Hiatus hernia

Date: 09 Feb 2020

By: admin_campbell

Comment: 0

Causes
Complications of a hiatus hernia
Diagnosing a hiatus hernia
Introduction
See what the doctor sees with Map of Medicine
Symptoms
Treating a hiatus hernia

Hiatus hernia – NHS Choices

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Hiatus hernia

Introduction

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Digestive health

Find out how to beat common digestive problems like bloating and indigestion

A hiatus hernia, or hiatal hernia, is when part of the stomach squeezes into the chest through an opening in the diaphragm called the hiatus.

The diaphragm is a large, thin sheet of muscle located between the chest and the abdomen (tummy).

Hiatus hernia and heartburn

A hiatus hernia itself rarely has any noticeable symptoms. However, it can cause a problem called gastro-oesophageal reflux disease (GORD).

GORD is when stomach acid leaks into the oesophagus (the tube that carries food to the stomach). It can occur if a hiatus hernia prevents the valve at the bottom of the oesophagus from working properly.

Your oesophagus can become severely irritated because it is not protected against stomach acid. This may result in symptoms such as heartburn, chest pain, an unpleasant sour taste in your mouth, and problems swallowing (dysphagia).

You should see your GP if you have frequent and severe symptoms of GORD.

Who is affected?

Hiatus hernia can affect anyone, but it’s more common in women and people who are over 50, overweight, pregnant or who smoke. It’s estimated that a third of people over 50 have a hiatus hernia.

There’s also a rare type of hiatus hernia that affects newborn babies.

Why it happens

It’s not exactly clear what causes hiatus hernia, but it may be the result of the diaphragm becoming weak with age or pressure on the abdomen.

Hiatus hernia can occur in newborn babies if the stomach or diaphragm doesn’t develop properly.

Types of hiatus hernia

There are two main types of hiatus hernia:

sliding hiatus hernias – hernias that move up and down, in and out of the chest area (more than 80% of hiatus hernias are this type)
para-oesophageal hiatus hernias – also called rolling hiatus hernias, this is where part of the stomach pushes up through the hole in the diaphragm next to the oesophagus (about 5-15% of hiatus hernias are this type)

This information mainly focuses on sliding hiatus hernias.

The type of hiatus hernia can usually be diagnosed using an X-ray or an endoscopy, where a long, tube-like instrument with a video camera and light source is used.

Read more about diagnosing a hiatus hernia.

Treating hiatus hernia

Treatment for sliding hiatus hernia usually focuses on relieving the symptoms of GORD, such as heartburn.

Lifestyle changes and medication are the preferred treatments. Surgery is usually only recommended as an alternative to long-term medication or if other treatments haven’t worked.

Lifestyle advice may include:

eating smaller, more frequent meals rather than three large meals a day
avoiding lying down (including going to bed) for three hours after eating or drinking
removing any foods or drinks that make your symptoms worse from your diet

If a hiatus hernia isn’t causing any noticeable problems, it doesn’t usually need to be treated.

Para-oesophageal hiatus hernias are repaired surgically if there is a risk of serious complications.

Further problems

It’s rare for a hiatus hernia to cause complications, but long-term damage to the oesophagus caused by leaking stomach acid can lead to ulcers, scarring and changes to the cells of the oesophagus, which can increase your risk of oesophageal cancer.

Read more about the complications of hiatus hernia.

Page last reviewed: 09/04/2013

Next review due: 09/04/2015

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Comments

The 44 comments about ‘Hiatus hernia’ posted are personal views. Any information they give has not been checked and may not be accurate.

Cruella118 said on 26 September 2014

Like Mistified I too am having trouble getting my GP to take my request for surgery seriously. I have been on differing medications now for the past 6 years or so. They all work for a certain time and then BAM I’m back to square one. I’m sleeping (if you can call it that) using 5 pillows and even then the pain and gurgling noises are still present. My hubby can also hear the gurgling when I lay down. I admit that I am slightly overweight and perhaps this isn’t helping, but the thought of doing any exercise when I’m surviving on about 4 hours sleep a night and trying to hold down a job doesn’t doesn’t exacty thrill me.

Mistified said on 22 September 2014

I get the feeling that one option that is mentioned on this site – ie you don’t want to be on medication for the rest of your life when you have a hiatus hernia – and would prefer an operation is not an option. I can’t fault my doctor – she has been superb – and I can’t fault the endoscopy department who were equally helpful – and also said on my follow up appointment my options would be fully discussed. WRONG! The ‘consultant’ who wasn’t even wearing his NHS badge – told me that they would try even more medication – after I told him I did not want medication for the rest of my life. I am only 45! Besides having a very limited diet – all medication I have taken lately have removed the best part of my taste – as well as giving me cramp and extreme fatigue. Neither did he listen to the fact I have pains that the PPI’s and antacids do not help – and I see many people on here have the same problems. It is well seen the stranglehold drug companies have on the NHS. I want to get better – not rely on chemicals!

Mistified said on 22 September 2014

I have had problems with a cough for years – and finally 2 years ago – a GP finally correctly diagnosed me with a hiatus hernia. After a lengthy discussion and problems with medications – she referred me for an endoscopy to confirm her thoughts. This was done – and the hiatus hernia was found. They said at the endoscopy that there would be a follow up where they would discuss surgery and medication. I had that consultation today. I wasn’t listened to. I wasn’t given any options but trying more medication – which frankly I really don’t want medication for the rest of my life. He didn’t even examine me! I was absolutely disgusted. Try explaining pains that PPI’s don’t stop and neither antacids. I sometimes wish these people got the experiences of some of us patients on here – and I’m pretty sure they would be asking for surgery too. I want my life back.

Paul Maybin said on 10 August 2014

I get chest pains and a feeling that my heart is missing beats particularly after eating. My symptoms have got worse in the last year or so and I am going to approach my GP about surgery. From what I have read it is difficult to get a referral for surgery but clearly Lansoprazole and Mucogel along with Ranitidine isn’t working. I have tried losing weight which hasn’t worked at all. I believe that this ailment is also causing shoulder and neck pain. I think more needs to be done for those that are symptomatic.

lady in red said on 30 July 2014

My hiatus hernia was brought on by stress at home and work. The chest pains were as though I was having a heart attack and very frightening. The pain would travel from my chest round into my back. I permanently feel fat and bloated even though I am very slim. I believe eating smaller meals and more regular helps. I have gurgling noises in my throat when I swallow. My food sometimes gets stuck and so does liquids. It is so embarrassing some times. I take Omeprazole but I don’t think it helps much. Stress makes my condition worse. I try not to eat before bed as this causes problems. I understand and sympathise if anyone is going through this. It is an awful condition.

