TL;DR
Struggling with the persistent discomfort of a hiatus hernia? You're not alone. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we understand the impact on your quality of life.
Key takeaways
- What a hiatus hernia is and its common symptoms.
- How diagnosis works in the private sector.
- The differences between the NHS and private treatment pathways.
- Types of private surgery available in the UK.
- How private medical insurance can cover the costs.
Struggling with the persistent discomfort of a hiatus hernia? You're not alone. At WeCovr, an FCA-authorised broker that has helped arrange over 900,000 policies, we understand the impact on your quality of life. This guide explores your options for private medical insurance in the UK to access prompt diagnosis and treatment.
Learn about hiatus hernia symptoms and treatment via private healthcare
A hiatus hernia can be a source of daily frustration, causing symptoms like heartburn, acid reflux, and difficulty swallowing. While the NHS provides excellent care, long waiting lists can mean a significant delay in getting the treatment you need. For many, this is where private healthcare offers a vital alternative.
This comprehensive guide will walk you through everything you need to know about tackling a hiatus hernia privately. We'll cover:
- What a hiatus hernia is and its common symptoms.
- How diagnosis works in the private sector.
- The differences between the NHS and private treatment pathways.
- Types of private surgery available in the UK.
- How private medical insurance can cover the costs.
- What to expect during recovery and beyond.
Let's dive in and explore how you can regain control of your health.
What Exactly is a Hiatus Hernia?
To understand the treatment, it's helpful to first understand the condition.
Your chest and abdomen are separated by a large, thin muscle called the diaphragm. There's a small opening in this muscle called the hiatus, which allows your oesophagus (the food pipe) to pass through and connect to your stomach.
A hiatus hernia occurs when the upper part of your stomach pushes, or 'bulges', up through this opening and into your chest.
It's a very common condition. In fact, according to NHS guidance, it's thought that around one in three people over the age of 50 have a hiatus hernia, although many will not experience any symptoms.
There are two main types:
- Sliding Hiatus Hernia (95% of cases): This is the most common type. The top of the stomach and the section of the oesophagus that joins it slide up into the chest through the hiatus. It often slides back down, especially when you stand up.
- Para-oesophageal (or 'Rolling') Hiatus Hernia: This is less common but can be more serious. A part of the stomach pushes up through the hole alongside the oesophagus. It doesn't slide back and forth, and there's a risk its blood supply could be cut off (strangulation), which is a medical emergency.
For many, a small hiatus hernia causes no problems. But for others, it can lead to persistent and uncomfortable symptoms that significantly disrupt daily life.
Common Symptoms of a Hiatus Hernia
The main issue with a hiatus hernia is that it weakens the valve (the lower oesophageal sphincter) that's meant to stop stomach acid from flowing back up into your oesophagus. This backflow is known as gastro-oesophageal reflux disease (GORD), and it's the cause of most hiatus hernia symptoms.
If you have a symptomatic hiatus hernia, you might experience:
| Symptom | Description |
|---|---|
| Heartburn | A burning sensation in the chest, often after eating, which may be worse at night. |
| Acid Reflux | A sour or bitter taste in your mouth as stomach acid comes back up. |
| Belching & Bloating | Feeling full quickly, gassy, and frequently needing to burp. |
| Dysphagia | Difficulty or pain when swallowing, feeling like food is stuck in your chest. |
| Chest Pain | A sharp or burning pain in the chest that can sometimes be mistaken for a heart attack. |
| Bad Breath | Halitosis caused by regurgitated stomach contents. |
| Hoarseness or Sore Throat | A persistent cough or change in your voice, especially in the morning. |
| Nausea | Feeling sick, sometimes leading to vomiting. |
These symptoms can be triggered or made worse by certain foods (spicy, fatty), large meals, lying down after eating, and bending over.
Getting a Diagnosis: The NHS vs. The Private Route
If you're experiencing these symptoms, the first step is always to see your GP. They will assess your condition and can often make a preliminary diagnosis based on your symptoms alone.
The NHS Pathway
- GP Consultation: Your GP will likely recommend initial lifestyle changes and may prescribe medication like antacids or a Proton Pump Inhibitor (PPI) such as omeprazole to reduce stomach acid.
- Referral to a Specialist: If your symptoms are severe or don't improve with medication, your GP will refer you to a gastroenterologist or an upper gastrointestinal (GI) surgeon on the NHS.
- Waiting Lists: This is where delays often occur. According to the latest NHS England data, referral-to-treatment (RTT) waiting times can be many months long. As of late 2024, the overall waiting list for consultant-led elective care stood at over 7.5 million procedures, highlighting the strain on the system.
- Diagnostic Tests: Once you see a specialist, they may arrange for further tests like an endoscopy (a camera test to look at your oesophagus and stomach) or a barium swallow x-ray.
- Treatment Plan: Based on the results, a treatment plan will be made, which could involve long-term medication or, in severe cases, a recommendation for surgery. The waiting time for the surgery itself can add further significant delays.
