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Hiatus hernia

Key points

  • Hiatus hernia is when part of your stomach slides upwards into your chest, through a hole in your diaphragm.
  • Many people with a hiatus hernia have no symptoms. However, some people develop heartburn.
  • The exact cause of hiatus hernia isn’t known. However, you’re more likely to develop it if you’re overweight and as you get older (over 50).
  • Treatment aims to relieve symptoms. Changing your lifestyle, taking medicines and having surgery are possible treatments.

This section contains answers to frequently asked questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email.

Which foods make the symptoms of hiatus hernia worse?

Answer

There are certain foods and drinks that can make your symptoms worse. These include spicy foods, alcohol and caffeine.

Explanation

Making changes to your lifestyle can help control the symptoms of acid reflux caused by a hiatus hernia. Some food and drink can increase the amount of acid in your stomach or relax the muscle at the bottom of the oesophagus and make heartburn worse. These include:

  • chocolate
  • spicy food
  • fatty food
  • tomato-based foods, including spaghetti sauce and salsa
  • alcoholic drinks
  • drinks that contain caffeine, such as coffee and cola

You might find it helpful to keep a food diary so that you can start to recognise which foods make your symptoms worse. When you know what these are, you can stop eating them or have less of them.

What medicines can I take to help me feel better if I have a hiatus hernia?

Answer

You can take a number of different types of medicine that should help you feel better. They work by either neutralising stomach acid or reducing the amount of acid produced in your stomach, and by protecting your stomach and oesophagus.

Explanation

Antacids work by counteracting or neutralising the acid in your stomach. Some antacids also cover the surface of your oesophagus and stomach which forms a protective barrier against acid.

You won’t need a prescription for these medicines– you can buy them from a pharmacy or supermarket. They are available in tablet or liquid form. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

How well antacids work varies from person to person. If you find they don’t relieve your symptoms, your GP or pharmacist may recommend a different medicine.

Proton pump inhibitors (for example, omeprazole, lansoprazole and pantoprazole) reduce the amount of acid being produced. Histamine blockers, sometimes called H2-receptor blockers (for example, ranitidine and cimetidine), also reduce the amount of acid your stomach produces, although they don’t work as well as proton pump inhibitors. You won’t need a prescription to buy H2-receptor blockers but you will need one for proton pump inhibitors.

Always ask your GP for advice and read the patient information leaflet that comes with your medicine.

What are the risks of surgery for a hiatus hernia?

Answer

As with every procedure, there are some risks associated with having surgery for a hiatus hernia. These are specific to you and differ for every person but may include feeling full and uncomfortable especially after eating and difficulty swallowing. Ask your surgeon to explain how these risks apply to you.

Explanation

Complications are when problems occur during or after the operation. Side-effects are the unwanted but mostly temporary effects you may get after having the procedure.

Complications and side-effects following surgery for a hiatus hernia are rare. The main ones are listed below.

  • Feeling bloated and full, especially after you’ve eaten. Some people get uncomfortable as it’s difficult to burp after this type of surgery. This is called ‘gas-bloat syndrome’.
  • Finding it difficult or painful to swallow – this usually gets better within six weeks of having the operation.
  • Injury to the area around your stomach and diaphragm.
  • Wound infection.
  • Hernias through surgical wounds – this is where the tissues in your abdomen push up through your wound causing a bulge.
  • Bleeding in your stomach or spleen area at the time of the operation – this is rare it but will need immediate medical treatment.

Sometimes the benefits of the operation don’t last and it may need to be done again. If your symptoms come back after your operation, talk to your surgeon.

I am overweight and often get heartburn. Could I have a hiatus hernia?

Answer

If you’re overweight or obese, you’re more likely to get heartburn and indigestion. You’re also more likely to develop a hiatus hernia.

Explanation

The exact reasons why being overweight causes heartburn aren’t known. However, being overweight or obese can increase the pressure inside your abdomen (tummy) which may have an effect. Being very overweight may also affect how well the opening from your stomach to your oesophagus (the pipe that goes from your stomach to your mouth) works. Whatever the cause, acid from your stomach can flow backwards into your oesophagus. This is called acid reflux and is what causes heartburn.

Heartburn is a common symptom of a hiatus hernia. Other symptoms include finding it difficult or painful to swallow, feeling sick or being sick and a cough or wheezing when breathing at night. Speak to your GP if you have any of these symptoms or think you might have a hiatus hernia.

Exercising and eating healthily can help you to lose excess weight and reduce your symptoms. Try to do 150 minutes (two and a half hours) of moderate exercise over a week in bouts of 10 minutes of more. You can do this by carrying out 30 minutes on at least five days each week.

 

Reviewed by Sarah Smith, Bupa Health Information Team, October 2013.

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  • This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.

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