Last updated 2026-11-08 · Medically reviewed by Dr Raman Garg · Punjab, India
Written and medically reviewed by Dr Raman Garg, Surgical Gastroenterologist and Laparoscopic Hernia Surgeon, Bombay Gastro & Cancer Institute, Bathinda, Punjab, India.
What a hiatal hernia is
Your food pipe passes through a small opening in the diaphragm, the muscle sheet between chest and belly, to reach the stomach. This opening is the hiatus. If it widens, part of the stomach can slide up into the chest. That is a hiatal hernia, also called a hiatus hernia.
Unlike a groin hernia, you cannot see or feel it from outside. You notice it through its effects. The valve at the bottom of the food pipe works less well, so acid and food come back up.
Most hiatal hernias are the sliding type, where the stomach moves up and down. A smaller number are the paraesophageal type, where part of the stomach rolls up beside the food pipe. This type is less common but more important to treat, because the stomach can get twisted or trapped.
When reflux points to a hiatal hernia
Everyone gets acidity after a heavy wedding meal. That is not a hernia. Think about a hiatal hernia when:
- burning or sour taste returns most days for more than 3 months
- tablets such as omeprazole or pantoprazole give only short relief, or you need them every day for years
- food or sour water comes up into the throat, especially when lying down or bending
- you wake at night coughing or choking
- food feels stuck in the chest
- you feel full quickly, bloated, and breathless after meals
- you have a hoarse voice, throat clearing or a dry cough with no cause
Punjab eating habits do not help. Late dinners, heavy parathas, tea on an empty stomach, and sleeping soon after a meal all make reflux worse.
Chest pain: rule out the heart first
This is the most important rule on this page. Reflux and heart pain can feel the same. Burning or pressure in the middle of the chest can be a heart attack.
If you have chest pain, pain spreading to the arm, jaw or back, sweating, breathlessness, or fainting, treat it as a heart problem until proven otherwise. Go to the nearest emergency room now. Do not take another antacid and wait.
If you are over 40, have diabetes, high BP, high cholesterol, smoke or have a family history of heart disease, get an ECG and heart check before anyone blames acidity. Only after the heart is cleared should the stomach and food pipe be investigated.
Tests to find out
| Test | What it shows | When it is used |
|---|---|---|
| ECG and heart check | Rules out a heart cause of chest pain | First, for any chest pain |
| Upper GI endoscopy | Looks inside the food pipe and stomach, shows the hernia, inflammation, ulcers | Reflux not settling, swallowing trouble |
| Barium swallow | X-ray of swallowed liquid, shows hernia size and position | To plan surgery, to see a large hernia |
| Oesophageal manometry | Measures food pipe muscle pressure | Before anti-reflux surgery |
| 24-hour pH study | Measures acid coming up over a full day | When the diagnosis is unclear |
| CT scan | Shows a large or complicated hernia | Selected cases |
Most people need only the first two. We decide the rest during consultation. BGCI has an advanced endoscopy suite and a fully equipped in-house diagnostic laboratory, so most first-line tests happen under one roof. Typical Punjab costs for 2026:
| Item | Starting (Rs) | Average (Rs) | Maximum (Rs) |
|---|---|---|---|
| OPD consultation | 500 | 700 | 1,000 |
| Upper GI endoscopy | 2,000 | 3,200 | 5,000 |
| Barium swallow | 1,200 | 2,000 | 3,500 |
| CT scan abdomen (when needed) | 3,500 | 6,000 | 9,000 |
| Pre-operative blood tests, ECG and chest X-ray | 1,500 | 2,500 | 4,000 |
Note: These are typical Punjab costs for 2026. The final cost may vary after Dr Raman Garg examines you, depending on the hernia type, size, number of sides, mesh used and your health.
Lifestyle steps that really help
These do not remove the hernia, but they reduce symptoms in many people, especially with a small hernia.
- Eat smaller meals, 4 or 5 times a day, not 2 big ones.
- Finish dinner at least 3 hours before sleeping.
- Raise the head end of the bed by 15 to 20 cm with blocks. Extra pillows alone do not work well.
- Lose weight if you carry extra weight around the belly.
- Avoid triggers: fried food, very spicy food, tea and coffee on an empty stomach, aerated drinks, alcohol and tobacco.
- Do not wear tight belts or lift heavy straight after meals.
- Take tablets as advised. Do not self-medicate for years. Long tablet use without a diagnosis can hide something more serious.