The Private Healthcare Pathway
The private route offers a way to bypass these long waits, giving you faster access to specialists and diagnosis.
| Stage | NHS Pathway | Private Pathway (with PMI or Self-Pay) |
|---|---|---|
| GP Referral | Required. You are referred to a specific NHS hospital trust. | Often required by insurers. You can request an 'open referral' to choose any specialist/hospital within your insurer's network. |
| Wait for Specialist | Months, sometimes over a year. | Days or weeks. |
| Wait for Diagnostics | Can be weeks or months after the specialist appointment. | Often done within a week, sometimes on the same day as the consultation. |
| Choice of Specialist | Limited. You see the consultant available at your local trust. | You can choose your preferred consultant and hospital from your insurer's approved list. |
| Wait for Surgery | Months or even years for non-urgent procedures. | Typically scheduled within a few weeks of the decision to operate. |
| Environment | NHS ward, which may be shared with several other patients. | Private en-suite room for your recovery. |
Using private medical insurance in the UK is the most common way to fund private treatment. It allows you to access this faster pathway without facing a daunting upfront bill.
Is a Hiatus Hernia Covered by Private Medical Insurance?
This is the most critical question for many, and the answer depends on one key factor: whether it is a pre-existing condition.
UK private medical insurance (PMI) is designed to cover acute conditions that arise after your policy has started. It does not cover chronic or pre-existing conditions.
- Acute Condition: A disease, illness, or injury that is likely to respond quickly to treatment and lead to a full recovery (e.g., a cataract, a hernia, a joint replacement).
- Chronic Condition: A disease, illness, or injury that has one or more of the following characteristics: it needs ongoing or long-term monitoring, has no known cure, is likely to recur, or requires palliative care (e.g., diabetes, asthma, high blood pressure).
- Pre-existing Condition: Any illness or symptom for which you have sought advice, diagnosis, or treatment before the start of your policy.
Here's how this applies to a hiatus hernia:
- If you are diagnosed with a hiatus hernia AFTER your PMI policy begins: Your policy will almost certainly cover the costs of diagnosis and treatment, including surgery if deemed necessary by a consultant. This is a classic example of what PMI is for.
- If you were diagnosed or had symptoms BEFORE your PMI policy begins: The hiatus hernia will be considered a pre-existing condition and will be excluded from cover. This applies even if you just had symptoms (like persistent heartburn) but didn't have a formal diagnosis yet.
Underwriting: How Insurers Assess Pre-existing Conditions
When you apply for a policy, insurers use a process called underwriting to decide what they will and won't cover.
| Underwriting Type | How it Works for a Hiatus Hernia |
|---|---|
| Moratorium (Most Common) | You don't declare your medical history upfront. The insurer automatically excludes any condition you've had in the 5 years before your policy started. However, if you go for a set period (usually 2 years) without any symptoms, treatment, or advice for that condition, the exclusion may be lifted. |
| Full Medical Underwriting (FMU) | You complete a detailed health questionnaire. The insurer reviews your medical history and may write to your GP. They will then explicitly state what is excluded from your policy from day one. This provides certainty but means a pre-existing hiatus hernia will be permanently excluded. |
An expert PMI broker like WeCovr can help you understand the nuances of underwriting and find a policy that best suits your personal circumstances, completely free of charge.
Private Hiatus Hernia Surgery: Your Options
If lifestyle changes and medication haven't worked, or if your hernia is severe, your consultant may recommend surgery. The goal of surgery is to repair the hernia and reinforce the valve at the bottom of the oesophagus to prevent acid reflux.
The most common procedure is a laparoscopic Nissen fundoplication. Don't be put off by the name! It's a type of keyhole surgery.
Laparoscopic Nissen Fundoplication
- What it is: A minimally invasive procedure. The surgeon makes several small incisions in your abdomen and uses a laparoscope (a tiny camera) and special instruments to perform the operation.
- The Process: The surgeon pulls your stomach back down into the abdominal cavity and tightens the opening in the diaphragm. They then wrap the top part of the stomach (the fundus) around the lower oesophagus. This strengthens the valve, making it much harder for acid to reflux.
- Benefits:
- Less pain and scarring than open surgery.
- Shorter hospital stay (usually 1-2 nights).
- Quicker recovery time.
- Very high success rate (over 90%) in relieving reflux symptoms.
Other Surgical Options
While fundoplication is the gold standard, a few other options may be available privately:
- LINX® System: This involves placing a small, flexible ring of magnetic titanium beads around the oesophagus. The magnetic attraction keeps the valve closed to prevent reflux, but it's weak enough to open when you swallow. It's a less invasive option but not suitable for everyone, particularly those with very large hernias.
- Endoscopic Procedures (TIF): Transoral Incisionless Fundoplication (TIF) is a newer procedure performed through the mouth with an endoscope, meaning no external cuts. It's less common and generally reserved for smaller hernias.
