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).
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.
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).
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.