Hiatus hernia

A hiatus hernia is when part of your stomach moves up into your chest. It's very common if you're over 50. It does not normally need treatment if it's not causing you problems.


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).

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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

Get an urgent GP appointment

A GP may be able to help you.

Ask your GP practice for an urgent appointment.

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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.

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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.

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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.

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