Hiatus hernia

Question 1

What is a hiatus hernia?

Answer 1

Herniation of the stomach through the diaphragm which allows stomach contents to reflux into the oesophagus

Question 2

1) What is a sliding hiatus hernia?
2) What is a rolling hiatus hernia?
3) Which of these is the most common?

Answer 2

1) Stomach slides up through the diaphragm, with the gastro-oesophageal junction passing up into the thorax
2) Separate portion of the stomach (i.e. the fundus), folds around and enters through the diaphragm opening, alongside the oesophagus
3) Sliding hiatus hernia

Question 3

Name 2 risk factors for a hiatus hernia

Answer 3

• Obesity
• Increasing age
• Pregnancy

Question 4

Name 2 symptoms of hiatus hernia

Answer 4

• Heartburn
• Acid reflux
• Reflux of food
• Burping
• Bloating
• Halitosis (bad breath)

Question 5

Name an investigation that may show a hiatus hernia

Answer 5

• Chest x-rays
• CT scans
• Endoscopy
• Barium swallow testing

Question 6

1) What is the conservative management of hiatus hernia?
2) When is surgical management indicated?

Answer 6

1) Medical treatment of GORD
2) When there’s a high risk of complications or symptoms are resistant to medical treatment