When surgery is advised
Surgery is not needed for most small hiatal hernias. It is considered when:
- symptoms persist despite proper medicines and lifestyle change
- you do not want lifelong tablets
- regurgitation, choking or night coughing continues
- the hernia is large or paraesophageal
- there is bleeding, iron deficiency, or narrowing of the food pipe
- breathing or swallowing is affected
The usual operation is laparoscopic repair. The surgeon pulls the stomach down, closes the widened gap, and wraps the top of the stomach around the food pipe (fundoplication) to rebuild the valve. It is done through small cuts and takes about 1.5 to 2.5 hours. Most patients walk within hours and go home within a short time. Read more on hiatal hernia surgery in Punjab and laparoscopic hernia surgery. Dr Raman Garg was among the first surgeons in Bathinda to perform complex hiatus hernia surgery.
Typical Punjab cost for 2026:
| Item | Starting (Rs) | Average (Rs) | Maximum (Rs) |
|---|---|---|---|
| Hiatal hernia repair with fundoplication | 90,000 | 1,30,000 | 2,00,000 |
Note: These are typical Punjab costs for 2026. The final cost may vary after Dr Raman Garg examines you, depending on the hernia type, size, number of sides, mesh used and your health.
BGCI is empanelled with almost all major insurers and TPAs for cashless treatment, including Aditya Birla Health Insurance, Niva Bupa, Care Health Insurance, ICICI Lombard and Medi Assist TPA. The insurance desk arranges pre-authorisation. See the full table at hernia surgery cost in Punjab.
A Punjab example
A 48 year old transport owner from Malout lived on pantoprazole for four years. Every night he slept propped on three pillows and woke coughing. His ECG was normal, an endoscopy showed a hiatal hernia with inflammation of the food pipe, and a barium swallow showed its size. After discussing options, he chose surgery. He no longer needs daily tablets. This is one example, not a promise, and every patient is assessed individually.
Warning signs: do not wait
When to see a doctor or go to a hospital: same day for severe chest or upper belly pain, repeated vomiting with inability to pass anything, vomiting blood, black stools, food that will not go down, or sudden breathlessness. Go to the nearest emergency room or call +91 82641-60001. Our OPD runs Monday to Saturday, 10 AM to 5 PM, and emergency care support is available 24/7.
Also book a visit soon for trouble swallowing, unplanned weight loss, anaemia, or reflux that lasts beyond 3 months.
Dr Raman Garg is a Surgical Gastroenterologist with 20+ years of experience and has done 10,000+ laparoscopic surgeries, including 1,000+ laparoscopic hernia repairs. He sees patients from Mansa, Muktsar and across Punjab, India. Out-of-town patients can share endoscopy and scan reports on WhatsApp for an online consultation before travelling. See hernia surgery in Punjab for the full list of hernia types, and read about hernia surgery in women if you are weighing pregnancy or C-section history.
This page is general information; your plan is set after Dr Raman Garg examines you.
Call +91 82641-60001 | WhatsApp your ultrasound report | Book appointment
Call +91 82641-60001 WhatsApp your report Book appointmentLast updated: 8 November 2026. Medically reviewed by Dr Raman Garg, Bombay Gastro & Cancer Institute, Power House Road, Near Street No. 10, Bathinda, Punjab 151001, India.
Frequently asked questions
Can a hiatal hernia cause acid reflux?
Yes. A hiatal hernia can weaken the valve at the bottom of the food pipe, so acid and food come back up. Many people with a small one have no symptoms, but a larger hernia often causes burning, regurgitation and night cough.
Can hiatal hernia cause chest pain?
Yes, but chest pain should never be assumed to be acidity. Get an ECG and heart check first, especially if you are over 40 or have diabetes or high BP. Only after the heart is cleared should reflux and hernia be investigated.
How is a hiatal hernia diagnosed?
Most often by upper GI endoscopy, sometimes with a barium swallow. Manometry and pH studies are used before surgery or when the diagnosis is unclear. A heart test comes first if there is chest pain.
Does a hiatal hernia need surgery?
Often not. Small hernias with mild reflux are managed with lifestyle changes and medicines. Surgery is considered for symptoms that persist despite treatment, large or paraesophageal hernias, bleeding or narrowing of the food pipe.
Pet mein acidity bar bar ho to kya hiatus hernia ho sakta hai?
Haan, agar jalan, khatta paani muh mein aana ya raat ko khaansi mahine bhar se zyada rahe aur dawai se aaram na mile, to hiatus hernia ho sakta hai. Pehle dil ki jaanch karwayiye, phir endoscopy se sahi wajah pata chalti hai.