Bariatric surgery · Obesity and metabolism

Hiatus hernia

Understand movement of part of the stomach into the chest and its link with reflux.

Editorial publication · Medical review pending.

Understand

A hiatus hernia occurs when part of the stomach moves into the chest through the opening in the diaphragm.

It may be silent or cause heartburn, reflux, bloating, nausea, bad breath and difficult or painful swallowing.

The exact cause is often unclear; age, pregnancy, excess weight and abdominal pressure may contribute.

History and examination assess reflux and check for alarm features or another chest or digestive cause.

Gastroscopy or a contrast X-ray can show the hernia; other tests assess reflux before selected procedures.

Many cause no problem; symptoms may persist or fluctuate and complications are uncommon.

Smaller meals, leaving time before lying down, weight loss when useful and acid treatment are common; surgery is reserved for selected severe cases.

Seek advice if symptoms last, worsen or do not respond to pharmacy treatment.

Increasing difficulty swallowing, repeated or bloody vomiting, unplanned weight loss, severe abdominal pain or chest pain needs prompt assessment.

A procedure linked to a condition does not establish an indication for your individual situation.