Hiatus hernia: After many nights of being woken up by a burning sensation in my chest and throat, I consulted my GP, who diagnosed a hiatus hernia. Can you tell me how I might have got this?
A hiatus hernia occurs when the upper part of the stomach, which is joined to the gullet, moves upwards into the chest cavity through the hole in the diaphragm. The diaphragm is the large muscle which divides the chest cavity from the abdominal cavity. It is a common problem and it is estimated that it affects about 10 per cent of the population. It is most common in the elderly and middle-aged women who are overweight. It can also occur during pregnancy.
If the problem is with my stomach, why do I get a burning feeling in my throat?
A hiatus hernia in itself should not cause too much discomfort but if it is associated with a reflux of the acid content of the stomach, severe heartburn can occur. This leads to a painful, burning sensation in the chest and throat as you describe. Some sufferers experience a sudden regurgitation of acid fluid into the mouth, particularly when they lie in bed or bend forward. Other symptoms of the condition include belching, pain on swallowing hot fluids and a feeling of food lodging in the gullet.
Can it cause other problems in the long term?
Although the hernia is not usually serious, the reflux of acid can cause inflammation of the lower end of the gullet. Called reflux oesophagitis, it may cause bleeding or a stricture (narrowing) of the gullet.
I have been prescribed medication, but are there other things I can do to help the situation?
If you are over your ideal weight, losing a few pounds can make a big difference. Cigarettes do not help the condition, so if you smoke, now would be a good time to try to kick the habit.
Coffee, alcohol, hot drinks and spicy foods can aggravate reflux, so you would be advised to cut back.
Eat several small meals throughout the day and avoid heavy meals at any time, but particularly in the evenings.
Use an extra pillow or two in bed to prop yourself up. Raise the head and shoulders higher than the rest of the body and it will help reduce the reflux of acid. Alternatively, you might find that raising the head of the bed by about 10 cms helps.