Hiatus means gap or hole (in Greek). The gullet (oesophagus) is the food passage from your
mouth to your stomach. Unlike most hernias, hiatus hernia does not occur within the abdominal
wall, but within the chest area and specifically affects the digestive system. To get there it has to
pass through a hole in a flat sheet of muscle that separates the chest (containing your lungs and
heart) from your abdomen (where your guts live).
The gullet passes through a hole or hiatus. Sometimes this hole enlarges and the top of the stomach passes upwards into the chest – this is called a hiatus hernia. The difficult part about fixing a hiatus hernia is that you can’t just close off the hole, because you always have to leave a small gap for the gullet to pass through.
Unlike an abdominal hernia, hiatus hernia rarely causes symptoms which can make it difficult to diagnose. However, if you do experience any symptoms they are likely to be as below.
The repair is usually done laparoscopically. The classical operation was a ‘wrap around’ procedure, but now more and more surgeons are tending to using mesh. The repair is very technical and can be difficult to get right with good results. The aim of the repair is to narrow the opening just the right amount – not too little so the repair fails, and not to much so that the passage of the food is prevented. Alternative treatment can be provided to ease symptoms of acid reflux and heartburn for which medications may be provided.