Hiatus Hernia

In some people, the hiatus can enlarge and the stomach can slip up into the chest through it.

In medicine, when something pushes out of an area it should stay in, it is called a hernia.

Therefore, the stomach "herniates" through the hiatus in the diaphragm and moves into the chest.

As such, anything that is in the stomach - including food, drink and stomach acid, can now move easily back up into the oesophagus (gullet).

This is the cause of the usual symptoms of hiatus hernia:

- heart burn or food regurgitating into the back of the throat on lying down, straining or bending forwards.

Treatment

If a doctor suspects a hiatus hernia, they usually ask for an endoscopy (a thin flexible tube put down the throat and into the oesophagus to see what is going on) or an X-ray with the patient drinking some contrast (which shows up on X-ray).

Treatments can be:

Conservative:
  • Lose weight, wear loose belts and clothes
  • Drugs, to prevent the contact of stomach acid on the oesophagus, or to reduce the stomach acid

Surgery (see diagram):

  • Can be done open or by "keyhole" (laparoscopic) surgery methods
  • The stomach is pulled down into the abdomen, the top is wrapped around the lower oesophagus and the hiatus is stitched smaller

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