Hi, Thanks for writing in to us. I am sorry to hear that you are in severe pain due to a small hiatus hernia. There are two main types of hiatus hernia: 1. Sliding hiatus hernias - Hernias that move up and down, in and out of the chest area. Over 80% of hiatus hernias are this type. 2. Para-oesophageal hiatus hernias - Where part of the stomach pushes up through the hole in the diaphragm next to the oesophagus. They re sometimes called rolling hiatus hernias. About 5-15% of hiatus hernias are this type The type of hiatus hernia can usually be diagnosed using an X-ray or an endoscopy (where a long, tube-like viewing instrument that contains a video camera and light source) is used. Treatment for sliding hiatus hernia usually focuses on relieving the symptoms of GORD, such as heartburn. Lifestyle changes and medication are the preferred treatments. Surgery is usually only recommended as an alternative to long-term medication or if other treatments haven t worked. Lifestyle advice may include: •eat smaller, more frequent meals - rather than three large meals a day •avoid lying down (including going to bed) for three hours after eating or drinking •remove any foods or drinks from your diet that make your symptoms worse If a hiatus hernia isn t causing any noticeable problems, then it doesn t usually need to be treated. Para-oesophageal hiatus hernias are repaired surgically if there is a risk of serious complications Hope this helps