A hiatus hernia or hiatal hernia occurs when the upper part of your stomach pushes up through your diaphragm and into your chest region. A hiatus hernia rarely has noticeable symptoms but it can cause gastro-oesophageal reflux disease (GORD). GORD can occur if a hiatus hernia prevents the valve at the bottom of the oesophagus from working properly and can cause stomach acid to leak into the oesophagus. This condition mostly occurs in people who are over 50 years old.
Cause Of Hiatus Hernia
Hiatus means gap or hole (in Greek). The gullet (oesophagus) is the food passage from your mouth to your stomach. Unlike most hernias, hiatus hernia does not occur within the abdominal wall, but within the chest area and specifically affects the digestive system. To get there it has to pass through a hole in a flat sheet of muscle that separates the chest (containing your lungs and heart) from your abdomen (where your guts live).
The gullet passes through a hole or hiatus. Sometimes this hole enlarges and the top of the stomach passes upwards into the chest – this is called a hiatus hernia. The difficult part about fixing a hiatus hernia is that you can’t just close off the hole, because you always have to leave a small gap for the gullet to pass through.
Symptoms Of Hiatus Hernia
Unlike an abdominal hernia, hiatus hernia rarely causes symptoms which can make it difficult to diagnose. However, if you do experience any symptoms they are likely to be as below.
- Stomach acid
- Chest pain
- Trouble swallowing
- Air entering the esophagus
Symptoms May Be Triggered From
- Too hot foods or drink
- Spicy foods
- Acidic foods
- Drinking alcohol
- Being overweight
The repair is usually done laparoscopically. The classical operation was a ‘wrap around’ procedure, but now more and more surgeons are tending to using mesh. The repair is very technical and can be difficult to get right with good results. The aim of the repair is to narrow the opening just the right amount – not too little so the repair fails, and not to much so that the passage of the food is prevented. Alternative treatment can be provided to ease symptoms of acid reflux and heartburn for which medications may be provided.
Our Specialist Hiatus Hernia Consultants
At London Hernia we have two specialist Consultants in Mr Majid Hashemi and Mr Abuchi Okaro that deal with the treatment of hiatus hernia. Both have a wealth of experience in dealing with upper GI conditions and will be able to provide you with expert advice and the best possible treatment, should it be required.