Hiatus Hernia

This is a condition where part or whole of your stomach moves into the chest. Normally the last inch to half an inch of the gullet is in your tummy, but due to a weakness in the opening of the diaphragm, through which the gullet passes from the chest into the tummy, the stomach moves into the chest.

Are there different kinds of hiatus hernias?

Largely speaking, there are two different types of hiatus hernias. 

The commonest and most often diagnosed is a ‘sliding’ hernia. In this hernia, the top of the stomach ‘slides’ into the chest. This can be seen on an endoscopy. Small section of the upper stomach is seen above the level of the diaphragm. 

The second and rarer variety is called a ‘rolling’ hernia. In this condition the stomach rolls into the chest. Varying amount of the stomach can herniate into the chest. Sometimes the whole stomach and bowel can be seen in the chest.


What symptoms can I get with a hiatus hernia?

The sliding hernias are mostly asymptomatic and often seen on endoscopy that was done for another reason. Sliding hernias generally do not give any symptoms, in particular they do not cause any pain. They may be seen in patients with heartburn / reflux, but may not be the cause for the symptoms. See heartburn section for further information.

The rolling hernias can be asymptomatic and picked up on scans or x-rays done for other purposes. But, they can give some significant symptoms. They can cause fullness and ‘indigestion’ even after small meals, reflux/heartburn, can cause vomiting and chest discomfort after meals, shortness of breath (as they can be compressing on the lungs and the heart).


What treatment will I need for hiatus hernia?

If it is a sliding hiatus hernia and you are not getting any symptoms from it, you will not need any treatment. However, if you have symptoms of heartburn or reflux, you may need some acid suppressing medication or surgery. See heartburn (hylerlink) section for further information. 

Most of the rolling type of hernias will certainly need a surgical treatment as there is a chance that the stomach that has herniated into the chest may get blocked or twisted. In extreme emergencies, part or the whole of the stomach can die as a result of the blood supply to it is cut off due to an extreme twist (strangulation). 

If you are worried that you may have a hiatus hernia, or have been diagnosed of one, book an appointment with Mr Jayanthi for further assessment of symptoms, further investigations if required and to discuss treatment options.


Gastric Sleeve

A gastric sleeve surgery is a restrictive procedure where the size of your stomach is reduced therefore limiting the amount of food you can eat which will help towards weight loss.


Gastric Band

A gastric band involves dividing your stomach into two by placing a silicone band around the stomach therefore creating a small pouch at the top of your stomach (roughly the size of a golf ball).


Gastric Bypass

In the UK, the most common gastric bypass surgery is a combination of restrictive and malabsorptive procedure procedures called Roux-en-Y (RYGB) which creates a two-way weight reducing effect.

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