Dr Harsh Shah
MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Registered with Gujarat Medical Council, Reg. No. G-38738
Robotic Hernia Surgeon · Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Ahmedabad
In short
“Small sliding hiatal hernia” is one of the commonest lines on an endoscopy report, and one of the most alarming to read. For most people it is not a reason for an operation.
It describes a part of the stomach that slides up through the opening in the diaphragm where the food pipe passes. This page explains what the report is telling you, and which findings make a surgical opinion worthwhile.
The wording is standard, and each phrase describes something quite specific. The table below takes them one at a time.
What the words on your report describe
| On the report | What it describes | What it usually means |
|---|---|---|
| Sliding hiatal hernia | The join between food pipe and stomach sits above the diaphragm. | By far the commonest type. Small ones often cause nothing. |
| Size in centimetres | A rough measure of how much has moved up. | Larger ones are more often linked with reflux that persists. |
| Oesophagitis | Acid has inflamed the lining of the food pipe. | Graded by severity. Treated medically in the first instance. |
| Barrett's oesophagus | The lining has changed after long-standing reflux. | Needs regular surveillance by the gastroenterologist. |
| Paraoesophageal or rolling hernia | Part of the stomach rolls up beside the food pipe. | A different problem. This is the type more likely to need surgery. |
For a surgical opinion on a hiatal hernia, bring the endoscopy report and the images with you.
Where the main symptom is heartburn that responds to treatment, the approach is medical.
Weight reduction if you are overweight. Avoiding late heavy meals. Raising the head end of the bed. Stopping smoking. Acid-reducing medicine as advised by your physician or gastroenterologist.
Many people live with a small sliding hiatal hernia without it ever causing trouble.
Before surgery, further tests are usually needed to understand how the food pipe works. A pressure study and a 24-hour acid study are the usual pair, so that the right operation is chosen rather than the standard one.
Warning signs that need help the same day
A large hiatal hernia can occasionally twist. That is an emergency and is treated as one.
For a small sliding hernia with heartburn, your physician or gastroenterologist. Medical treatment settles most of them.
A surgical opinion is sensible when the findings in the list above are present, or when the medicine is no longer holding the symptoms.
Usually not. Most small sliding hiatal hernias are managed with lifestyle measures and acid-reducing medicine if needed.
The anatomical hernia does not close, but symptoms often settle with treatment, and many small ones never cause trouble.
No. It is a hernia through the diaphragm into the chest, behaves differently, and is assessed with different tests.
Usually an endoscopy, a pressure study of the food pipe and a 24-hour acid study, sometimes with a contrast swallow or CT.
Your physician or gastroenterologist for most small hernias. A surgical opinion is appropriate when the findings above are present.
The main page on this site is robotic hernia surgery in Ahmedabad. These cover the neighbouring questions.
Where to find us
Dr Harsh Shah, MS, MCh (Surgical Gastroenterology), DrNB (Surgical Gastroenterology)
Shah's Gastro, Cancer & Robotic Surgery Centre
Apollo Hospital, Bhat, Gandhinagar
Gota OPD, Ahmedabad
Bring your reports. Second opinions are welcome.
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