When to worry about indigestion with hiatus hernia

A hiatus hernia occurs when part of the stomach moves through the opening in the diaphragm. It can make reflux and upper-abdominal discomfort more likely, with burning, sour fluid, belching, fullness, or nausea. Symptoms may be worse after eating or when lying down.

Indigestion can also come from causes unrelated to the hernia. A clinician can distinguish reflux-type symptoms from other problems by asking about timing, swallowing, chest discomfort, medicines, and response to treatment.

Try smaller meals, remain upright after eating, and identify foods or drinks that bring on symptoms. Avoid lying down soon after a meal and raise the head of your sleeping position if advised. A pharmacist or clinician can help choose an acid-reducing medicine and check it is suitable with your other treatment.

Seek urgent help for vomiting blood, black stools, severe chest or abdominal pain, fainting, or breathing difficulty. Arrange prompt review for food sticking, painful swallowing, repeated vomiting, unexplained weight loss, or indigestion that continues despite the plan you were given. New chest pressure should be assessed urgently rather than assumed to be reflux.

Ask whether reflux explains your symptoms, how to take acid treatment, whether swallowing symptoms need investigation, how to sleep comfortably, and when the hernia should be reviewed.