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Hiatus Hernia
A hiatus hernia occurs when part of the stomach pushes up through the diaphragm into the chest. The diaphragm is a large muscle that separates the chest cavity from the abdomen and helps with breathing. The opening in the diaphragm through which the oesophagus (food pipe) passes is called the hiatus.
Hiatus hernias are relatively common, especially in people over the age of 50.
Many people have no symptoms and may not know they have one.
It is often found during investigations such as gastroscopy or imaging for other conditions.
Many people with a hiatus hernia do not experience any symptoms.
However, when symptoms do occur, they are often related to gastro-oesophageal reflux where stomach acid moves back up into the oesophagus.
Symptoms of Hiatus Hernia
Heartburn or burning chest pain
Regurgitation of food or sour-tasting fluid
Difficulty swallowing (dysphagia)
A feeling of food being stuck in the chest or throat
Frequent burping or bloating
Chest discomfort, especially after eating or when lying down
If you experience persistent reflux, difficulty swallowing, unexplained weight loss, or chest pain, it is important to seek medical assessment.
A gastroscopy or imaging may be recommended to check the oesophagus and stomach.
Treatment for a Hiatus Hernia
Treatment depends on the type of hernia and the severity of symptoms.
Most people with a hiatus hernia can manage their symptoms effectively with lifestyle changes and medication.
Your gastroenterologist or oesophago-gastric surgeon can guide your treatment and ensure appropriate monitoring.
Controlling Reflux Symptoms
In most cases, treatment is aimed at controlling reflux symptoms, for example by
Eating smaller meals and avoiding large or late meals
Avoiding foods that worsen reflux
Elevating the head of the bed
Avoiding lying down soon after eating
Weight loss if overweight
Stopping smoking
Medications
Antacids – for quick relief of heartburn
Proton pump inhibitors (PPIs) (e.g., omeprazole, pantoprazole) – more effective long-term acid suppression
These medications can significantly reduce symptoms and help heal inflammation of the oesophagus caused by acid reflux.
Surgery
Surgery may be considered the symptoms are not well controlled with medications and lifestyle changes or there are complications related to reflux.
The most common surgical procedure is laparoscopic fundoplication.
Find A Specialist
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Dr James Wilkins
General & Oesophago-gastric Surgeon
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Dr Nigel S. Rajaretnam
General, Oesophago-gastric & Endocrine Surgeon
