Persistent indigestion may be due to an ulcer, to irritation of the stomach or to the presence of what is called an hiatus hernia.
We now realise that it is not the presence of the hernia itself, but of the associated reflux of acid into the gullet which causes the trouble.
The gullet or oesophagus runs through the chest, then passes through a gap or hiatus in the diaphragm, the sheet of muscle which separates the chest from the abdominal cavity. Once through this hiatus, it widens out to become the stomach.
Hiatus hernia becomes increasingly common as we age. Symptoms do not seem to correlate with the size of the hernia.
Associated with the hernia is gastro-oesophageal reflux. The distortion in the anatomy allows the acid contents of the stomach to regurgitate into the lower part of the gullet and this irritates the lining and is responsible for the symptoms.
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