Taking Charge of Your Health

A hiatus hernia is a hole or gap that’s wider
than normal in the muscle called the diaphragm which separates the chest cavity from the
abdominal cavity. It’s a horizontal sheet and it allows, normally, the gullet or the
oesophagus to go through this tiny hole, but when you have a hiatus hernia, it means that
that hole has become wider than usual, and that has allowed the stomach to pass across
upwards through that widened hole, so that part of the top part of the stomach is now
in the chest cavity rather than being entirely in the abdominal cavity. So that, in a nutshell,
is what a hiatus hernia is. Well, hiatus hernia can give a patient a number of symptoms but
equally a lot of people can have a hiatus hernia and not even know about it, so it can
have no symptoms. For those patients that have symptoms, typically they will suffer
from indigestion and heartburn – the feeling of something burning in the chest area just
below the breastbone. Some folks might even get some discomfort in the upper abdominal
area, and some may get some nausea and some bloating, so these are all the kinds of symptoms
we can associate with hiatus hernias. The treatment for a hiatus hernia really depends
on patients and what kind of symptoms they are having. Typically if they’re getting classical
heartburn type symptoms, this can be treated through dietary modifications – so, for example,
avoiding eating late at night. So there are a lot of lifestyle changes that patients can
adopt to reduce the symptoms from a hiatus hernia. If these don’t work then there are
a number of effective medications that are available such as Gaviscon liquid, or Rennies.
Others are a bit stronger, for example you can get Zantac or renitidine. In those patients
where these tablets and these lifestyle changes do not work, there we have the option of offering
surgical treatment. There are essentially two kinds of operations we can do to fix hiatus
hernia. There is a standard anti-reflux operation, classically called the Nissen fundoplication. The alternative operation, which is a newer operation, is called the LINX implant operation,
so that’s the sort of modern surgical technique that we use to treat hiatus hernias and the
symptoms from hiatus hernia. The short answer of course is no, because this is a mechanical
problem where the hole in the diaphragm is bigger than normal anatomy, and there is no
medication that you can use to make the hole any smaller. It’s a mechanical problem and
an anatomical anomaly, and therefore it has to be fixed surgically. But really the question
should be whether the patient who has a hiatus hernia has any symptoms, so if you have a
hiatus hernia and don’t have any symptoms, then you don’t necessarily need an operation
to fix it. Equally, if you have a hiatus hernia and you have symptoms that you can manage
with lifestyle changes, with medication, then again in that situation you do not need an
operation. Typically we use operations to fix hiatus hernias in those patients where
either they don’t want to take the medications lifelong, or the medications don’t work, and
in those situations, definitely having a surgery to fix the hiatus hernia and to stop the acid
reflux and heartburn is highly effective to treat this condition. If a patient is getting
acid reflux and heartburn day after day, week after week, month after month, year after
year, and this is not treated, then the acid can actually damage the lining of the oesophagus
or the gullet, and that can lead to inflammation, that’s known as oesophagitis, and that in
itself can be quite a painful condition. It can cause problems with swallowing, it can
cause discomfort in the chest – but worst of all, there will be a small proportion of
patients where the constant acid damage of the lining of the oesophagus can eventually
turn into a pre-cancerous condition called Barrett’s oesophagus, and that of course in
the long run can itself convert into cancer. Acid reflux and heartburn should really be
taken seriously and treated.

72 thoughts on “Hiatus hernia: signs, symptoms and treatment

  1. I'm hithus harnia Wath is tritment I'm faram 15 year prablam Wath tretmint oprition r medicine?
    I'm not right English
    My language urdu

  2. Hey i have a sliding hiatis hernia my symptoms are reflux am on 40mgs of omeprizole 2 times a day and renitadine at night reflux is under control but i am nauseous 24/7 for the last 8months or so am on odansertron 2 times a day and doesn’t help much , i had an appointment for the surgeon but am holding off for aslong as possible due to recovery time being quite long and haven’t heard good things about it any ideas ? Im thinking i may need to give the surgery a go are there any complications ect and do you think it will fix me ?

