What is a hiatus hernia?
Hiatus hernia is a condition in which a part of the stomach slips up into the chest through the opening in the diaphragm (the hiatus) which normally just contains the oesophagus.
The most common type of hiatus hernia is a sliding hernia. This is when the lower oesophageal sphincter is pushed up into the chest cavity away from the hiatus, leading to symptoms of heartburn and gastric reflux.
The other kind of hiatus hernia is a para-oesophageal hiatus hernia where the stomach slips up into the chest to lie beside the oesophagus. This kind of hernia is less common, but is more of a cause for concern.
Is a hiatus hernia life threatening?
Most hiatus hernias are not life threatening. However, a para-oesophageal hiatus hernia can, on rare occasions, be life-threatening.
If the hernia twists in the chest it can result in a loss of the blood supply to the stomach (ischaemia) and perforation of the stomach into the chest cavity.
Are hiatus hernias common?
Hiatus hernias, particularly the sliding type, are common among people aged over 50, with an estimated third of people in this age group affected.
How can a hiatus hernia be treated?
Most small, sliding hiatus hernias do not require surgical treatment, and can be treated with medication and lifestyle changes such as eating smaller meals more regularly, avoiding lying down for three hours after eating or drinking, and removing certain foods from your diet.
Troublesome hiatus hernias can be repaired using keyhole surgical techniques, although open surgery may still be required for particularly large hernias.
How long does treatment take?
A keyhole surgical procedure usually takes around two hours.
What is the recovery time for hiatus hernias?
After keyhole surgery, patients will typically be discharged within a day or two.
It is common to keep to a liquid diet for two to four weeks after surgery and then recommence a normal diet. Most patients will be able to go back to work within a week or 10 days.
What are the possible complications of hiatus hernia surgery?
Complications of hiatus hernia surgery include the rare complications of any surgery such as bleeding and infection.
Specific complications to hiatus hernia repair include a difficulty in swallowing solids, which is usually temporary.
There is also a chance of recurrence of the hernia, although this depends on a number of factors such as the size of the hernia.