal reflux disease (GORD).
When to get medical help
See a GP if:
- your symptoms do not go away after 3 weeks
- your symptoms are very bad or getting worse
- medicines from the pharmacy do not help
Get advice from 111 now if you have indigestion or acid reflux and:
- you have lost weight for no reason
- swallowing becomes difficult
- you're being sick (vomiting) frequently
- there's blood in your sick
- you have pain in your upper tummy
111 will tell you what to do. They can arrange a phone call from a nurse or doctor if you need it.
Other ways to get help
Get an urgent GP appointment
A GP may be able to help you.
Ask your GP practice for an urgent appointment.
Broadly, treatment follows these steps:
- Change your eating habits – for example, eat smaller, more frequent meals and do other things to help with the symptoms of GORD.
- If you smoke, try to give up – tobacco smoke can irritate your digestive system and make your symptoms worse.
- Buy medicines from the pharmacy – ask the pharmacist what you should take to help with the symptoms of GORD.
- See a GP – if medicines from the pharmacy and changing your eating habits do not help, a GP can prescribe stronger medicines.
- Further tests – if stronger medicines do not work, a GP can send you for further tests to find out if your symptoms are caused by a hiatus hernia. They might also prescribe medicines for long-term GORD.
- Surgery – a GP might refer you to a specialist to check if you need surgery. This usually only happens if other treatments have not worked and you keep having very bad symptoms.
Surgery for a hiatus hernia
Keyhole surgery is usually used for a hiatus hernia. This involves making small cuts in your tummy (abdomen).
It's done under general anaesthetic, so you'll be asleep during the operation.
After surgery, it usually takes:
- 2 to 3 days to go home
- 3 to 6 weeks to go back to work
- 6 weeks before you can eat what you want
- a few months to recover from side effects like bloating, burping, farting and difficulty swallowing
There's a small risk (about 1 in 100) that your side effects will not go away and you'll need more surgery.
It's not clear what causes a hiatus hernia. Anyone can have one, but it's more common if you're over 50, pregnant or overweight.