emrose2 said on 22 July 2014

I have just been diagnosed with a hiatus hernia about a month ago. During the build up of my first exam I experienced a pain in my chest like having a golf ball in my chest. Every time I ate I would get a tight severe pain in my chest which meant I did not want to eat as it was simply too painful. the doctor did not know what it was but guessed severe heartburn so gave me medication for that one was omeprazole, gaviscon 4 times a day and then pain relief. I had my endoscopy which was awful and they said it was a hiatus hernia and gave me no advice on what to do or tell me what I can do to fix it just dismissed me. I go to gastro due to stomach pains but I am not seeing him till August and then I got a random letter saying to attend an appointment to see a general surgery consultant. Not entirely sure why. I am trying to exercise and go gym just to tone and be fitter but I am now getting severe heartburn after an hour of cardio. Does anyone else get this after exercise? also what do you do to prevent it. Also just to let you know I am only 20 and I am not overweight wi a BMW of 22 roughly I have lost weight so it may have changed. Oh and my appetite has plummeted again.

anbuma said on 14 July 2014

I have just been diagnosed with hiatus hernia ,duodenitis and gastritis following an endoscopy.like others I had a cough(for 2 years) when I laydown at night and it was dismissed because my chest was fine even tho I had said it wasnt a chesty cough.this all started 3 years ago with pressure on my ribs and stomach and nto wantign to /being able to eat much yet all scans etc were said to be normal,teh gp prescribed me omeprazole after the endoscopy even though I was on lansoprazole and I ahd been advised recently to stop taking omeprazole.i assumed the gp was going to give me a different med for pain relief as i cant tolerate NSAIDS and he didnt give me any antibiotics to clear the inflammation.been totally dismissed by gps and consultants.i don’t smoke or drink and exercise by walking my dogs tho it is a struggle lately a si feel really weak,oh ihave also had persistent chronic pelvic pain fro almost a year and no diagnosis for that or anything else.
I am 5.6 and weight 88 kgs having gained about 14 kgs in 3 years btu that is all abdominal and not fat or due to diet as I have a poor appetite(for about 7 years)haven’t eaten cake sbiscuits snacks or puddings for that time.i have lost weight everywhere else tho gp wont recognize this,my symptoms match those of ovarian cancer(not saying have it btu it cant be ruled out -my lowest CA125 was37,swollen abdomen and persistent pelvic pain -and of lupus(skin rashes and swelligns etc)cannto get referrals to appropriate consultants and at wits end.i know gps wont accept this butmy dogs have been so concerned fro me and this week they are off their food,constantly crying and whimpering and nestling close.hate being left and by ny side 24/7.dog sdo detect illness in their owners and no matter what anyone says I believe mine sense something serious is going on.plus I know my body

RickCSF said on 09 July 2014

Hi everyone, I’m reading down with great interest and its almost a relief to see so many other people like myself. I’m 44, a little overweight, but not excessive and recently started tryign to tone my body anyway, I don’t smoke, don’t drink excessively either, but have been suffering for over 2 years with the symptoms and only just gone through the procedure to find the cause (loads of messing about by the GP surgery basically before they even put me for a referral).

So have been diagnosed with a Hiatus Hernia, little concerned as apparently they found I had small ulcers as well, but they don’t call them ulcers as they’re smaller than 5mm? They either are or they’re not.

Am in constant discomfort in my chest, but am active in my work and I don’t want to slow down in my every day activity.

I would welcome any guidance on possible food that may help, am all for diet change

bigeron said on 26 June 2014

With my hiatus hernia I have developed a nasty tickerly cough especially at night. I have discussed this with my GP, and she has given me several pumps, which do not seem to relief it. I find that some nights I wake because of persistent coughing and find I am fighting to get my breath and after a bout of this I begin to sweat. During the day it is not so bad and only seems to develop as the day wears on. I take gaviscon before I go to bed, and when the flare up eases I then go to bed, but as soon as I lay down I start to cough again. I have spent many nights sitting upright in a chair to get some sleep. If an operation is the answer to the problem, why are surgeons reluctant to do it.

brightyswf said on 07 February 2014

I am a 45 year old (smoker) male who has had a hiatus hernia for several years now. I take Lansoprazole each morning (am also on Statins too each evening) and can function normally in every way…. except….

I consider myself to still be very fit , and play racketball three mornings a week at 6am along with circuit training, this is no problem to me at all, yet if I do any form of training in the afternoon or evening, I can barley run 100 yards without experiencing excruciating chest pain that feels very scary and similar to a heart attack.

Having been referred by my GP, I have had an angiogram (which came out fine) and even tried GTN spray (in case it was small vein syndrome) which didn;t work either.

So I still have no answers, but am wondering if this has anything to do with the meds I am taking – has anyone else experienced a similar problem. It limits my exercise routines and has stopped my playing rugby.

Any thoughts??

thanks

ian

bobblybits said on 20 January 2014

I was diagnosed with a hiatus hernia over 20 years ago and have managed it firstly by a change of diet and lifestyle then as it became more of a problem medication.
It got to the point I was taking omeprazole ranitidine and lots of Gaviscon tablets and liquid just to get through 24hrs.
As the meds were increased I started having trouble swallowing food and was referred to see a consultant who as they do, ordered a number of further tests.
The upshot is, I have recently been diagnosed not only with the Hiatus Hernia but also Achalasia type 2.
My concerns are that I am told I need surgery but on reading about both conditions the treatment for one is counter productive to the other.
I cant get a straight answer as to if surgery is the answer or will it just add to the problems.
Anyone else out there with both conditions or in a similar situation.

steven o said on 15 January 2014

after years of suffering from a hiatus hernia i was`nt overweight over 50 or a smoker i was lucky enough to get the operation (laproscopic nissen fundoplication) it was the best thing ever it was thirteen years ago im now 47 and i have never had one bit of trouble regarding heartburn.i would advise anyone who has put up with this for any length to time push your doctor to try and get the op.i can recommend it 100%

slinky30 said on 14 January 2014

I am one of the rare cases and was born with a HH, i am now 31 and it makes my life a misery, i am frequently in a lot of pain, ive had to have my teeth painted as the enamel had worn off due to the acid. i have a rolling HH and the pain and not being able to eat anything while my stomach is stuck up in my diaphragm is awful, yet i am still being fobbed off by doctors and not even referred for any more tests. i feel like an old lady some days, i cannot even go out and have a drink as alcohol just makes me sick, i have changed my diet, drink pro biotic drinks, i dont eat fried food, eat sweets or chocolate, ive stopped drinking any fizzy drinks, and i just dont enjoy eating anymore. reading the comments here have made me feel im not alone in feeling like this, and made me determined to get the doctors to listen to me and get this sorted !

Avril Elaine said on 18 December 2013

I am 59 and have been diagnosed with a Hiatus Hernia but the acid reflux is being controlled using a combination of a medicine – a low dose of omeprazole 1 tablet per day – drinking ginger and lemon or mint teas daily and having the equivalent of a small pot of bio yoghurt each day. It has taken a couple of months to settle down but on my last visit to the hospital ( a few days ago) I was told to continue with my omeprazole otherwise my pain and discomfort could return after a couple of weeks. I still have to be careful with hot drinks and hot food as this makes my pain flare up in my oesophagus. I now take much more time over my meals, chewing the food for a much longer time as digestion starts in the mouth.

