A hiatus hernia occurs when part of the stomach pushes up through the diaphragm into the chest. Many people live with a hiatus hernia without needing surgery, but when it causes persistent acid reflux, difficulty swallowing, or chest pain that does not respond to medication, surgical treatment can offer lasting relief.
Mr Mohamed Aly is a specialist laparoscopic upper GI surgeon based in Northwest London. He leads hiatus hernia surgery at The Hillingdon Hospitals NHS Foundation Trust and also offers treatment through Circle Healthcare and London International Patient Services. He offers over 99% keyhole (laparoscopic) surgery, meaning minimal scarring and a rapid recovery.
What Is a Hiatus Hernia?
The diaphragm is a sheet of muscle that separates the chest from the abdomen. There is a small opening in the diaphragm called the hiatus, through which the oesophagus passes on its way to the stomach. A hiatus hernia occurs when the stomach — or occasionally other abdominal organs — slides or pushes up through this opening into the chest.
There are two main types: a sliding hiatus hernia, which is the most common, and a para-oesophageal hernia, which is less common but more likely to require surgery.
Symptoms
Common symptoms of a hiatus hernia include:
- Persistent heartburn or acid reflux
- Regurgitation of food or liquid
- Difficulty swallowing (dysphagia)
- Chest pain or discomfort
- Feeling full quickly after eating
- Shortness of breath in larger hernias
Symptoms often worsen after meals, when lying down, or when bending forward.
When is surgery recommended?
Surgery is considered when symptoms are not controlled by medication such as proton pump inhibitors (PPIs), when you wish to stop taking long-term medication, when the hernia is large or at risk of complications, or when there is a risk of the hernia becoming stuck or twisted (strangulation).
Mr Aly will assess your individual situation and discuss whether surgery is the right choice for you. Not everyone with a hiatus hernia requires an operation, and all options will be explained clearly at your consultation.
The Operation — Laparoscopic Hiatus Hernia Repair
The mainstay of hiatus hernia surgery is repair of the hiatus itself. Mr Aly returns the stomach to its correct position below the diaphragm and narrows the enlarged opening in the diaphragm using stitches, restoring the normal anatomy. In larger hernias, where a significant portion of the stomach has moved into the chest, this repair is the primary and most important component of the operation.
In patients who also suffer from acid reflux, and where this has been confirmed through appropriate investigations, an anti-reflux procedure called a fundoplication may be added. This involves wrapping the upper part of the stomach around the lower oesophagus to strengthen the valve and prevent acid from travelling upwards. However, this is an additional step performed selectively — not a routine part of every hiatus hernia repair.
The operation is performed under general anaesthetic using a laparoscopic (keyhole) approach through small incisions in the abdomen. Mr Aly performs over 99% of these operations using keyhole techniques, meaning less scarring, less pain, and a faster recovery. Most patients are discharged the following day and return to normal activities within 2–4 weeks.
Recovery
Most patients experience a straightforward recovery following laparoscopic hiatus hernia repair. You can expect:
- 1 to 2 nights in hospital after the procedure
- A soft or liquid diet for the first 2 to 4 weeks while swelling settles
- A return to light activities within 1 to 2 weeks
- A return to work within 2 to 4 weeks for a desk job, or 4 to 6 weeks for manual work
- Avoiding heavy lifting for 4-6 weeks
Mr Aly provides all patients with detailed dietary advice after surgery and arranges close follow-up to monitor recovery. Any questions after your operation can be directed to our team at any time.
How to book
To arrange a consultation with Mr Aly to discuss hiatus hernia surgery, please contact our team. We welcome GP referrals, self-paying patients, and patients with health insurance. Mr Aly works with all major insurers including Bupa, AXA Health, Vitality, Aviva, WPA, and Cigna. Same-day diagnostic investigations are available wherever possible.