Hiatus hernia

A hiatus hernia is a defect in the diaphragm that allows part of the stomach to leave the abdominal cavity, via the hiatus (the gap in the diaphragm through which the oesophagus passes), and enter the thoracic cavity during breathing (Figure 1A).

Hiatus hernia can be present at birth (congenital) or acquired later on in life due to ageing or obesity. Initially, the misplaced portion of the stomach will slide back and forth freely, but over time adhesions may form and it can become fixed within the thoracic cavity. Although the LOS may still function, the presence of a hiatus hernia makes it easier for the stomach contents to reflux into the oesophagus, and hence all the symptoms and complications of acid reflux are more likely to occur. A parahiatal hernia, or paraoesophageal hernia, occurs when part or almost all of the stomach protrudes through the hiatus into the thorax to the left of the oesophagus, with the LOS remaining in place (Figure 1B). This is a situation that usually requires remedial surgery.

Laryngopharyngeal reflux

More to reflux than Acid

Heartburn in Pregnancy