Komodo1 said on 30 November 2013

For many many many months Ive had a palpable lump at the top of my ab, just below solar plexus, coupled with very offensive wind, upper right and central ab pains and a sort of foggy headedness at times. Over recent weeks its got really very bad and I have an intense pressure behind the solar plexus, and horrific pain between my shoulder blades. I have had 3 visits to a&e as I feared I was having a heart attack only to be told I wasn’t and duely discharged. Are these common symptoms of a HH.? I get breathless at times. My B/P is ok etc but pain is scarey at times. Worsened by a beer, a cigarette of by lying flat

Evil Edna said on 24 November 2013

hello
I was diagnosed with a Hiatus hernia around 10 years ago during an Endoscopy investigation for my Crohn’s Disease. At first it did not give much trouble but soon got worse and worse with the usual symptoms of reflux with much burning of my throat and tubes and the terrible pain that others will be familiar with, having to sleep sitting up, even though I do not eat in the evening before bed for around 5 or 6 hours. I was given Ranitadine which seemed to do the trick for a short time but became less and less effective. Each time I have been to the GP I have been [what I consider to be] fobbed off with a bottle of Gaviscon [the only chewable liquid known to man] and recently when the pain had got really bad [takes the breath away and even impedes movement] I went back to the GP and was told to double the amount of the Ranitadine I take. This I have done with no effect – I will be returning to my GP and asking to be referred to a specialist – preferably a surgeon – as I consider that is the only thing that will help. I would live to hear what others have done in similar situations and whether it was successful. I welcome all views..

clodsal said on 15 October 2013

Hi All, I have just found out I actual have a H.H small but never the less very painful and looking back has caused me problems for the last 10 years with heartburn to wakening up in the middle of the night panicking I can’t breathe and about to die! I had a very expensive scan in Harley st for my heart in response to chest pains. The scan showed no problems for my heart and tubes but a small line indicated I had a H.H!
I have read all the comments sent and have found them useful on the best way forward.
I would have thought the best way is surgery sorting it out once and for all avoiding aggravating it and making things worse. It’s not going to get better but worse not to mention all the on-going problems. I can also see the doctors are not interested to do this in young people just pass it off with medication and see how things will go. I am 56 quite fit for my age and not a hypochondriac but I have made my mind up already ( surgery ) now that I know what the problem is. It has never been suggest all the times I mention gastric problems or sleep problems with swallowing acid. I welcome your views.

luizalotos said on 27 September 2013

Hi everyone,

I was diagnosed 3 week ago with HH, 3 cm.

After some internet research I found that HH which is less than 3 cm is small but 5 cm is consider as big one.

For more than couple months my problems was significantly increased.
I was more often painfully bloated, had reflux, heartburn’s and incredible pain in the center of my upper stomach. In various times not only after eating but often at nights as well.

I have few serious pains at work where everybody around me noticed that because I was immediately changed on my face and I was just able to sit down, have difficulties with breeding.

I was disappointed that on this website do not stand clear what can be the cause of HH like for example : gardening where is constant abdominal pressure ,
( more when we are over weight ) or any constant activities or certain job which involve constant or very often bending up can also cause or simply increases this problems.

Is what happen to me when I was change my duties at work.
Specially after my lunch or tea break when I had my meal I was need to bending over to do my work and I was immediately have reflux and following heartburn every day ! I end up to have just yogurt or smoothie and even after that have this problems but less.

Nights was the worst ones, pain was coming out from nowhere often after 2 am ( I do not know why because my last meal was around 6 pm ) and holds around hour. Squeezing , sharp taking my breath away..
I was feel more and more tired .

I’m training to bring to your attention that some of your usual activities or jobs can increases your problems despite of medicines you taking to ease off painful and unpleasant symptoms.

chloefitz said on 22 September 2013

I was diagnosed last year with a hiatus hernia and im only 19. Ive had symptoms for years. I get really bad chest pains, acid reflux and more or less all the symptoms you can get. I wad put on omeprazole and ranitidine but these did not help the problem. Ive now been off work for four months with a pain in my chest everyday and im being sick everytime I eat. The doctors have tried me on alsorts of tablets and they didnt work. Im on a liquid diet as I cant stomach solid foods. I went back to the doctors and he recommended surgery. However when I saw the surgeon he told me I couldnt have it done and I needed a ph monitor in for 24 hours to check how much acid is being produced. Ive now had it done and ive been waiting ages for my results. So dont be fooled if the doctors tell you you can have an operation because the surgeon will say different. :/

SirAsh86 said on 18 September 2013

In June I was diagnosed with a HH & possible Barretts. So was put on omeperazole and an anti sickness medication. For months prior to this & still continuing I have had sever chest pains, a tearing sensation, acid reflux & feeling/being sick. The sensation is very uncomfortable & I literally feel strangled & the discomfort goes through to my back & behind my left shoulder blade. I saw a specialist yesterdayxwho cleared me of Barretts but said there was some unusual mucosa, referred me to a Gastro team & said if that didnt work hed possibly operate. Looks like im gunna have my meds doubled again which is frustrating given im a 27 year old who usually stays active & been told to literally do no gym work.just small walks & rest. The HH is visable in my chest its like a golfball iy leaves me out of breath at the easiest of tasks such as going upstairs or walking a few hundred yards. I guess im looking for some advice as its been 5 months since iv been diagnosed & im fed up of being passed around & feeling like a 109 year old (no offence) as I feel so tired too. Doctors just wanna throw tablets at people & it just seems older people are treated because the danage is done & I cant understand why when it comes to prevention of future problems why surgery on someone my age is so difficult I feel like im going nuts…. Help!

Mark Gravesend said on 27 August 2013

I was diagnosed with a HH 30 years ago after lifting a very heavy load. Most of the time I have no symptoms at all, but if I lift something awkwardly and put load on the stomach then I suffer a dull ache for a few weeks. I cannot bear any load on my stomach, so try to stay slim – someone asked about losing weight off the tummy – the best thing for me is walking or running as it does not stress the muscles around the tummy, but strengthens the core. I find that staying away from hot drinks, fizzy drinks and white/partially baked bread helps a lot. Cold milk and ice cream help, or cold water. Over the past 6 months my symptoms have become considerably worse. For the first time I am struggling to sleep and though I dont have heartburn, I do get incredible trapped wind/gas which is what causes the pain. Thanks everyone for the tips below.

ash1989 said on 29 July 2013

hello everyone, I don’t really find this page that useful as it states information already known, however the comment you are all writing are useful. I had severe chest pains and still on going, diagnosed with hiatal hernia. I never experience heartburn but pains as if im going to have a heart attack. I was prescribed 30mg omeprazole once daily but the pain seems to be getting worse. im just glad that I am not the only one.. I have now been told to keep a food diary… I did loose a lot of weight recently and need to put it back on however the GP said I have to avoid a huge list of foods. I just feel pretty neglected really as people tell me removal is very hard to receive?????

