Hiatus hernia

A hiatus hernia is when part of your stomach moves up into your chest. It’s very common if you’re over 50. It doesn’t normally need treatment if it’s not causing you problems.

Check if you have a hiatus hernia

You can have a hiatus hernia without knowing, and without it being a problem.

With a hiatus hernia you can have:

  • a painful burning feeling inside the chest, often after eating (heartburn)
  • bringing up small amounts of food or bitter tasting fluids (acid reflux)
  • bad breath
  • feeling bloated and belching
  • feeling or being sick
  • difficulty or pain when swallowing

These are the symptoms of gastro-oesophageal reflux disease (GORD).

See a GP if:

  • your symptoms don’t go away after 3 weeks
  • your symptoms are very bad or getting worse
  • medicines from the pharmacy don’t help

Get an urgent GP appointment if:

  • you’re over 55 and you’ve lost weight for no reason
  • swallowing becomes very difficult
  • you throw up (vomit) frequently
  • you throw up blood

Treatment for a hiatus hernia

Broadly, treatment follows these steps:

  1. Change your eating habits - for example eating smaller meals more often and doing other things to help with the symptoms of GORD.
  2. Buy medicines from the pharmacy - ask the pharmacist what you should take to help with the symptoms of GORD.
  3. See a GP - if changing your eating habits and medicines from the pharmacy don’t help your GP can prescribe stronger medicines.
  4. Further tests - if stronger medicines don’t work your GP can send you for further tests to find out if your symptoms are caused by a hiatus hernia. They might also prescribe medicines for long-term GORD.
  5. Surgery - your GP might refer you to a specialist to check if you need surgery. This usually only happens if other treatments haven’t worked and you keep having very bad symptoms.

Surgery for a hiatus hernia

Surgery for hiatus hernia is usually keyhole surgery (done through small cuts in your tummy area - your abdomen). It’s done under general anaesthetic - you’ll be asleep during the operation.

After surgery it usually takes:

  • 2 to 3 days to go home
  • 3 to 6 weeks to go back to work
  • 6 weeks before you can eat what you want
  • a few months to recover from side effects like bloating, belching, farting and difficulty when swallowing

There’s a small risk (about 1 in 100) that your side effects won’t go away and you’ll need more surgery.

What causes a hiatus hernia

It’s not clear what causes a hiatus hernia. Anyone can have one, but it’s more common if you’re over 50, pregnant or overweight.

Call 111

If you can’t speak to your GP or don’t know what to do next.