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Conditions - Hiatus Hernia

A hiatus hernia occurs when part of the stomach protrudes through the diaphragmatic hiatus meaning that part of the stomach ends up in a position above the diaphragm. This condition predisposes the patient to GORD. There are 2 main types of hiatus hernia:

Sliding hiatus hernia

This is most common and occurs when the junction of the esophagus and stomach (which is usually several centimeters below the diaphragm) slides upward to lie above the diaphragm. The herniated portion of the stomach moves up and down as the patient breathes and swallows. These herniae are often asymptomatic but can contribute to reflux symptoms.

Rolling hiatus hernia

Often referred to as roller or para oesophageal herniae, these occur when the upper part of the stomach called the fundus bulges upward through the opening in the diaphragm that transmits the esophagus. The junction of the stomach and oesophagus generally remains in place. This type of hernia usually remains in place alongside the esophagus within the chest cavity.


Patients are often asymptomatic but when symptoms do occur, it is usually due to reflux of acid from the stomach into the oesophagus. This causes heartburn and occasionally trouble swallowing. Sudden regurgitation of fluid into the mouth or pharynx can also occur especially when lying down or bending forwards. Nonspecific symptoms include belching and pain when swallowing hot fluids. Occasionally the stomach can become trapped and this can cause severe chest or upper abdominal pain associated with vomiting. This is an emergency which requires urgent attention.

For more information on Hiatus Herniae treatment offered by Dr. Robert Finch click here.

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