Hiatal Hernia & Acid Reflux — Symptoms & Treatment in Lucknow
A hiatal hernia occurs when part of the stomach pushes up through the diaphragm into the chest, through the opening where the food pipe normally passes. It is a common cause of acid reflux and heartburn, and while many people manage well with medication and lifestyle measures, some benefit from surgery.
Dr Sandeep Kumar Verma assesses and treats hiatal hernia and reflux in Lucknow, offering laparoscopic anti-reflux and hernia-repair surgery for carefully selected patients.
What is a hiatal hernia?
The diaphragm is the muscle separating the chest from the abdomen, with a small opening (the hiatus) through which the food pipe passes to join the stomach. When this opening widens and part of the stomach slides up through it, it is called a hiatal hernia.
Small sliding hiatal hernias are common and often cause acid reflux (GERD). Larger 'paraoesophageal' hernias are less common but can occasionally cause more serious problems and are more likely to need surgery.
Symptoms to watch for
- Heartburn and acid reflux, often worse after meals or when lying down
- Regurgitation of food or sour fluid into the throat
- Chest discomfort and difficulty swallowing
- A chronic cough, hoarseness or disturbed sleep from reflux
- Bloating and early fullness with larger hernias
Causes & risk factors
- Age-related weakening of the diaphragm opening
- Being overweight and raised abdominal pressure
- Chronic straining or coughing
- Sometimes present from a younger age in predisposed individuals
How it is diagnosed
- Upper GI endoscopy — to see the hernia and assess the food pipe lining
- Barium swallow X-ray
- Oesophageal manometry and pH studies in selected cases before surgery
How a hiatal hernia is treated
Most people with a small hiatal hernia and reflux are managed effectively with lifestyle measures (weight, meal timing, head-of-bed elevation) and acid-reducing medication. Surgery is considered when symptoms are not controlled by medication, when there are complications of reflux, or for large paraoesophageal hernias.
Surgery is performed laparoscopically and involves repairing the diaphragm opening and creating an anti-reflux valve (fundoplication). Dr Verma carefully selects patients who will genuinely benefit, after appropriate testing.
When to see a GI surgeon
- Frequent heartburn or reflux not controlled by usual measures
- Difficulty or pain on swallowing
- Reflux symptoms with weight loss, anaemia or vomiting — needs assessment
- Known large hiatal hernia with new chest or abdominal pain — seek prompt care
Hiatal Hernia: common questions
Does a hiatal hernia always need surgery?
No. The majority of hiatal hernias causing reflux are managed successfully with lifestyle measures and medication. Surgery is reserved for symptoms that medication cannot control, complications of reflux, or large paraoesophageal hernias. The decision is made after appropriate testing.
Will anti-reflux surgery cure my acid reflux?
For suitably selected patients, laparoscopic anti-reflux surgery is very effective at controlling reflux and often allows medication to be stopped. Careful assessment beforehand — including endoscopy and, in some cases, specialised tests — helps ensure the right patients are offered surgery.
Concerned about hiatal hernia?
Dr Sandeep Kumar Verma offers clear assessment and expert treatment. Book a consultation for personalised advice.