JSTEP123 said on 25 July 2013

Lanzoprazol seems to be the best for me I take 30mg unless I am having bad flare up then was told to double up for 2 weeks until it clears by the Dr. I have GORD aswell. Avoid Milk, Tea (my worst enemy if 2 cups or more), KitKats and not so much spicy food (although not great) but rich food ie rich sauces, I tend to get terrible reflux and nausea after things like that and then the pain in diaphram and back goes berserk at that point. Relax. Stressed out = doubled over for me. I crunch up on all fours to relieve pain at times. Try an alkaline diet and Chamomile tea is a blessing. I feel all your pain its a horrible thing when you get a flare up. As for tummy fat I’m afraid excersize for that area prob only way. Crunches, Pilates and try kettle bells but dont over do as that will make you feel like someones tearing your insides.

lizamy said on 23 July 2013

Does any-one else get horrific pain after eating? Everytime I eat I get a searing pain in my upper stomach on the left hand side and it goes right through to my back. I am taking Esomeprazole when I have flare ups but it doesn’t seem to help. I have lost weight as I was told to do but the weight fell off my legs, face, arm and hips but not off my belly and I can’t do situps etc as it pushes my gut and the pain starts up all over again. I have been diagnosed with an HH, and am to start on another medication which i don’t know the name of but really don’t want to rely on meds all the time. Does any one have any good ideas to lose belly fat and any alternative treatments beside chemicals.

Gimmeshelter said on 19 June 2013

I was diagnosed with a HH and gastritis today via a Gastroscopy. I was on Omepraole and Peptac liquid but had to cease this 2 weeks prior to the gastroscopy. My symptoms are not as bad as many on here in that I don’t get really bad pain, more discomfort under my breast bone and can;t eat after 7pm otherwise I’m awake all night.

THe Omeprazole worked after about 4 weeks, but as soon as I stopped them all the symptoms returned. Interestingly I recently read something on Omeprazole (Proton Pump Inhibitor) which said that in trials it had been fond that drinking ginger tea and/or plain water a better result in reducing stomach acid than Proton Pump Inhibitors. I tried both drinking cold water and ginger tea and I definatly got relief with both. THe ginger tes was amazing and calmed everything down almost straight away. I’d be interested to see if it works on others who may have more severe symptoms.

santaclara said on 10 June 2013

Regarding Edd200sx ask your doctor for a referral as your symptoms are similar to my husbands. He was treated for a chest infection and it turned out to be inflammation of the pancreas. Hope you get sorted out.

ensnaturae said on 12 May 2013

So sorry you are suffering same kind of thing as me, especially those poor souls who almost choke in the middle of the night. My worst experience of that felt like suffocating, I couldnt breath with gastric acid blocking airways, only for a few moments but truly disgusting – plus – stomach acid is germy stuff and the result is very often a throat or lung infection, so that I get a horrible dry cough; runny nose and sneezing each time it occurs.
Without a doubt, diet makes a difference – if you Search via Google etc – *hiatus hernia diet* – theres plenty of advice, but I think each of us probably has particular foods that are worse, just for us, too. I have been feeling ropey for a few days, and realize today the cheap tea Im drinking by the bucket load, is the cause. Just thinking about another cup, makes the dull ache & indigestion come back. I found the most soothing no trouble food for *me* that may not be any use to anyone else – has been a really good mixed Muesli with lots of diff grains, fruit and nuts but no huge chunky bits, with yogurt or semi skimmed milk or the stuff called ‘lait ribot’ here in France – I think its just sour milk. Another nosh that gives me no problems is a veggie ‘fry’ up – not very greasy, with beans and potatoes, with some parmesan on top. I cant survive without getting very tired, without a lot of protein, so I buy extra powered brown rice and pea protein online.(there are lots of diff kinds) It tastes ok mixed with other stuff, or as milk shakes, and is very very easy to digest. Rice is always ok, theres all kinds of things that will mix with that – and taste nice, and *small* quantities of mince or similar with plenty of rice, can be trouble free, but be careful. I dare not eat any meat at all after about 5pm, it will surely cause the horrible choking sensation again. Stomach acid is a vile taste – with burning, and gets into nose, throat everywhere and cant be washed out for hours. yuk. Stay as well as you can, people.

casey43 said on 30 April 2013

I am suffering with heartburn & all the other symptoms that other people have put on here. I have an appointment for camera down my throat which is in 2 weeks been told by my doctor to stop taking omeprazole in couple of days but i stopped taking them a couple of days ago by another doctor. I had an ultrasound about 3 weeks ago doctor thought it was my gallstones but the scan all ok. I am suffering at the minute i am trying to eat regular but everytime i eat i feel sick my mouth feels dry & horrible taste dont know if that is the acid i have pain in my shoulder blades

Edd200sx said on 29 April 2013

I was diagnosed 3 months ago during a hospital admission with a hh after eating some greasy fish and chips also gallstones diagnosed at the same time.

The pain was indescribable and now I’m on omeprazole and donperidone and still feel like anything I eat or drink is going to come back out.

I have Backache cant swallow properly pain in left chest after eating anything. I’ve lost over a stone in weight.

My doctor today refused point blank to do anything about either problem and said keep taking the pills which will cost me £90 a year? What on top of my taxes? Why thanks doc for nothing.

I’ve heard nothing from the hospital even though the consultant said she would have me back in at some point
To sort things out.

I’m disgusted with the nhs.

niknak1967 said on 29 March 2013

Foe several years i have been suffering bloated stomach and reflux. I went to docs thinking i might have ovarian cancer, some symptoms same. After having gastroendoscopy found i have a hiatus hernia.In the last few months have been feeling dreadful, stomach swollen to point of bursting, pain in chest and back, and now shoulder pain.Was put on lansaprazaloll at first which did not work, now on pantoprazalol and dicycloverine. Still having symtoms. and now breathlessness as well as not being able to lye on stomach..Cant put up with for much longer, feel like i no quality of life. I think i have a rolling hernia which usually requires surgery. Going back to docs next week to discuss next step. Is surgery. Any tips and advice would be great right now. I’m a 45 working mum of two who just wants to be able to get up and feel normal.

Romadean said on 25 March 2013

I have suffered with a Hiatus Hernia for years and have tried, Zantac, Omeprazole and for the past 6 years, Lansoprozal. Last summer (after a gall bladder removal) I felt more uncomfortable lying down, so was referred to Benenden as a member. I had yet another Endoscopy as well as a GERD Acid tube inserted up through my nose for 24hrs. This confirmed the high acid content and a 3cm Sliding Hernia. As they no longer perform the operation, they advised taking 15mg of Lansoprozal morning and evening, with 30mg of Esomeprazol mid-day. Regrettably this did not help! So back on Lansoprazol and Gaviscom Extra at night.
I was then referred to a Gastro Surgeon and await a Laporascopic Nissen Fundoplacation in April, which I am told has a 95% success Rate! No more medication needed! Fingers crossed that all goes well??
A London Health clinic advised me that a correctable diet with Digestive Enzymes should put the Acid back into the lower bowel where it should be, in order to aid digestion of food particles. I have cut out tomatoes and have reduced coffee and most alcohol, which have helped.
I would love to hear from any other patient that has undergone the surgical correction.

jules02 said on 15 March 2013

I have a hiatus hernia which hardly bothers me but,has just flared up, up til now it has lasted about 3 days. Been to the drs and then the hospital because of the pain. All they have both said is take gaviscon advance and increase the dose of omeprazole. Up to now that hasnt helped.Still in the same amount of pain. Anyone got any other advice?

