My mother has a hiatus hernia - what is that

asks Ursula:
A. It's when part of the stomach bulges up through an opening (hiatus) in the diaphragm into the chest cavity. The diaphragm is the muscle at the bottom of the rib cage and separates the chest from the abdomen.

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Q. What are the symptoms
A. Indigestion, mainly. This is caused by stomach acid refluxing (flowing back) into the oesophagus. The valve that prevents this happening normally is weakened by the hiatus hernia. This is very painful because the oesophagus is not designed to deal with stomach acid and so it gets burned.

Some people on suffer from mild indigestion after meals, while others get pain so severe is can be mistaken for heart disease. In that case, the pain is felt from the breastbone to the throat. Sometimes there is a bitter taste in the mouth, called waterbrash.

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Q. Is it dangerous
A. If left untreated, the stomach acid can irritate and inflame the oesophagus until the oesophagus gets narrower. Called stricture, it can cause swallowing difficulties. Rarely, if severe reflux is left for years, it could result in cancer of the oesophagus.

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Q. What causes hiatus hernia
A. It's not known. Sometimes babies are born with it (congenital hiatus hernia) or, more usually, it develops later in life, particularly in people who are overweight or who smoke. It can also happen in pregnancy as the uterus grows and pushes upwards.

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Q. How is it diagnosed
A. Because hiatus hernia shares symptoms with other conditions, it's important to get a proper diagnosis. This may involve endoscopy (a camera is put down the oesophagus and into the stomach), or a barium meal (swallowing a special fluid that shows up on x-ray).

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Q. How is it treated
A. Your GP will give you antacids for the indigestion. You may also be given drugs to reduce the acid in your stomach. In severe cases, keyhole surgery may be used to seal the opening in the diaphragm to prevent the hernia coming through.

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Q. Are there any self-help measures
A. Yes, small and frequent meals help, as does avoiding rich or fatty foods. Certain foods, such as bananas, citrus fruits and chocolate can make it worse. Cut right down on coffee and alcohol.

It's also a good idea to avoid lying down or bending over within an hour of eating. You can lift the top end of your bed to keep your head higher than your body.

Stopping smoking and losing weight will help, too.

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By Sheena Miller

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