Classifying hiatus hernia. Does it make a difference to management?

Hiatus hernia is a not uncommon finding but often does not require treatment unless symptomatic. At present, hernias are categorised into either the sliding variety or the rolling type. Understanding how these differ as to their symptoms and their cause provides a basis for a logical treatment plan.

To describe the differences between a sliding and a rolling hernia, highlighting the management approaches for each.

Sliding hernia is often associated with reflux and usually treated medically, but surgery is needed for some patients. Para-oesophageal hernia may be a serious problem with major complications. Large or symptomatic para-oesophageal hernias need surgical treatment.