The diaphragm is a horizontal sheet of muscle sheet which separates the oesophagus from the stomach.  There is a small hole in the diaphragm which allows food from the oesophagus to go through into the stomach and acts like a one way valve to prevent acid or food reflux into the oesophagus.  However, when the hole has become wider than usual, the stomach may pass upwards through this hole such that top part of the stomach is now in the chest cavity and acid can reflux up into the oesophagus.

Image credit Harvard Health

Symptoms

The symptoms of hiatus hernia are similar to those with Gastro Esophageal Reflux Disease or GERD

• Indigestion or feeling of fullness
• Heartburn or chest discomfort
• Bloated feeling after meals
• Nausea or vomiting
• Frequent burping
• Regurgitation food or liquid (sour or bitter taste going up your throat)

Click to view BupaUK video on Hiatus Hernia

Diagnosis

The diagnosis of a hiatus hernia can be made by your doctor using one of these tests

• Oesophageal gastro duodenoscopy
• Barium Swallow X-ray

Treatment for hiatus hernia

Treatment options depends of the severity of the symptoms

1. Lifestyle Modification may help if the symptoms are mild; 

• Lose weight to a suitable BMI for your age and height
• Wear loose fitting trousers
• Eat healthily and avoid oily of fried foods
• Do not eat at least 3 hours before sleep
• Eat smaller frequent meals and avoid eating a single large meal
• Avoid acidic or spicy foods
• Stop smoking

2. Anti-Reflux Surgery will be necessary if the symptoms are severe or if there are signs of oesophagitis (inflammation of the oesophagus) which can pre-dispose to Barrett’s oesophagus (a pre-cancerous condition).

See your doctor if you experience frequent heartburn symptoms

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