  3. Why does my stomach want to come up through the hole? You make it sound like the thing is sentient and has a desire to escape! Freaking me out, man.

  4. Can it cause a drop In BP esp early n the AM & also I feel like I wake up short of breath. I can feel movement such as pulsing under my ribcage…feels like a heartbeat but movement like a spasm.

  5. Please help !! I'm from Canada and looking for Hiatal Hernia surgery. I'm suffering from heartburn all day long if I not take my PPI which I dont want take all my life. Any recommendation ? Thank you.

  6. Thank you for this video it's been very helpful I have Googled all this information about hiatal hernia and acid reflux and I have changed my diet and I have been cured God bless you dr.

  7. Just to let you know doctor. The drugs you suggest are temporary as are life style changes. If not treated with surgery it only gets worse. I have acid coming out my nose when I sleep and still doctors are pushing the drugs. They still won't check for hernia. Now my esophagus hurts right up to my tonsils. Why would you suggest drugs knowing it can turn into cancer?

  8. I have a moderate sliding HH. Medications dont work. 2 years of suffering. I now have esophigitus and the Dr saays it is not the HH. Im lost and sick of suffering.

  9. im scared of the cancer risk. I dont have much symptoms just slight phlegm in the mornings and sometimes i can feel something maybe last nights food in my food pipe i think its called silent reflux but it might just be normal. I dont take any meds because it doesnt bother me. But im scared of getting cancer by it. Am i at risk?

  10. The acid reflux is often caused by not enough acid in the stomach. When the stomach acid is low the hiatus gap relaxes making it easier for stomach contents to rise up. A lot of people get help from drinking apple cider vinegar and water or lime/lemon juice to raise the stomach PH. When you have trapped air in your stomach, you can try 1/2 teaspoon of Bi carbonate of soda in a little water. This will relax the hiatus alowing the air to be burped out.
    If you have acid, one of the best ways to halt it is to eat an apple. Medical land won't tell you this as they don't make money from it. Taking anti acids is probably the opposite thing you should do. Anti acids obviously reduce the acid in your stomach, which is a bad thing, as it greatly reduces your intake of nutrients and minerals from food and can result in cronic fatigue, amongst other things.
    Most doctors know next to nothing about nutrition. Medical school teaches them hardly anything.
    The best way to fix your hernia or at least make it 90% better is through better nutrition and when you eat. I know because I've done it.
    My doctor used to say an operation is simple and easy, until one of his patients had one and is now much much worse.

  11. Hi, I'm from Nepal. I've observed "clean based ulcer at posterior wall" of my stomach while I've done 1st endoscopy on 27 Sept., 2018. Then Dr. advised for triple therapy. 2nd gastroscopy report of 15 Nov. 2018 showed "deformed bulb with healing ulcer". Again started same therapy with changing one medicine. 3rd gastroscopy report of 20 Dec. 2018 showed "Hiatus hernia (grade 1) deformed bulb". Dr told ulcer is normalized and you can take normal food from now. But when I've seen your video, I can not stop to write you. May you suggest what can be cause, effect and easiest way of solution for this level of hernia?

