Introduction
A hiatus hernia occurs when part of the stomach bulges through an opening in the diaphragm, called a hiatus. If the hiatus hernia is large, it can cause food and acid to re-enter your oesophagus, leading to heartburn or gastro-oesophageal reflux disease (GORD).
There are two main types of hiatus hernia: sliding and rolling. There are also combinations of the two types. The most common type is a sliding hiatus hernia, where the hernia slides in and out of the lower chest.
Causes
Some people are born with an unusually large hiatus, so the opening in the diaphragm is more susceptible to a hernia. When you are over the age of 50, changes to muscle, ligaments and tendons occur which makes hiatus hernia more likely. Hiatus hernia can be brought on by excessive straining, for example when coughing, sneezing, violent vomiting, or heavy lifting. Pregnancy or being overweight are also contributing factors. Smoking weakens the muscles, including the diaphragm, increasing the risk of developing a hiatus hernia.
Symptoms
Sometimes, a hiatus hernia might not be symptomatic, and is incidentally detected on imaging such as a chest X-ray or CT scan that is performed for other reasons. Often, a hiatus hernia will give rise to GORD symptoms, including an acidic taste in the throat, heartburn, chest pain, difficulty swallowing, burping and hiccups, regurgitation, and nausea. Some people may also experience a feeling of fullness or bloating in the upper abdomen, especially after meals.
Diagnosis
Dr Moar will ascertain your symptoms, their duration and intensity. He will then conduct an endoscopy, contrast swallow X-ray or CT scan and oesophageal function test, if they are deemed necessary.