What is a hiatus hernia?
A hiatus hernia happens when part of the stomach squeezes up into the chest through an opening (the hiatus) in the diaphragm — the sheet of muscle that separates the chest from the tummy. It is common, especially with age, and many people have one without ever knowing.
Symptoms
A hiatus hernia itself often causes nothing. Its main effect is making acid reflux more likely, so symptoms are usually those of reflux:
- heartburn — a burning feeling in the chest
- acid or food coming back up
- an unpleasant sour taste
- burping, bloating or discomfort after meals
What causes it
Often there is no single cause. It becomes more common as we age, and anything that raises pressure in the tummy — excess weight, pregnancy, repeated heavy lifting or a persistent cough — can play a part.
How it is managed
Most hiatus hernias are managed by controlling reflux rather than fixing the hernia: eat smaller meals, avoid eating close to bedtime, cut back on trigger foods, alcohol and smoking, lose excess weight, and raise the head of the bed. Acid-reducing medicines from a pharmacist or GP help many people. Surgery is only considered for the small number with severe or complicated hernias.
When to get checked
See a GP for frequent reflux or heartburn lasting three weeks or more. Difficulty swallowing, unexplained weight loss, vomiting or signs of bleeding need prompt assessment — and sudden severe chest pain should always be treated as a possible emergency.
Common questions about hiatus hernia
- What are the symptoms of a hiatus hernia?
- Many cause no symptoms. When they do, the common ones are heartburn, acid reflux, an unpleasant taste, burping and discomfort after eating — essentially the symptoms of reflux, which the hernia makes more likely.
- What causes a hiatus hernia?
- The exact cause is often unclear. It becomes more common with age, and pressure on the tummy — from being overweight, pregnancy, heavy lifting or persistent coughing — can contribute.
- How is a hiatus hernia treated?
- Most are managed by treating the reflux — smaller meals, not eating late, losing excess weight, raising the head of the bed, and acid-reducing medicines. Surgery is reserved for the minority with severe symptoms or certain types of hernia.
- Is a hiatus hernia dangerous?
- Usually not — most are harmless and managed easily. Rarely, certain types can cause complications, which is why warning signs like difficulty swallowing, vomiting or bleeding should be checked promptly.