Achalasia, Hiatal Hernia and Heartburn

Achalasia, Hiatal Hernia and Heartburn

Mary from Humble, TX sent us this question: “I have a Hiatal Hernia with Achalasia. Can surgery on these be done at the same time? What type of surgeon does these? A GI doctor, Thoracic Surgeon, or regular Surgeon? I live around Cypress, Humble area.”


Dear Mary,

Achalasia is a rare esophageal motility problem that may coexist with a hiatal hernia. Both achalasia and hiatal hernia are associated with heartburn. The treatment in your case consists of hiatal hernia repair with Heller myotomy and Toupet fundoplication. All three procedures are concomitantly done laparoscopically, i.e. through tiny incisions. The success rate of this approach is very high along with a very low complication rate. Heller myotomy open the non-relaxing lower esophageal sphincter associated with achalasia. Consequently, swallowing improves and dysphagia resolves. Hiatal hernia repair and Toupet fundoplication reliably stop acid reflux without affecting swallowing.

The best surgeon to perform this surgery is a competent surgeon who specializes in acid reflux management. Thoracic surgeons do not typically specialize in acid reflux, but some offer hiatal hernia repair and fundoplication surgery. A regular general surgeon does not perform these surgeries on a regular basis and surgery outcome is typically poor. GI doctors are not surgeons. They may perform balloon dilation of lower esophageal sphincter. This approach is typically reserved for older patients who cannot tolerate general anesthesia.

There are very few heartburn and acid reflux centers in Houston dedicated to the management of esophageal problems like achalasia. Houston Heartburn and Reflux Center is proud to offer state-of-the-art treatment solutions for acid reflux, and esophageal dysmotility like achalasia. Give us a call at 832-945-8717 and one of our friendly receptionists will help you schedule an appointment.