Hiatus Hernia Repair

Hiatus hernia is a common condition that affects people at any age, especially those over 50. It can cause uncomfortable symptoms associated with gastro-oesophageal reflux disease (GORD) and may need surgical repair.

What is a hiatus hernia?

A hiatus hernia is when the upper stomach squeezes through an opening in the diaphragm called the hiatus. This area, where the oesophagus normally passes through the muscle, may become stretched or weaker with age or pressure on the abdomen.

There are two types of hiatus hernia: 

Sliding hiatus hernia

• Hernias that move up and down, in and out of the chest area. These are the most common type of hiatus hernia (around 80%).

• Sliding hiatus hernias often cause persistent symptoms of GORD, including heartburn, chest pain, difficulty swallowing (dysphagia) or acid taste in your mouth,

• Over time, stomach acid leaking into the bottom of the oesophagus can damage the oesophagus.

• More serious complications include ulcers, oesophageal stricture, Barrett’s oesophagus and cancer.

Para-oesophageal hiatus hernia 

• Also called rolling hiatus hernias, where part of the stomach pushes up next to the oesophagus. These are a rarer type of hiatus hernia (around 5-15%).

• GORD doesn't usually occur in these cases, but there's a risk of the hernia becoming strangulated, cutting off the blood supply to the area.

• A strangulated hernia usually requires emergency surgery to correct the problem.

A gastroscopy can confirm whether you have a hiatus hernia, which type it is, and the treatment options that are right for you.

Surgery for hiatus hernia 

Surgery may be recommended if you have tried other treatments (including lifestyle changes and medications prescribed by your GP) and are still experiencing issues. Surgery is also an option if you want to avoid taking medications in the long term.

Dr Hopkins is highly trained in the surgical treatment of hiatus hernias using a procedure called a partial fundoplication. During this procedure, Dr Hopkins will use keyhole surgery to return the stomach back to its correct position before wrapping part of the stomach around the lower oesophagus. This helps to reinforce the repair and prevent further damage from the reflux coming back. 

Read more about fundoplication surgery here.

The immediate and long-term benefits of having a fundoplication make it the preferred treatment option for people with a hiatus hernia, as shown by long-term studies.

Recovery from hiatus hernia surgery

Surgery for hiatus hernia is performed under general anaesthetic and you’ll be admitted to hospital to stay overnight, usually going home the following day. Recovery takes approximately 3-4 weeks and you’ll need to follow a special ‘soft food’ diet during this time. 

If you have any questions about hernia surgery or would like to make an initial appointment to see Dr Hopkins, please get in touch.

Is hiatus hernia surgery an option for me?

If you are suffering from symptoms as a result of a hiatus hernia (for example, reflux, chest tightness, anaemia, difficulty swallowing), then surgery may be an option for you. Dr Hopkins treats all patients individually and will discuss the benefits and risks of the surgery to make a shared decision of whether an operation is suitable for you. 

Why choose Dr Hopkins?

Dr Hopkins has a special interest in hiatus hernia and reflux surgery. He has published long-term research into the success of the different surgical approaches in a randomised controlled trial (Hopkins, Irvine, Watson et al., British Journal of Surgery 2020).

Dr Hopkins is experienced in performing hiatus hernia surgery and surgery for reflux and is able to tailor the operation to suit your needs with a focus on your quality of life.