Hiatus Hernia
What is Hiatus Hernia?
A hiatus hernia is when part of the stomach squeezes or slides upwards into the oesophagus (food pipe). It is common in the over 50s, can be symptomless and may not need treatment.
However in some people it can have a big impact on digestion and cause unpleasant symptoms (such as heartburn, acid reflux, regurgitation, pain after eating, bad breath, bloating and/or difficulty swallowing).
These symptoms are shared with people affected by GORD (gastro-oesophageal reflux disease) and can significantly impact a patient’s day to day quality of life, but there are also long term health complications to consider. The leaking stomach acid from the hiatus hernia can lead to changes to the cell lining of the oesophagus (food pipe) and increases the risk of oesophageal cancer.
A growing number of hiatus hernia patients are looking at surgery and non-surgical procedures to treat the condition permanently.
Hiatus Hernia
Questions and Appointments
For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary Debra Hyams.
Treating a Hiatus Hernia
Prior to having an endoscopy (a camera down the throat investigation), a person is unlikely to know they have a hiatus hernia and their GORD type symptoms may be managed with conservative measures such as stopping smoking, cutting down alcohol, eating smaller meals and avoiding ‘trigger’ foods. Patients may take over the counter stomach acid remedies or be prescribed medications called PPIs.
If these measures do not work, then the GP may send the patient for further investigations, such as an endoscopy (camera down the throat). It is during this procedure that the gastroenterologist may diagnose a hiatus hernia and decide if the patient would benefit from surgery.
Hiatus hernia surgery involves making small cuts in the patient’s abdomen (keyhole surgery) and fixes the hiatus hernia by pushing it back down into the stomach and repairing the hole in the diaphragm through which the hernia forms. To stop reflux the surgeons will then wrap the top of the stomach around the lower part of the food pipe. However, the nature of the wrap means that some patients can develop troubling symptoms (bloating, flatulence, swallowing difficulties) and even an inability to belch or vomit if needed. In up to 10% of cases the key hole surgery may need to be converted to an open operation.
Dr Haidry and his surgical colleagues are now working together and are able to offer an advanced procedure called Concomitant hiatal hernia repair and transoral incisionless fundoplication (cTIF), which is a less invasive alternative to traditional surgery and offers a speedier recovery time.
Have a question?
If you have a question and would like to find out more, please contact Dr. Haidry’s secretary
What is cTIF?
cTIF combines two techniques that have been used for many years independently – a hiatal hernia repair and transoral incisionless fundoplication (also known as TIF).
TIF is a minimally invasive advanced endoscopy procedure which creates a new ‘anti reflux valve’ to prevent stomach contents leaking up. It can fix small hiatus hernias (up to 2cm). Until cTIF anyone with a hiatus hernia over 2cm would need surgery to fix the problem.
During a cTIF procedure the hiatus hernia is first repaired with keyhole surgery by a surgeon and straight after (while under the same general anaesthetic), the endoscopist will complete the TIF procedure to create a new flap valve.
The join between the bottom of the food pipe and stomach created during the TIF procedure is associated with less side-effects, so for instance the patient can still belch (cTIF patients experience less gas/bloating) and vomit. There is a much lower risk of swallowing issues after cTIF compared with traditional hiatus hernia surgery.
Read more about cTIF here.
In The Press
Sixty-minute stomach operation could banish heartburn in weeks.
Read the full article in the Daily Mail – here.
Get In Touch
For any enquiries about conditions, tests or treatments, please feel free to call Dr Rehan Haidry’s medical secretary Debra Hyams on:
Tel: 0203 423 7609 | Email: rhaidrymedsec@ccf.org