TREV N said on 28 February 2013

It really annoys and upsets me when I read articles saying that ‘although in many cases a hiatus hernia causes no symptoms’ or for some other websites putting it in some other way to that effect.

I was diagnosed with a hiatus hernia many many years ago, and I have been rolling around in agony quite often.

Everyday from morning to night, I suffer terrible with pains in my stomach, and these pains do not go. They are constant pains.

If someone has a bunion or a corn on their foot and it is painful, the pain may tend to go away gradually by not wearing tight shoes or resting your foot.

However, if someone accidentally stood on that persons foot, that person would be in agony.

My pains are just like somebody standing or pressing on my stomach, which is very similar to someone standing on somebody’s bunion or a corn day and night, where there is no relief from pain.

If it hadn’t been the case that I have a family to think about, then I know for certain that I wouldn’t have been here long ago as the pain is unbearable at times.
Some people think it is just from eating a banana or some other heavy or rich food late on, and some other people think that its just down to eating fatty foods which I don’t eat at all and neither do I eat bananas late at night as I have heard that can cause heart attacks.

GazUK said on 25 February 2013

Hi, petejones2k,

I’m male -26 – and have been suffering with heartburn for the last 3 years.

I’ve just been diagnosed (only saw docs today) and just through by me providing him [the doc] with my symptons, has diagnosed me with hiatus hernia. No tests done.

petejones2k said on 18 February 2013

I was diagnosed with a hiatus hernia and oesophagitis/reflux and some mucosal break,Im male 25 and have been haing trouble for basically a year now anyway the woman doing it took biopsies from a certain section of this area and im wondering did anyone else have these taken when they were diagnosed?

pease786 said on 22 January 2013

Hi margo4
I am also going through the same thing had an endoscopy last week and the doctor told me I had an hiatus hernia,
I have been getting a lot of belching, rib pains both sides more on the right side, back pain I am burping all the time it’s worse lying down and in bed, doctors first thought it was gallstones, I can’t sit properly or bend down I’m in pain all the time, it’s all linked with the stomach and digestive system if you are burping a lot or you find you have trapped wind I take these tablets which you can get from the pharmacy called windeeze they help release the air or gas in the body, but all this pain and burping is because of the hernia, if it’s really bad then see your doctor and an operation may be an option.

MX52 said on 21 January 2013

After a recent endoscopy I was diagnosed as having a hiatus hernia. I’ve suffered with heartburn and chest pain/acid reflux etc for more than 20 years, but only in the last three has the problem got significantly worse. I was even taken to A & E twice in two weeks with suspected heart pain, but it was not diagnosed as anything heart related. I really think there is a direct link between that time coinciding with the menopausal symptom of sudden weight gain around my middle, which I think has put pressure on my stomach. It is really hard to shift. Not being able to do abdominal exercises is part of the problem, but I do know I have to lose some weight, which will help alleviate the problem. It is easier said than done, but think about it, it makes sense – excess fat around the middle squeezes all the internal organs and there’s not many places they can go, so it is bound to affect lung capacity and stomach shape and comfort. I love my food, so this is a difficult challenge for me, but I am sick of feeling breathless, having pain, thinking I’ve got heart problems, etc, and I have to take control of what my future will shape up to be, healthwise. If you’re even just a wee bit overweight, it will change how your insides function. I always knew that, but now I understand the implications of it a lot more. I need to drop 2 stone. I will join a slimming club for motivation and will get what exercise I can. Wish me luck, and good luck in your own resolutions on the hiatus hernia, everyone.

margo4 said on 28 December 2012

Hi I was diagnosed with a Hiatus Hernia last week. I have read your comments with interest.!! Has any one experienced a pain in their left side, which gets worse, makes you burp constantly then makes you feel nausius.? I dont know if it is connected with the
Hiatus Hernia, or a seperate issue altogether.
I would be pleased to here from anyone who has also experienced this problem.
margo4

Birdynumnum said on 17 December 2012

May sound odd but Peppermint Tea with 5/6 drops of pure Peppermint Oil (available from health food shops) works brilliantly – soothes and gets rid of bloating. I can’t eat bread, pastry,usual suspects & diagnosed with H.Hernia but this really helps. jobirdynumnum.17.12.12

vik1976 said on 12 November 2012

hi i have had a endoscopy last year twice and the hosp diagnosed me with a hiatus hernia- was precribed the same usaul tablets. Omprazole, lamprazole and also recenlty zantec. Keep feeling cold all the time with discomfort uder the brest bone – feel bloted after a meal and also get reflux. Not sure what to do as nothing seems to help. Please can anyone recommend anything?

meemee said on 12 August 2012

i have this problem since 1980 and it is very painful every drs ive been too have neglected this problem until recently new drs are looking into it this has cause me loads of medical problems as mine feels like a babys head it has got large and now my organs are coming through it i have had all treatment but nothing works so now thank god im going to see a surgeon i truly think it was so wrong to leave me in this condition for 34yrs as i ruptured it giving birth i do hope no one else suffers like i have all these yrs

Seviyorumcok said on 20 February 2012

I was diagnosed today with a hiatus hernia after experiencing the most awful pains in my chest which had me thinking I was going to die! I can tolerate a lot of pain but this pain in my chest was off the scale! I was rushed into hospital after I nearly passed out with the pain, I also had projectile vomiting. The ambulance man thought I was having a heart attack!

After 2 weeks of tests E.C.G’s, blood tests etc etc plus xrays and ct scans I got my diagnoses. Hiatus Hernia.

I do have a particular bad type of this condition and I will be seeing my consultant next wk to discuss my operation. It would of helped if this site covered the operation side of things however it was ok. it told me some helpful stuff. I also get the worst type of acid reflux as well as food coming back into my mouth which is not pleasant.

derique said on 11 November 2011

This page is helpful, but does not cover my recently diagnosed condition where CT scan reveals whole stomach is in the chest having passed through the diaphragm.
I had a prolonged chest condition resulting in drastic coughing and it appears that this has forced the stomach through the diaphragm.
I have no symptoms apart from slight feeling in the chest.
Can stomach be pushed back without surgery?

carrhouse said on 12 May 2011

There is a good description of hiatus hernias and treatments. However there is nothing about diet; yet foods can have a major impact and I understand treatment can include dietary changes. Could you please add to this a list of foods to be avoided and those that can be safely eaten. Is it also possible to link this to recipe suggestions?

Useful links

NHS Choices links

External links

British Hernia Centre

Symptom checker

If you have a health problem, our symptom checker can help you manage it or find out where to go for help

Eat right for your digestion

How to eat and drink to ensure a good digestion, including foods to avoid and which ones to fill up on.

