Q: What is the treatment and diet for hiatus hernia and reflux oesophagitis?

A:That is a rather broad question. I will give a brief answer, and refer you to a couple of useful texts on the web.

• Diaphragm. The "diaphragm" is a flat muscle that separates the chest from the abdomen.
• Hiatus. The "hiatus" is a hole in the diaphragm. The food pipe passes through this hole.
• Hiatus hernia. Sometimes the stomach, which lies in the abdomen, passes up into the chest through the hiatus. This is called a "hiatus hernia". Only a small part of the stomach moves into the chest.
• Reflux. Normally, food and acid in the stomach do not regurgitate into the food pipe. If they do, the condition is called "reflux". The acid in the food irritates the food pipe. Therefore the main symptom of reflux is heartburn. Patients with hiatus hernia are more likely to develop heartburn. However, many people with heartburn do not have a hiatus hernia, and many people with hiatus hernia do not have heartburn.
• Diagnosis of hiatus hernia. Usually made by endoscopy.
• Treatment. Hiatus hernia does not need treatment unless the patient also has heartburn. For heartburn, the best treatment is medicines that control stomach acid, like pantoprazole. Small, dry, bland food at night helps. If the symptoms are severe and uncontrolled by medicines, surgery will help. The surgery to prevent reflux is called "anti-reflux surgery". The surgery is the same, whether the patient has reflux with a hiatus hernia or without.