Hiatus Hernia

What is a hiatus hernia?

A hiatus hernia happens when part of your stomach pushes up into your chest area. This is very common, especially if you're over 50. Many people have one without knowing it, and it often doesn't cause any problems.

What are the symptoms?

You might not have any symptoms at all. If you do, they usually include:

• A burning feeling in your chest after eating (heartburn)
• Bringing up small amounts of food or bitter liquid
• Bad breath
• Feeling bloated
• Feeling sick or being sick
• Pain or difficulty when swallowing

These symptoms are the same as those caused by acid reflux (when stomach acid comes back up into your throat).

What can you do to help yourself?

There are several things you can try at home:

Do:

• Eat smaller meals more often instead of big meals
• Raise the head of your bed by 10-20cm so your chest is higher than your waist
• Try to lose weight if you need to
• Find ways to relax and reduce stress

Don't:

• Eat foods or drinks that make your symptoms worse
• Eat within 3-4 hours of going to bed
• Wear tight clothes around your waist
• Smoke
• Drink too much alcohol
• Stop taking any medicines your doctor has given you without speaking to them first

How can a pharmacist help?

Your local pharmacist can give you advice about medicines that might help. They might suggest antacids or alginates, which can ease your symptoms. These work best when taken with food or just after eating.

Remember, these medicines help with symptoms but don't cure the problem. You shouldn't take them regularly for long periods without speaking to your GP.

When should you see your GP?

See your GP if:

• Your symptoms don't get better after 3 weeks
• Your symptoms are very bad or getting worse
• Medicines from the pharmacy don't help

When to get urgent help

Get urgent help from your GP or call NHS 111 if you have indigestion or acid reflux and:

• You've lost weight without trying
• Swallowing becomes difficult
• You're being sick frequently
• There's blood when you're sick
• You have pain in your upper tummy

These could be signs of something more serious that needs checking quickly.

What treatment might your GP offer?

If pharmacy medicines and lifestyle changes don't help, your GP can give you stronger medicines. If these don't work either, they might send you for tests or refer you to a specialist.

Surgery is sometimes needed, but only if other treatments haven't worked and you're still having very bad symptoms. This is usually keyhole surgery done under general anaesthetic. Recovery can take several weeks to months.

What causes a hiatus hernia?

Doctors aren't sure what causes hiatus hernias. Anyone can get one, but they're more common if you're over 50, pregnant, or overweight.

Remember, if you're worried about any symptoms, speak to your GP. They can help you work out the best way to manage your condition.

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Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.