Reflux & Hiatal Hernia Surgery
GERD (acid reflux)
Gastroesophageal reflux disease (GERD) happens when stomach contents flow back up into the esophagus. Common symptoms include heartburn, regurgitation, a sour taste, trouble swallowing, hoarseness or a chronic cough. Many people do well with lifestyle changes and medication. Surgery may be an option for some patients whose symptoms continue despite treatment, or who have a hiatal hernia that contributes to reflux.
Hiatal hernia
The hiatus is the opening in the diaphragm where the esophagus passes through to the stomach. In a hiatal hernia, part of the stomach slides up through this opening into the chest. Small hiatal hernias often cause no symptoms; others are linked with reflux.
Paraesophageal hernia
A paraesophageal hernia is a type of hiatal hernia in which part of the stomach pushes up next to the esophagus. It can cause chest or upper abdominal pressure, trouble swallowing, feeling full quickly, or vomiting. These hernias are usually evaluated by a surgeon because they can sometimes lead to serious problems.
Surgical treatment
- Hiatal and paraesophageal hernia repair: the stomach is returned to the abdomen and the opening in the diaphragm is tightened.
- Anti-reflux surgery (fundoplication): the top of the stomach is wrapped around the lower esophagus to strengthen the barrier against reflux. It is often done together with hiatal hernia repair.
These operations are typically performed with minimally invasive techniques through small incisions. Before surgery, testing may include an upper endoscopy (EGD) and esophageal manometry, which measures how well the esophagus muscles work. Dr. Tufts will talk with you about which surgical approach fits you best.
MiVu™ reflux testing during your EGD
Confirming reflux has often meant a Bravo™ wireless pH capsule recording for 48 to 96 hours. Dr. Tufts now also offers MiVu™ mucosal integrity testing, a few-minute measurement of the health of the esophageal lining taken during your upper endoscopy, with results during the procedure and no capsule left behind. Dr. Tufts will decide whether Bravo™ or other testing is still needed, especially before surgery. Learn about MiVu™ →
Barrett’s esophagus
Long-standing reflux can change the lining of the lower esophagus, a condition called Barrett’s esophagus. It is found on EGD and confirmed with biopsies, and it calls for regular surveillance endoscopy. The TissueCypher® Barrett’s Esophagus Test, run on biopsy tissue already taken, may be recommended to help personalize follow-up. Barrett’s esophagus & TissueCypher® →
Recurrent paraesophageal hernias are primarily repaired with the Da Vinci robot. Dr. Tufts performs open, laparoscopic, and robotic surgery, tailoring the approach to provide the optimal care for each patient.
Where surgery is performed
Dr. Tufts operates at AdventHealth Port Charlotte and Murdock Surgery Center. Consultations and follow-up visits are at the Charlotte Harbor Surgical office in Port Charlotte.
We care for patients from Port Charlotte, Punta Gorda, North Port, Englewood and across Charlotte County and Southwest Florida.
Frequently asked questions
Does every hiatal hernia need surgery?
No. Small hiatal hernias are common and often cause no symptoms. Surgery is considered when a hernia is large, causes reflux or other symptoms that do not respond to medicine, or leads to complications.
Is a hiatal hernia the same as GERD?
No, but they are related. A hiatal hernia can weaken the barrier that keeps stomach acid out of the esophagus, so many people with a hiatal hernia also have reflux (GERD).
What tests will I need before surgery?
Testing often includes an upper endoscopy (EGD) and imaging such as a barium swallow or CT scan. Some patients also need esophageal function or acid (pH) testing.
How is a hiatal hernia repaired?
Repair is usually done laparoscopically through small incisions. The stomach is returned to the abdomen, the opening in the diaphragm is tightened, and an anti-reflux procedure is often added.
Will I need a special diet after surgery?
Yes, for a short time. Most patients start with liquids and soft foods and slowly return to a regular diet as swallowing feels normal. Your care team will give you written diet instructions.
What is GERD?
Gastroesophageal reflux disease (GERD) is when stomach acid or contents flow back into the esophagus often enough to cause symptoms or irritation, such as heartburn, regurgitation, a sour taste, cough or hoarseness.
What can I do at home to reduce reflux?
Helpful steps include avoiding large or late meals, raising the head of your bed, losing excess weight, stopping smoking and limiting foods that trigger your symptoms.
When should reflux be checked by a surgeon?
Consider an evaluation if symptoms continue despite medicine, if you have trouble swallowing or regurgitation, if you would rather not take medicine long term, or if you have a hiatal hernia.
Will I still need reflux medicine after surgery?
Many patients are able to reduce or stop reflux medicine after anti-reflux surgery, but results vary and some people still need medicine. Your surgeon will discuss what to expect for you.
Can untreated reflux cause problems?
Long-standing reflux can inflame the esophagus and, in some people, lead to narrowing or Barrett’s esophagus. An upper endoscopy (EGD) can check for these changes.
Schedule a consultation with Dr. Tufts
Call Charlotte Harbor Surgical in Port Charlotte. Mon–Thu 7:30 am–4:00 pm, Fri 7:30 am–12:00 noon.