← All conditions / Hernias & reflux
Understanding the condition
A hiatal hernia occurs when part of the stomach moves through the diaphragm into the chest. Sliding and paraesophageal hernias have different patterns. They can be associated with reflux, swallowing difficulty, pressure after meals or anemia; some cause few symptoms.
What the evaluation looks for
The assessment may include endoscopy and contrast imaging. Additional testing depends on reflux symptoms and the operation being considered.
How treatment is chosen
Not every hiatal hernia requires repair. Symptoms, anatomy, operative risk and the risk of future complications guide the discussion. Repair may be combined with an anti-reflux procedure; recurrence and swallowing effects should be discussed.
Questions worth asking
- Which type of hiatal hernia do I have?
- Are my symptoms likely to improve with repair?
- What are the risks of observation and of surgery?
When to seek help promptly
Sudden severe chest or upper abdominal pain, repeated retching or inability to swallow requires urgent assessment. New chest pain should not be assumed to be reflux.