Specialist treatment for hiatus hernia in Otago and Southland
A hiatus hernia occurs when part of the stomach moves upward through the diaphragm into the chest.
This can weaken the natural valve between the stomach and oesophagus, allowing stomach acid to reflux into the oesophagus.
Many patients with a hiatus hernia experience symptoms such as heartburn, reflux, chest discomfort or difficulty swallowing.
Mark Grant is an Upper Gastrointestinal and Bariatric Surgeon based in Dunedin, providing specialist assessment and surgical treatment for hiatus hernia for patients across Otago, Southland, Queenstown, Wanaka and Invercargill.
What is a hiatus hernia?
The oesophagus passes through a small opening in the diaphragm called the hiatus before joining the stomach.
A hiatus hernia occurs when part of the stomach pushes through this opening into the chest cavity.
This change in anatomy can weaken the anti-reflux barrier and allow acid to move back into the oesophagus.
Hiatus hernias are common and may range from small sliding hernias to larger para-oesophageal hernias.
Symptoms of a hiatus hernia
Many hiatus hernias cause acid reflux symptoms, but some patients may experience additional symptoms.
Common symptoms include:
- heartburn or burning discomfort in the chest
- acid reflux or regurgitation
- difficulty swallowing
- chest pain after eating
- bloating after meals
- chronic cough or throat irritation
Large hernias may also cause:
- early fullness when eating
- shortness of breath
- anaemia from irritation of the stomach lining
What causes a hiatus hernia?
Several factors may contribute to the development of a hiatus hernia.
These include:
- weakening of the diaphragm with age
- increased pressure in the abdomen
- obesity
- heavy lifting
- pregnancy
- chronic coughing
Some people are also born with a naturally larger hiatus opening.
When is hiatus hernia surgery recommended?
Many small hiatus hernias can be managed without surgery.
Treatment usually begins with:
- dietary changes
- weight management
- reflux medications
Surgery may be considered when: - reflux symptoms persist despite medication
- a large hiatus hernia is present
- regurgitation occurs frequently
- swallowing problems develop
- complications such as oesophagitis occur
For suitable patients, surgery can restore the normal anatomy and significantly reduce reflux symptoms.
Laparoscopic hiatus hernia repair
Hiatus hernia surgery is usually performed using laparoscopic (keyhole) surgery.
This allows the operation to be performed through small incisions in the abdomen.
During the procedure:
- The stomach is returned to its normal position in the abdomen
- The opening in the diaphragm (hiatus) is repaired with sutures
- The anti-reflux valve is reinforced using a fundoplication
This helps restore the natural barrier preventing acid reflux.
Because the procedure is minimally invasive, most patients experience:
- less pain after surgery
- faster recovery
- smaller scars
- shorter hospital stay
Recovery after hiatus hernia surgery
Most patients stay in hospital one night after surgery.
Recovery usually includes:
- gradual return to normal diet
- temporary changes in swallowing
- return to work within 2–3 weeks
- avoiding heavy lifting for several weeks
Diet typically progresses from soft foods to normal diet over several weeks.
Expected outcomes
Hiatus hernia repair combined with anti-reflux surgery has excellent long-term outcomes.
Studies show that:
- most patients experience significant improvement in reflux symptoms
- many patients are able to stop reflux medication
- approximately 80% of patients remain symptom free 10 years after surgery
A small percentage of patients may develop recurrence of the hernia over time.
Risks of hiatus hernia surgery
All surgery carries some risk, although complications are uncommon.
Potential risks include:
- bleeding or infection
- injury to nearby organs
- difficulty swallowing during early recovery
- recurrence of the hernia
Careful patient selection and experienced surgical care minimise these risks.
Hiatus hernia surgery for patients across Otago and Southland
Patients often travel to Dunedin for specialist Upper GI surgery.
Mark Grant provides assessment and surgical treatment for hiatus hernia for patients from:
- Dunedin
- Queenstown
- Wanaka
- Invercargill
- Oamaru
- Central Otago
Consultations are typically arranged following referral from a GP or specialist.
Consultation for hiatus hernia repair
If reflux symptoms or a hiatus hernia are affecting your quality of life, specialist evaluation can help determine the best treatment options.
Assessment may include:
- review of symptoms
- gastroscopy
- oesophageal function testing
- imaging of the hiatus hernia
These tests help determine whether surgery is appropriate.
Reflux surgery for patients across Otago and Southland
Patients frequently travel to Dunedin for specialist Upper GI surgery.
Mark Grant provides reflux and hiatus hernia surgery for patients from:
- Dunedin
- Queenstown
- Wanaka
- Invercargill
- Oamaru
- Central Otago
Referrals are usually made by your GP or specialist.
FAQs
Can a hiatus hernia heal on its own?
Small hiatus hernias may not cause symptoms and may not require treatment. Symptomatic hernias may require medication or surgery.
Is hiatus hernia surgery major surgery?
Most repairs are performed laparoscopically (keyhole surgery), which allows faster recovery compared with open surgery.
How long does recovery take?
Most patients return to light activities within 2–3 weeks after surgery.
Does hiatus hernia surgery cure reflux?
For many patients, surgery significantly improves reflux symptoms and reduces the need for medication.