Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • suspected strangulated hernia/volvulus
  • suspected unresolved food bolus obstruction

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Category 1 (appointment clinically indicated within 30 days)

  • hiatus hernia with upper gastrointestinal symptoms with any of the following
    • anaemia 
    • unintentional weight loss
    • epigastric pain
    • progressive dysphagia
  • symptomatic para-oesophageal hernia for example, recurrent obstruction/gastric volvulus

Category 2 (appointment clinically indicated within 90 days)

  • asymptomatic para-oesophageal hernia
  • severe volume reflux or acid reflux with episodes suggestive of aspiration and/or severe impairment to quality of life

Category 3 (appointment clinically indicated within 365 days)

  • sliding hiatus hernia with failure of first-line management

For more on outpatient referrals, see the general referral information page.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander  
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter required
  • past medical/surgical history
  • medications and allergies
  • age
  • presenting symptoms
    • duration and frequency of symptoms
    • description of symptoms, including pain frequency/duration/triggers, nausea and/or vomiting, dysphagia, presence or absence of reflux symptoms, unintentional weight loss
    • epigastric tenderness
  • height/weight
  • body mass index (BMI)
  • physical examination findings
  • barium swallow
  • chest-abdomen computed tomography (CT)
  • other relevant diagnostic/imaging reports including location of company and accession number

Additional information to assist triage categorisation

  • reports of prior gastroscopies and pathology results of specimens

Clinical management advice

Incorporating a dietitian's expertise into the management of hiatus hernia can lead to better symptom control, improved nutritional status, and an enhanced understanding of how diet and lifestyle choices can impact the condition.

Hiatus Hernia symptoms related to excessive reflux may include:

  • backflow of food and liquids, both solid and liquid
    • dysphagia (difficulty swallowing) is more prevalent in people with paraesophageal hiatus hernia
  • night time symptoms of reflux, regurgitation, or choking
  • unintentional weight loss

The use of proton pump inhibitors is strongly advised as part of first-line management for hiatus hernia. Unusual manifestations of hiatus hernia may include, a persistent cough, recurring chest infections.

Clinical resources

Consumer resources