Can Hiatal Hernia Surgery Fix My Acid Reflux? When Is Reflux Surgery Necessary?
If you suffer from frequent heartburn, acid reflux, or GERD, a hiatal hernia could be part of the problem. Here's how to know when it's time to talk to a surgeon.
Almost everyone experiences heartburn occasionally. But if you're regularly reaching for antacids, avoiding your favorite foods, or waking up at night with burning in your chest or throat, you may be dealing with something more serious than occasional indigestion.
For some patients, chronic acid reflux is associated with a hiatal hernia, a condition that occurs when part of the stomach pushes upward through an opening in the diaphragm.
The good news? Not everyone with a hiatal hernia needs surgery. But for patients with persistent symptoms, complications, or reflux that doesn't respond adequately to medication, minimally invasive hiatal hernia repair or anti-reflux surgery may provide lasting relief.
At ATX Robotic Surgery, our board-certified general surgeons, Dr. Shey Ditto and Dr. Jonathan Huynh, can evaluate your symptoms and help determine whether surgical treatment may be appropriate.
What Is a Hiatal Hernia?
A hiatal hernia occurs when the upper portion of your stomach moves through the hiatus, a natural opening in the diaphragm where the esophagus passes into the abdomen.
There are two main types:
Sliding hiatal hernia: The most common type, in which the junction between the esophagus and stomach slides upward into the chest. This type is often associated with acid reflux.
Paraoesophageal hiatal hernia: A less common type in which part of the stomach moves alongside the esophagus into the chest. Larger paraoesophageal hernias can sometimes cause difficulty swallowing, chest discomfort, or other complications.
Many people have small hiatal hernias without ever knowing it. Others experience significant symptoms that interfere with their daily lives.
Can a Hiatal Hernia Cause Acid Reflux or GERD?
Yes. A hiatal hernia can contribute to gastroesophageal reflux disease (GERD), particularly when it disrupts the normal barrier that keeps stomach acid from flowing backward into the esophagus.
Common symptoms include:
Frequent heartburn or burning in the chest
Acid reflux or a sour taste in the mouth
Regurgitation of food or stomach contents
Difficulty swallowing
Chest or upper abdominal discomfort
Symptoms that worsen after eating or when lying down
Chronic cough, hoarseness, or throat irritation that may be related to reflux
Interrupted sleep due to nighttime reflux
Not all reflux is caused by a hiatal hernia, and not every hiatal hernia causes reflux. A thorough evaluation can help identify the underlying problem.
How Do I Know If I Need Hiatal Hernia or Acid Reflux Surgery?
You may be a candidate for hiatal hernia repair or anti-reflux surgery if your symptoms persist despite appropriate treatment, you have troublesome regurgitation, or your hernia is causing complications.
Some reasons to consider a surgical consultation include:
1. Your heartburn keeps coming back.
If you're experiencing frequent reflux despite dietary changes and appropriate medication, it may be time to explore additional treatment options.
2. You don't want to rely on reflux medication indefinitely.
Some patients with objectively confirmed GERD may be candidates for surgery as an alternative to long-term medication. Surgery is not appropriate for everyone, and the risks and benefits should be carefully considered.
3. You experience reflux when lying down or sleeping.
Nighttime reflux can significantly affect your sleep and quality of life. Persistent symptoms may warrant further evaluation.
4. You have difficulty swallowing or food feels stuck.
These symptoms deserve medical attention because they can have several causes, including esophageal narrowing, motility disorders, or a larger hiatal hernia.
5. You've been diagnosed with a large hiatal hernia.
Some large or paraoesophageal hiatal hernias may require surgical repair, particularly when they cause symptoms or complications.
6. You have complications from chronic GERD.
Conditions such as severe reflux-related esophagitis or peptic esophageal strictures may prompt consideration of surgery. Patients with Barrett's esophagus also require appropriate surveillance, even if reflux surgery is performed.
What Is Robotic Hiatal Hernia Repair?
Robotic-assisted hiatal hernia repair is a minimally invasive surgical approach that uses small incisions and specialized robotic instruments to help the surgeon repair the hernia.
Depending on your anatomy and medical needs, surgery may involve:
Moving the displaced portion of the stomach back into its normal position below the diaphragm.
Repairing the enlarged opening in the diaphragm.
Performing an anti-reflux procedure, such as a fundoplication, when appropriate.
A fundoplication involves wrapping part of the upper stomach around the lower esophagus to strengthen the barrier against acid reflux.
There are different types of fundoplication, and the appropriate approach depends on factors such as your symptoms, esophageal function, and overall health.
Robotic technology provides surgeons with enhanced visualization and precise instrument control. For appropriately selected patients, minimally invasive surgery may offer benefits such as smaller incisions, less postoperative discomfort, and a shorter hospital stay compared with traditional open surgery.
However, outcomes vary, and robotic surgery is not necessarily superior to conventional laparoscopic surgery for every patient.
Will Hiatal Hernia Surgery Permanently Cure My Acid Reflux?
Hiatal hernia repair and anti-reflux surgery can significantly improve reflux symptoms in appropriately selected patients, but surgery does not guarantee a permanent cure.
Many patients experience substantial improvement in heartburn and regurgitation following surgery.
However, some patients may continue to need reflux medication, develop recurrent symptoms, or experience a recurrent hernia over time.
Potential side effects include temporary difficulty swallowing, bloating, and changes in the ability to belch or vomit. Your surgeon can explain the expected benefits and risks based on your individual condition.
How Do Doctors Determine Whether Reflux Surgery Is Right for Me?
Before recommending surgery, your surgeon may review your medical history, medications, symptoms, and previous testing.
Depending on your circumstances, additional tests may include:
Upper endoscopy (EGD): To evaluate the esophagus, stomach, and signs of reflux-related damage.
Barium swallow: To assess the anatomy of the esophagus and stomach and identify a hiatal hernia.
Esophageal pH monitoring: To measure acid exposure and help confirm GERD.
Esophageal manometry: To evaluate how well the esophageal muscles function, particularly before anti-reflux surgery.
These tests help determine whether your symptoms are caused by GERD, a hiatal hernia, or another condition, and which treatment approach is most appropriate.
Is It Time to See a Surgeon About Your Hiatal Hernia or Acid Reflux?
If chronic heartburn, regurgitation, or a diagnosed hiatal hernia is interfering with your daily life, you don't have to assume that ongoing discomfort is something you simply have to live with.
And remember: Seeing a surgeon doesn't automatically mean you need surgery.
At ATX Robotic Surgery, board-certified general surgeons Dr. Shey Ditto and Dr. Jonathan Huynh provide individualized evaluations to help patients understand their treatment options, including minimally invasive and robotic surgical approaches when appropriate.
Whether you've recently been diagnosed with a hiatal hernia, have struggled with GERD for years, or are wondering whether reflux surgery could help, we're here to help you take the next step.
Schedule a consultation with ATX Robotic Surgery today to find out whether hiatal hernia repair or anti-reflux surgery may be right for you.
Modern Surgery. Human Touch.
Medical note: Severe or unexplained chest pain, especially with shortness of breath, sweating, or pain radiating to the arm or jaw, requires emergency evaluation. Sudden severe abdominal or chest pain with persistent vomiting or inability to swallow may also indicate an emergency.