  12. I've been I long term sufferer of reflux acid since I was a baby I was 3 and a half months premature and diagnosed with hydrocephalus at 6 weeks old had intensive brain surgery to install a shunt to drain vairical fluid from my brain as mine wasn't fully developed since I was a baby I've taken gaviscon in my bottles then when I was 12 started taking omeprazole 20mg 2 a day then as I've got older is was getting worse and making me very I'll violently throwing up hot cold sweats constant shaking diarrhoea for about 3 days then I would be fine again so didn't think nothing of it then I got very I'll towards the end of June 2018 had been diagnosed with a hiatis hernia 3 cm wide and open I've also been diagnosed with barretts oesophagus i had a endoscopy back in July 2018 and a biopsie taken which is how they found out I'm still yet to see any one surgical I'm on esomeprazole 40mg take 2 in the morning 2 in the evening i also take liquid gaviscon advance after every meal and before bed every day.I take 112 capsules a week and use 1000mls of liquid gaviscon every 2 weeks I've also got a frontal sinus eostoma in the front of my head ( means a benign tumour growing in the sinus area in the right side of my forehead) been off work 6 months because of it have now been prescribed sertraline for anxiety. I'm 34 this year and the pre cancerous about the barretts oesophagus has really scared me is there any one else suffering with a hiatis hernia and barretts oesophagus on here please could u let me know what you have had done and was there any complications post op and if surgery was unsuccessful and way surgery is best to permanently solve these problems.
    All the best
    Chris tibby

  13. My doctor says my hernia is too small for surgery but the symptoms are miserable everyday of every hour. My acid reflex was getting worse within time and they prescribed me all sorts of medicines that did absolutely nothing to help. Luckily, I crossed the path of a man who had the same problem and suggested Nexium. Ever since my acid has no longer been an issue and I can eat whatever I wanted without suffering the effects. It was a true game changer after 7-8 years of this. HOWEVER, I could always feel my hernia and it doesn’t stop the excessive gas building up in my stomach. I constantly burp and most of the time it gets stuck and I have to breathe in through my stomach really hard to air it out. Burping has always been painful…it takes the air out of me and the gas comes one after another. The effects are tremendous for a “little” hernia. What should I do?

  14. Dumb question. Why doesn't the esophagus and throat have the same tissue as the stomach and colon in that it can easily handle low PH levels?

  15. i have a hiatal hernia and it has me so sick no matter what i do i keep getting swolling and barley able to do anything it has me in bed and what should i do.

  16. Does a hiatal hernia cause constant shortness of breath. I feel right around my sternum is right and when I breath, I feel it. So I feel like my body ain’t breathing normally .

  17. My doctor says I have this, but I rarely have heartburn and reflux, and never pain. I have very uncomfortable early fullness after eating very little, neusea, air in upper GI tract and often swollen belly. I eat and weight super healthy. Is my doctor wrong?? I think I might have gastroparesis. How do you know the difference?

  18. what if the medications do not work and you stay in pain w/ heart burn, cramping and swelling along esophageal spams

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  20. I've been on a PPI since the mid-1980s. No doctor has ever suggested I quit taking it even though it says on the drug's patient data sheet it's for short-term use only.

  21. I have a 3 month old son he shows the sign and symptoms of hiatal hernia but the doctors say it will take time the baby's stamouch to get mature. What's your opinion on this??? Hiatal hernia in newborns?

  22. Gaviscon and Rennies !!?? Really ?? These are the exact stuff have made peoples symptoms much much worse after a while.. does exactly opposite after a temporary relief destroying natural stomach enzymes and good acids damaging the stomach organs… These pharmaceuticals doctors are not working with nature and come up with dangerous stuff.. basically not up to date individuals

  23. This doctor doesn't discuss the anxiety, shortness of breath and heart rhythm changes that cause your quality of life to be disrupted and make you constantly in the Flight or Fight pattern. The only option is to FIX the herniation and not mask it with medication and "Lifestyle changes"!!

  24. In my upper abdominal muscle. I feel pain like leg cramp. Is it hernia? Or is there such thing as stomach cramp?

  25. I've had mine 26 years felt like crap tablets don't work asked every doctor for operation in the UK GP surgery none let me have it. Ruined my life glad I don't pay in anymore as NHS is a joke

  26. I get really bad pain in my stomach and have take pain killers I'm also on Antacids but I don't feel that there working I think I need treatment

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  29. My stomach is cramping and and it feels like bumping in my stomach on the right bottom side is it a hernia?

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