Hiatus hernia

Symptoms

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

When to get medical 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.

Go to 111.nhs.uk or call 111.

Other ways to get help

Treatment

Broadly, treatment follows these steps:

1. Change your eating habits – for example, eat smaller, more frequent meals and do other things to help with the symptoms of GORD.
2. If you smoke, try to give up – tobacco smoke can irritate your digestive system and make your symptoms worse.
3. Buy medicines from the pharmacy – ask the pharmacist what you should take to help with the symptoms of GORD.
4. See a GP – if medicines from the pharmacy and changing your eating habits do not help, a GP can prescribe stronger medicines.
5. 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.
6. 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.

Causes

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.