Hernia, hiatus - Complications of a hiatus hernia

Complications from a hiatus hernia are rare, but they can be serious.

Hiatus hernias that slide in and out of the chest area (sliding hiatus hernias) can cause gastro-oesophageal reflux disease (GORD). This is where stomach acid leaks into the oesophagus (gullet). This can damage the oesophagus, increasing the risk of the problems described below.

Oesophageal ulcers

Damage to the lining of the oesophagus (oesophagitis) caused by stomach acid can lead to the formation of ulcers. The ulcers can bleed, causing pain and making swallowing difficult.

Ulcers can usually be successfully treated by controlling the underlying symptoms of GORD. In most cases, over-the-counter medicines called antacids or alginates are used to treat the condition.

Read more about treating GORD.

Oesophageal stricture

Repeated damage to the lining of your oesophagus can lead to the formation of scar tissue. If the scar tissue is allowed to build up, it can cause your oesophagus to become narrowed. This is known as oesophageal stricture.

An oesophageal stricture can make swallowing food difficult and painful. Oesophageal strictures can be treated by using a tiny balloon to dilate (widen) the oesophagus. This procedure is usually carried out under a local anaesthetic.

Barrett's oesophagus and cancer

Repeated damage to the oesophagus can also lead to changes in the cells lining your lower oesophagus. This is a condition known as Barrett's oesophagus.

Barrett's oesophagus does not usually cause noticeable symptoms other than those associated with GORD.

However, Barrett's oesophagus can increase your risk of developing oesophageal cancer.

Strangulated hernia

In some cases, a hiatus hernia causes part of the stomach to push up next to the oesophagus. This is known as a para-oesophageal hiatus hernia. GORD doesn't usually occur in these cases, but there is a risk of the hernia becoming strangulated.

Strangulation occurs when the hernia becomes knotted and the blood supply to the area is cut off. Emergency surgery is usually required to correct the problem.