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/conditions/articles/hernia-hiatus/complications

Hernia, hiatus

Complications of a hiatus hernia

[Original article on NHS Choices website]

Complications from a hiatus hernia are rare, but they can be serious.

Hiatus hernias that slide in and out of the chest area (sliding hiatus hernias) can cause gastro-oesophageal reflux disease (GORD). This is where stomach acid leaks into the oesophagus (gullet). This can damage the oesophagus, increasing the risk of the problems described below.

Oesophageal ulcers

Damage to the lining of the oesophagus (oesophagitis) caused by stomach acid can lead to the formation of ulcers. The ulcers can bleed, causing pain and making swallowing difficult.

Ulcers can usually be successfully treated by controlling the underlying symptoms of GORD. In most cases, over-the-counter medicines called antacids or alginates are used to treat the condition.

Oesophageal stricture

Repeated damage to the lining of your oesophagus can lead to the formation of scar tissue. If the scar tissue is allowed to build up, it can cause your oesophagus to become narrowed. This is known as oesophageal stricture.

An oesophageal stricture can make swallowing food difficult and painful. Oesophageal strictures can be treated by using a tiny balloon to dilate (widen) the oesophagus. This procedure is usually carried out under a local anaesthetic.

Barrett’s oesophagus and cancer

Repeated damage to the oesophagus can also lead to changes in the cells lining your lower oesophagus. This is a condition known as Barrett’s oesophagus.

Barrett’s oesophagus does not usually cause noticeable symptoms other than those associated with GORD.

However, Barrett’s oesophagus can increase your risk of developing oesophageal cancer.

Strangulated hernia

In some cases, a hiatus hernia causes part of the stomach to push up next to the oesophagus. This is known as a para-oesophageal hiatus hernia. GORD doesn’t usually occur in these cases, but there is a risk of the hernia becoming strangulated.

Strangulation occurs when the hernia becomes knotted and the blood supply to the area is cut off. Emergency surgery is usually required to correct the problem.

Useful Links

Published Date: 2013-09-02 11:39:58Z
Last Review Date: 2013-04-08 00:00:00Z
Next Review Date: 2015-04-08 00:00:00Z

Classification: Barrett's oesophagus,Bleeding,Heartburn,Hernia,Hiatus hernia

NHS Choices Syndication

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/conditions/articles/hernia-hiatus/diagnosis

Hernia, hiatus

Diagnosing a hiatus hernia

[Original article on NHS Choices website]

A hiatus hernia can usually be diagnosed after an endoscopy or an X-ray. Your GP will make an appointment for you to have this done in hospital.

Endoscopy

During an endoscopy the inside of your body is directly examined using an endoscope (a long, thin flexible tube that has a light source and video camera at one end), which sends images to an external monitor.

The endoscope will be inserted into your mouth and down your throat to look for any problems. The procedure is usually done while you are awake and you may be given a sedative to help you to relax.

Barium meal X-ray

The barium meal X-ray, also called the barium swallow test, is one of the most effective ways of identifying a hiatus hernia.

As part of the test you will be asked to drink some barium solution. Barium is a non-toxic chemical that shows up clearly on an X-ray. Once the barium moves down into your digestive system a series of X-rays will be taken to identify any problems.

If you need to have a barium meal X-ray, you will not be able to eat or drink anything for at least six hours before the procedure so that your stomach and duodenum (top of the small intestine) are empty. You may be given an injection to relax the muscles in your digestive system.

You will be given a white, chalky liquid containing barium to drink while lying down. This means your specialist will be able to see your stomach on an X-ray monitor more easily, as well as any ulcers or abnormal growths. Your bed may be tipped slightly during the test so that the barium fills all the areas of your stomach.

A barium swallow usually takes about 15 minutes to perform. Afterwards you will be able to eat and drink as normal, although you may need to drink more water to help flush the barium out of your system.

You may feel slightly sick after a barium meal X-ray and the barium may cause constipation. Your stools may also be white for a few days afterwards as the barium passes through your system.

Useful Links

Published Date: 2013-09-02 13:14:58Z
Last Review Date: 2013-04-08 00:00:00Z
Next Review Date: 2015-04-08 00:00:00Z

Classification: Hernia,Hiatus hernia

NHS Choices Syndication

Representations

/conditions/articles/hernia-hiatus/introduction

Hernia, hiatus

Introduction

[Original article on NHS Choices website]

A hiatus hernia, or hiatal hernia, is when part of the stomach squeezes into the chest through an opening in the diaphragm called the hiatus.

The diaphragm is a large, thin sheet of muscle located between the chest and the abdomen (tummy).

Hiatus hernia and heartburn

A hiatus hernia itself rarely has any noticeable symptoms. However, it can cause a problem called gastro-oesophageal reflux disease (GORD).

You should see your GP if you have frequent and severe symptoms of GORD.

Who is affected?

Hiatus hernia can affect anyone, but it’s more common in women and people who are over 50, overweight, pregnant or who smoke. It’s estimated that a third of people over 50 have a hiatus hernia.

There’s also a rare type of hiatus hernia that affects newborn babies.

Why it happens

It’s not exactly clear what causes hiatus hernia, but it may be the result of the diaphragm becoming weak with age or pressure on the abdomen.

Hiatus hernia can occur in newborn babies if the stomach or diaphragm doesn’t develop properly.

Types of hiatus hernia

There are two main types of hiatus hernia:

sliding hiatus hernias – hernias that move up and down, in and out of the chest area (more than 80% of hiatus hernias are this type)
para-oesophageal hiatus hernias – also called rolling hiatus hernias, this is where part of the stomach pushes up through the hole in the diaphragm next to the oesophagus (about 5-15% of hiatus hernias are this type)

This information mainly focuses on sliding hiatus hernias.

The type of hiatus hernia can usually be diagnosed using an X-ray or an endoscopy, where a long, tube-like instrument with a video camera and light source is used.

Read more about diagnosing a hiatus hernia.

Treating hiatus hernia

Treatment for sliding hiatus hernia usually focuses on relieving the symptoms of GORD, such as heartburn.

Lifestyle changes and medication are the preferred treatments. Surgery is usually only recommended as an alternative to long-term medication or if other treatments haven’t worked.

Lifestyle advice may include:

eating smaller, more frequent meals rather than three large meals a day
avoiding lying down (including going to bed) for three hours after eating or drinking
removing any foods or drinks that make your symptoms worse from your diet

If a hiatus hernia isn’t causing any noticeable problems, it doesn’t usually need to be treated.

Para-oesophageal hiatus hernias are repaired surgically if there is a risk of serious complications.

Further problems

Read more about the complications of hiatus hernia.

Useful Links

Published Date: 2014-02-06 15:28:36Z
Last Review Date: 2013-04-08 00:00:00Z
Next Review Date: 2015-04-08 00:00:00Z

Classification: Hernia,Hiatus hernia

NHS Choices Syndication

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Hernia, hiatus

See what the doctor sees with Map of Medicine

[Original article on NHS Choices website]

The Map of Medicine is used by doctors throughout the NHS to determine the best treatment options for their patients. NHS Choices offers everyone in England exclusive and free access to this cutting-edge internet resource, which lets you see exactly what your doctor sees.

