What is a hiatus hernia?

A hiatus hernia occurs when part of your stomach pushes upwards through the diaphragm, the muscle that separates your chest from your abdomen, through an opening called the hiatus. This can cause symptoms like heartburn and acid reflux.

What are the types of hiatus hernia?

The most common type is a sliding hernia, where the junction between your oesophagus (food pipe) and stomach moves up into your chest. A less common type, called a rolling hernia, involves part of the stomach pushing into the chest alongside the oesophagus. Rolling hernias are more likely to cause complications such as strangulation.

What causes a hiatus hernia?

Hiatus hernias often develop over time and are more common as you age. Increased pressure in your abdomen can contribute to the development of a hiatus hernia. Common causes of this pressure include:

• Being overweight
• Coughing or vomiting frequently
• Straining during bowel movements or urination
• Lifting heavy objects

Some people are born with a hiatus hernia (congenital hernia), but this is rare.

What are the symptoms of a hiatus hernia?

Many people with a hiatus hernia have no symptoms. However, larger hernias can cause gastro-oesophageal reflux disease (GORD), also known as acid reflux. Symptoms of GORD include:

• A burning feeling in your chest (heartburn), especially after eating
• Regurgitation of food or sour-tasting fluids
• Nausea or feeling sick
• Bloating and burping
• Bad breath
• Difficulty swallowing or a feeling that food is stuck
• A persistent cough, especially at night
• Waking up with a choking sensation

If these symptoms last more than three weeks, worsen over time, or do not improve with over-the-counter treatments, you should see a doctor.

When should you seek urgent help?

Seek medical advice urgently if you experience:

• Unexplained weight loss
• Difficulty swallowing
• Vomiting, especially if there’s blood in it
• Upper abdominal pain

How can you manage a hiatus hernia and reflux?

Most hiatus hernias do not require surgery and can be managed with lifestyle changes and medication. Here are some tips to reduce symptoms of acid reflux:

• Lose weight if you’re overweight
• Avoid alcohol and stop smoking
• Wear loose-fitting clothing
• Avoid lying down or bending over right after meals
• Elevate the head of your bed by 15 cm
• Avoid eating close to bedtime
• Take medications to reduce stomach acid, as advised by your doctor

Can diet help with a hiatus hernia?

Certain foods can trigger heartburn. If you have a hiatus hernia, try to avoid:

• Spicy foods
• Chocolate
• Caffeine
• Onions
• Citrus fruits

Instead, eat smaller, more frequent meals to ease pressure on your stomach.

How is a hiatus hernia diagnosed?

If your symptoms persist or worsen, you may be referred to a specialist for further evaluation. At Birmingham Endoscopy Clinic, we use the following tests to diagnose a hiatus hernia:

• Upper GI endoscopy: A thin, flexible tube with a camera is passed down your throat to check your oesophagus and stomach for signs of hernia or inflammation.

• Contrast X-ray: You’ll drink a special liquid that highlights your digestive tract on an X-ray, helping identify hernias and reflux.

• Oesophageal manometry and pH monitoring: A small tube measures pressure in your oesophagus and checks for acid reflux. This test may involve wearing a small monitor for 24 hours.

What are the treatment options for a hiatus hernia?

Most people with a hiatus hernia do not need surgery. However, if your symptoms are severe and do not improve with lifestyle changes or medication, surgery may be recommended.

Laparoscopic surgery (keyhole surgery)

• Procedure: Performed under general anaesthetic, this minimally invasive surgery takes 1-2 hours. Small incisions are made in your abdomen, and the stomach is repositioned below the diaphragm. The surgeon tightens the opening in the diaphragm with stitches and wraps the top part of the stomach around the lower oesophagus (fundoplication) to create a new valve.

• Goal: Reduce reflux symptoms and prevent the hernia from recurring.

• Recovery: Most patients go home the same day or within 1-2 days and recover within a few weeks.

Why choose Birmingham Gastroenterology Clinic?

At Birmingham Gastroenterology Clinic, we specialise in diagnosing and managing conditions like hiatus hernia with advanced diagnostic tools and a patient-centred approach. Our team will work with you to develop a personalised treatment plan, whether it involves lifestyle changes, medications, or surgery.

Contact us

If you’re experiencing symptoms of a hiatus hernia or acid reflux, contact us today to book a consultation. Early diagnosis and treatment can help you manage your symptoms and improve your quality of life.