Patient guide · Hernia surgery
Hiatus hernia: symptoms, and when it needs treatment
By Mr Trif Papettas FRCS, Consultant Colorectal & General Surgeon · Reviewed A hiatus hernia is quite different from a groin or abdominal-wall hernia — it involves the top of the stomach and the diaphragm, and it often shows up as acid reflux. Here is what it is, and when it needs treating.
What a hiatus hernia is
The oesophagus (gullet) passes through a small opening in the diaphragm to reach the stomach. In a hiatus hernia, part of the stomach slides up through that opening. The common type is a “sliding” hernia; less commonly, a “para-oesophageal” hernia forms alongside the gullet.
Symptoms
Many small hiatus hernias cause no symptoms at all. When they do, it is usually through acid reflux — heartburn, an acid or bitter taste, regurgitation, chest discomfort, or sometimes difficulty swallowing. Symptoms often overlap with ordinary reflux, which is why assessment matters.
How it's assessed
A hiatus hernia is frequently identified at gastroscopy — a camera examination of the gullet and stomach. Being examined by a JAG-accredited endoscopist means the procedure is held to an audited quality standard. In some cases additional tests are used to assess reflux and function.
When it needs treatment
Many hiatus hernias are managed well with lifestyle measures and acid-lowering medication. Treatment — including surgery in selected cases — is considered when troublesome reflux isn't controlled by medication, or for large or para-oesophageal hernias, which occasionally carry a risk of complications and need closer attention.
Getting checked
If reflux is persistent or you have difficulty swallowing, it's worth being assessed rather than simply living with it. Rapid-access private gastroscopy can usually be arranged quickly, without waiting for a GP referral.
Get a clear answer
Consultant-led hernia assessment across Warwickshire — Leamington Spa, Warwick and Stratford. No GP referral required.
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Mr Trif Papettas FRCS
Consultant Colorectal & General Surgeon at Nuffield Health Warwickshire Hospital, Leamington Spa. Fellow of the Royal College of Surgeons, JAG dual-accredited in colonoscopy and gastroscopy, with a large personal case volume in open, keyhole and robotic-assisted hernia repair — including complex and recurrent cases.