The information in the Map has been approved by the UK’s leading clinical experts, is based on the best available clinical evidence, and is continually updated. To take advantage of this unique resource go to:

Map of Medicine: hernias

Useful Links

Published Date: 2011-09-11 17:05:03Z
Last Review Date: 2011-07-18 00:00:00Z
Next Review Date: 2013-07-18 00:00:00Z

Classification: Hernia

Hiatus hernia – NHS Choices

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Hiatus hernia

Introduction

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Digestive health

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A hiatus hernia, or hiatal hernia, is when part of the stomach squeezes into the chest through an opening in the diaphragm called the hiatus.

The diaphragm is a large, thin sheet of muscle located between the chest and the abdomen (tummy).

Hiatus hernia and heartburn

A hiatus hernia itself rarely has any noticeable symptoms. However, it can cause a problem called gastro-oesophageal reflux disease (GORD).

You should see your GP if you have frequent and severe symptoms of GORD.

Who is affected?

Hiatus hernia can affect anyone, but it’s more common in women and people who are over 50, overweight, pregnant or who smoke. It’s estimated that a third of people over 50 have a hiatus hernia.

There’s also a rare type of hiatus hernia that affects newborn babies.

Why it happens

It’s not exactly clear what causes hiatus hernia, but it may be the result of the diaphragm becoming weak with age or pressure on the abdomen.

Hiatus hernia can occur in newborn babies if the stomach or diaphragm doesn’t develop properly.

Types of hiatus hernia

There are two main types of hiatus hernia:

sliding hiatus hernias – hernias that move up and down, in and out of the chest area (more than 80% of hiatus hernias are this type)
para-oesophageal hiatus hernias – also called rolling hiatus hernias, this is where part of the stomach pushes up through the hole in the diaphragm next to the oesophagus (about 5-15% of hiatus hernias are this type)

This information mainly focuses on sliding hiatus hernias.

The type of hiatus hernia can usually be diagnosed using an X-ray or an endoscopy, where a long, tube-like instrument with a video camera and light source is used.

Read more about diagnosing a hiatus hernia.

Treating hiatus hernia

Treatment for sliding hiatus hernia usually focuses on relieving the symptoms of GORD, such as heartburn.

Lifestyle changes and medication are the preferred treatments. Surgery is usually only recommended as an alternative to long-term medication or if other treatments haven’t worked.

Lifestyle advice may include:

eating smaller, more frequent meals rather than three large meals a day
avoiding lying down (including going to bed) for three hours after eating or drinking
removing any foods or drinks that make your symptoms worse from your diet

If a hiatus hernia isn’t causing any noticeable problems, it doesn’t usually need to be treated.

Para-oesophageal hiatus hernias are repaired surgically if there is a risk of serious complications.

Further problems

Read more about the complications of hiatus hernia.

Page last reviewed: 09/04/2013

Next review due: 09/04/2015

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Comments

The 44 comments about ‘Hiatus hernia’ posted are personal views. Any information they give has not been checked and may not be accurate.

Cruella118 said on 26 September 2014

Mistified said on 22 September 2014

Paul Maybin said on 10 August 2014

lady in red said on 30 July 2014

emrose2 said on 22 July 2014

anbuma said on 14 July 2014

RickCSF said on 09 July 2014

Am in constant discomfort in my chest, but am active in my work and I don’t want to slow down in my every day activity.

I would welcome any guidance on possible food that may help, am all for diet change

bigeron said on 26 June 2014

brightyswf said on 07 February 2014

Having been referred by my GP, I have had an angiogram (which came out fine) and even tried GTN spray (in case it was small vein syndrome) which didn;t work either.

Any thoughts??

thanks

ian

bobblybits said on 20 January 2014

steven o said on 15 January 2014

slinky30 said on 14 January 2014

Avril Elaine said on 18 December 2013

Komodo1 said on 30 November 2013

Evil Edna said on 24 November 2013

clodsal said on 15 October 2013

luizalotos said on 27 September 2013

Hi everyone,

I was diagnosed 3 week ago with HH, 3 cm.

After some internet research I found that HH which is less than 3 cm is small but 5 cm is consider as big one.

I have few serious pains at work where everybody around me noticed that because I was immediately changed on my face and I was just able to sit down, have difficulties with breeding.

I’m training to bring to your attention that some of your usual activities or jobs can increases your problems despite of medicines you taking to ease off painful and unpleasant symptoms.

chloefitz said on 22 September 2013

SirAsh86 said on 18 September 2013

Mark Gravesend said on 27 August 2013

ash1989 said on 29 July 2013

JSTEP123 said on 25 July 2013

lizamy said on 23 July 2013

Gimmeshelter said on 19 June 2013

santaclara said on 10 June 2013

ensnaturae said on 12 May 2013

casey43 said on 30 April 2013

Edd200sx said on 29 April 2013

I was diagnosed 3 months ago during a hospital admission with a hh after eating some greasy fish and chips also gallstones diagnosed at the same time.

The pain was indescribable and now I’m on omeprazole and donperidone and still feel like anything I eat or drink is going to come back out.

I have Backache cant swallow properly pain in left chest after eating anything. I’ve lost over a stone in weight.

My doctor today refused point blank to do anything about either problem and said keep taking the pills which will cost me £90 a year? What on top of my taxes? Why thanks doc for nothing.

I’ve heard nothing from the hospital even though the consultant said she would have me back in at some point
To sort things out.

I’m disgusted with the nhs.

niknak1967 said on 29 March 2013

Romadean said on 25 March 2013

jules02 said on 15 March 2013

TREV N said on 28 February 2013

It really annoys and upsets me when I read articles saying that ‘although in many cases a hiatus hernia causes no symptoms’ or for some other websites putting it in some other way to that effect.

I was diagnosed with a hiatus hernia many many years ago, and I have been rolling around in agony quite often.

Everyday from morning to night, I suffer terrible with pains in my stomach, and these pains do not go. They are constant pains.

If someone has a bunion or a corn on their foot and it is painful, the pain may tend to go away gradually by not wearing tight shoes or resting your foot.

However, if someone accidentally stood on that persons foot, that person would be in agony.

My pains are just like somebody standing or pressing on my stomach, which is very similar to someone standing on somebody’s bunion or a corn day and night, where there is no relief from pain.

GazUK said on 25 February 2013

Hi, petejones2k,

I’m male -26 – and have been suffering with heartburn for the last 3 years.

