Reflux Surgery

A hiatal hernia can play a role in the development of both acid reflux and a chronic form of acid reflux called gastroesophageal reflux disease (GERD). Hiatal hernias are defects in the breathing muscle (diaphragm) that allow the stomach to slide from its normal location in the abdomen up into the chest. These may be asymptomatic if small, or cause heartburn, reflux, cough, or regurgitation. Hiatal hernias are usually diagnosed with an endoscopy (EGD), which involves passing a flexible scope through the mouth into the stomach. Initial treatment of small hernias may consist of acid-reducing medications, but surgery is effective for patients who do not get adequate relief or choose not to take these medications long-term. Surgery is generally laparoscopic, and may involve wrapping the stomach around the esophagus (Nissen fundoplication). In patients who undergo bariatric surgery, hiatal hernias are frequently repaired at the same time if present.