Will I need surgery for Hiatus Hernia?

Hiatus hernias are very common and around 15% of the population may have one. A hiatus hernia is when the upper part of the stomach prolapses into the chest rather than sitting in the abdominal cavity. This is usually due to widening of the hiatus (gap that allows to food pipe to pass through) in the diaphragm muscle.

Whether treatment is required depends on whether you have symptoms. Hiatus hernias can cause the lower oesophageal sphincter (LES) and diaphragm to be less effective at preventing reflux. Hence acid reflux is a major symptom of a hiatus hernia. In many cases this can be controlled with medication such as Nexium or Somac (Proton Pump Inhibitors or PPI). In more severe cases, when medications don’t control symptoms or when patients don’t want to take lifelong medications surgery can be recommended. It is also recommended if food is being regurgitated or if food is getting stuck in the hernia. This can often lead to pain on swallowing.

For larger hiatus hernias surgery maybe recommended to prevent twisting of the stomach in future. The surgery is almost universally performed using a keyhole approach (laparoscopic). Most people need to stay in hospital for one night but are required to eat soft foods for 2-4 weeks after surgery. After this time normal foods and exercise can be restarted.

Traditionally fundoplication procedures were also performed with a hiatus hernia surgery, but this is not the case now. Surgery is tailored to each person and may include no fundoplication, a partial or full fundoplication. This may alleviate some of the traditional side effects associated with surgery, such as bloating.

I hope you find this helpful.