I’ve just been diagnosed (only saw docs today) and just through by me providing him [the doc] with my symptons, has diagnosed me with hiatus hernia. No tests done.

petejones2k said on 18 February 2013

pease786 said on 22 January 2013

MX52 said on 21 January 2013

margo4 said on 28 December 2012

Birdynumnum said on 17 December 2012

vik1976 said on 12 November 2012

meemee said on 12 August 2012

Seviyorumcok said on 20 February 2012

After 2 weeks of tests E.C.G’s, blood tests etc etc plus xrays and ct scans I got my diagnoses. Hiatus Hernia.

derique said on 11 November 2011

carrhouse said on 12 May 2011

Useful links

NHS Choices links

External links

British Hernia Centre

Symptom checker

If you have a health problem, our symptom checker can help you manage it or find out where to go for help

Eat right for your digestion

How to eat and drink to ensure a good digestion, including foods to avoid and which ones to fill up on.

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/conditions/articles/hernia-hiatus/treatment

Hernia, hiatus

Treating a hiatus hernia

[Original article on NHS Choices website]

Treatment for a hiatus hernia is usually only necessary if it’s causing problems.

In most cases, people with a hiatus hernia only experience problems if the hernia causes gastro-oesophageal reflux disease (GORD). GORD can cause symptoms such as heartburn and an unpleasant taste in your mouth.

Lifestyle changes and medication are the preferred treatments, although surgery may be used as an alternative to long-term medication or if other treatments are ineffective.

Lifestyle changes

A number of self-care techniques may help relieve symptoms of GORD caused by a hiatus hernia. These include:

eating smaller, more frequent meals rather than three large meals a day
avoiding lying down (including going to bed) for at least three hours after eating or drinking
avoiding drinking during the night
removing certain foods from your diet if you think they make your symptoms worse
avoiding alcohol, caffeine, chocolate, tomatoes, fatty foods, spicy foods and acidic food or drinks (such as citrus fruit juice) if they make your symptoms worse
avoiding bending over or stooping, especially after eating or drinking
raising the head of your bed by around 20cm (8 inches) by placing a piece of wood or blocks under it – do not use extra pillows because this may increase pressure on your abdomen

If you are overweight, losing weight may help reduce the severity and frequency of your symptoms.

If you smoke, consider stopping. Tobacco smoke can irritate your digestive system and may make your symptoms worse.

Medication

A number of different medications can be used to treat symptoms of hiatus hernia. These are described below.

Antacids

Antacid medicines can relieve some of the symptoms of hiatus hernia. They come in liquid or tablet form and can be swallowed or chewed. They help neutralise stomach acid when they reach the oesophagus and stomach by making it less acidic.

However, antacid medicines don’t work for everyone. They’re not a long-term solution if symptoms persist or you are in extreme discomfort.

Antacids should not be taken at the same time as other medicines because they can stop other medicines from being properly absorbed by your body. They may also damage the special coating on some types of tablets. Ask your GP or pharmacist for advice.

Alginates

Alginates are an alternative medicine to antacids. They work by producing a protective coating that shields the lining of your stomach and oesophagus from the effects of stomach acid.

H2-receptor antagonists

In some cases, a medicine known as an H2-receptor antagonist (H2RA) may be recommended if a hiatus hernia is causing GORD. Examples of H2RAs include cimetidine, famotidine and ranitidine.

H2RAs block the effects of the chemical histamine, which your body uses to produce stomach acid. H2RAs therefore help reduce the amount of acid in your stomach.

Side effects of H2RAs are uncommon. However, possible side effects may include diarrhoea, headaches, tiredness and a rash.

Some H2RAs are available over the counter at pharmacies. These types of HR2As are taken in a lower dosage than the ones available on prescription. Ask your GP or pharmacist if you are not sure whether these medicines are suitable for you.

Proton-pump inhibitors (PPIs)

Your GP may prescribe a medication called a proton-pump inhibitor (PPI). PPIs work by reducing the amount of acid produced by your stomach. Examples of the PPIs you may be prescribed include omeprazole, lansoprazole, rabeprazole and esomeprazole.

Most people tolerate PPI well and side effects are uncommon. When they do occur they are usually mild and may include headaches, diarrhoea, feeling sick, or constipation.

To minimise any side effects, your GP will prescribe the lowest possible dose of PPIs they think will be effective. You should let your GP know if the prescribed dose of PPIs doesn’t work. A stronger dose may be needed.

Prokinetics

If your symptoms are not responding to other forms of treatment, your GP may prescribe a short-term dose of a prokinetic. Examples of prokinetic medicines include domperidone and metoclopramide.

Prokinetics speed up the emptying of your stomach, which means there is less opportunity for acid to irritate your oesophagus.

A small number of people who take prokinetics have what is known as extrapyramidal symptoms. Extrapyramidal symptoms are a series of related side effects that affect your nervous system and can include:

muscle spasms
problems opening your mouth fully
a tendency to stick your tongue out of your mouth
slurred speech
abnormal changes in body posture

If you have the above symptoms while taking prokinetics, stop taking them and contact your GP or out-of-hours doctor immediately. They may recommend you stop taking them. The symptoms should stop within 24 hours of the medicine being withdrawn.

Prokinetics are not usually recommended for people under the age of 20 because of an increased risk of extrapyramidal symptoms.

Surgery

Surgery is usually only recommended for a sliding hiatus hernia if the problem fails to respond to lifestyle changes and medication.

You may also wish to consider surgery if you have persistent and troublesome symptoms but do not want to take medication on a long-term basis.

Prior to surgery you may need further investigations to check how well the oesophagus moves (manometry) and how much acid is being refluxed (24-hour oesopageal pH studies).

Laparoscopic nissen fundoplication (LNF)

A procedure called a laparoscopic nissen fundoplication (LNF) is one of the most common surgical techniques used to treat GORD and sliding hiatus hernias.

LNF is a type of keyhole surgery that involves making a series of small cuts in your abdomen. Carbon dioxide gas is used to inflate your abdomen to give the surgeon room to work in.

During LNF, the stomach is put back into the correct position and the diaphragm around the lower part of the oesophagus is tightened. This should prevent any acid moving back out of your stomach.

LNF is carried out under general anaesthetic, so you will not feel any pain or discomfort. The surgery takes 60 to 90 minutes to complete.

After having LNF, most people can leave hospital once they have recovered from the effects of the general anaesthetic. This is usually within two to three days. Depending on the type of job you do, you should be able to return to work within three to six weeks.

For the first six weeks after surgery it is recommended you only eat soft food, such as mince, mashed potatoes or soup. Avoid eating hard food that could get stuck at the site of the surgery, such as toast, chicken or steak.

Common side effects of LNF include difficulties swallowing (dysphagia), belching, bloating and flatulence.

These side effects should resolve over the course of a few months. However, in about 1 in 100 cases they can be persistent. In such circumstances, further corrective surgery may be required.

Para-oesophageal hiatus hernia

If you have a para-oesophageal hiatus hernia, where the stomach pushes up through the hole in the diaphragm next to the oesophagus, surgery may be recommended to reduce the risk of the hernia becoming strangulated.

See complications of hiatus hernia for more information.

Hiatus hernia

Hiatus hernia

Introduction

Digestive health

Hiatus hernia and heartburn

Who is affected?

Why it happens

Types of hiatus hernia

Treating hiatus hernia

Further problems

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