Reflux, Hiatus Hernia & Achalasia
Acid reflux, hiatus hernia and achalasia — when surgery becomes the right option, which operation, and when it isn’t.
Hiatus hernia condition page → Achalasia condition page →Nissen, Toupet or Dor: how I choose your anti-reflux wrap
How I match the wrap to you: your symptoms, how well your esophagus moves food down, and what the trials show.
Read the article Medication vs surgeryLong-term PPIs: the risks, and how reflux surgery can get you off them
What the evidence says about long-term omeprazole and pantoprazole, why PPIs can’t fix a hiatus hernia, and how often surgery gets people off them.
Read the article What to expectKeyhole hiatal hernia surgery and fundoplication: what actually happens
The tests, each step of the operation, Nissen vs Toupet wraps, and what recovery looks like week by week.
Read the article A deep diveWhy do hiatus hernias come back?
The risk factors for recurrence (obesity, tension, a short esophagus, weak crura) and how I build a repair to resist it.
Read the article Achalasia treatmentPOEM, Heller myotomy, balloon dilation or Botox for achalasia: how I compare them
The four main ways to open the valve, side by side — and why I still favour Heller myotomy with a partial wrap for most patients.
Read the article When to operateWhen does a hiatus hernia actually need surgery?
Most never do. The situations where surgery is genuinely worth considering — and, just as important, when it’s better to watch and wait.
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