Your consultant surgeon will discuss the best option for you based on the size of your hernia, your symptoms, and your overall health. With private health cover, you have the freedom to choose a surgeon who specialises in the procedure you're most comfortable with.
What are the Costs of Private Hiatus Hernia Surgery?
If you don't have private medical insurance, you can choose to 'self-pay'. This gives you the same benefits of speed and choice, but you will need to fund the entire cost yourself.
The costs can vary significantly depending on the hospital, the surgeon, and the specific procedure. Below are some estimated 'package price' ranges for 2025. These prices typically include the surgeon's fees, anaesthetist fees, hospital stay, and one follow-up appointment.
| Procedure | Estimated UK Private Cost (Self-Pay) |
|---|---|
| Initial Consultation with a Specialist | £200 – £350 |
| Endoscopy (Gastroscopy) | £1,500 – £2,500 |
| Laparoscopic Nissen Fundoplication | £8,000 – £12,000+ |
| LINX® Reflux Management System | £9,000 – £14,000+ |
Note: These are guide prices only. Diagnostic tests are often charged separately. A comprehensive private medical insurance policy can cover all these costs, subject to the terms and limits of your plan.
Recovery and Life After Surgery
Recovery from keyhole hiatus hernia surgery is generally much faster than from traditional open surgery.
- Hospital Stay: You'll typically stay in hospital for 1 to 2 nights. In your private room, you'll be monitored by nursing staff to ensure your initial recovery is smooth.
- Pain: You will have some discomfort around the small incision sites and possibly some shoulder-tip pain (caused by the gas used during surgery), but this is usually well-managed with standard painkillers.
- Returning to Work: Most people with desk-based jobs can return to work within 2-3 weeks. If you have a more physically demanding job, you may need 4-6 weeks off.
- Driving: You can usually drive again once you can perform an emergency stop without pain, typically after about 2 weeks.
The Post-Surgery Diet
Your stomach and oesophagus need time to heal. Your surgical team will give you very specific dietary instructions, which you must follow carefully to avoid complications. The progression usually looks like this:
- First 2 Weeks (Liquid Diet): You'll start with clear fluids and progress to thicker liquids like smoothies, soups, and yoghurts.
- Weeks 3-4 (Soft/Puréed Diet): You can move on to very soft, mushy foods like mashed potatoes, scrambled eggs, and well-cooked fish. You must chew everything thoroughly.
- Weeks 5-6 Onwards (Gradual Return to Normal): You can slowly start reintroducing more solid foods. You'll need to take small bites, chew well, and eat slowly.
For several months after surgery, you might find it difficult to swallow large, dry, or 'doughy' items like bread or tough steak. This is normal and usually improves with time.
Long-Term Wellness and Health Tips
Surgery can be life-changing for those with severe reflux, but maintaining a healthy lifestyle is key to long-term success.
- Diet: Even after surgery, it's wise to avoid overeating and limit trigger foods that used to cause you problems. WeCovr customers who purchase private health or life insurance get complimentary access to CalorieHero, our AI-powered calorie tracking app, which can be a fantastic tool for managing your diet and portion sizes post-surgery.
- Weight Management: Maintaining a healthy weight reduces pressure on your abdomen and the surgical repair, lowering the risk of recurrence.
- Sleep: Continue to sleep with your head and shoulders slightly elevated. This uses gravity to help keep any remaining stomach contents where they belong.
- Activity: Gentle exercise like walking is encouraged soon after surgery. You should avoid heavy lifting for at least 6-8 weeks to allow the internal tissues to heal fully.
- Travel: You'll be able to travel once you feel comfortable. For long flights, ensure you get up and move around regularly to prevent blood clots, just as you would after any surgery.
By investing in your health through prompt private treatment and adopting these wellness habits, you can look forward to a future free from the daily burden of reflux.
And when you get a policy with us, you can often benefit from discounts on other types of cover, such as life insurance or income protection, helping you build a complete financial safety net for you and your family. WeCovr's commitment to client satisfaction is reflected in our high ratings on major customer review platforms.
Choosing the Best PMI Provider for Your Needs
Finding the right private health cover can feel overwhelming. With so many providers and policy options, how do you choose? This is where working with an independent broker like WeCovr makes all the difference.
We are experts in the private medical insurance UK market. We are not tied to any single insurer, so our advice is completely impartial. Our goal is simple: to help you find the best possible cover for your budget and needs.
We can help you:
- Compare the Market: We'll compare policies from all the leading UK insurers, such as Bupa, AXA Health, Aviva, and Vitality.
- Understand the Jargon: We'll explain things like underwriting, outpatient limits, and hospital lists in plain English.
- Tailor Your Policy: We can help you adjust your cover to manage your premium, for example, by choosing a higher excess or a 6-week wait option.
- Handle the Application: We'll guide you through the entire application process, making it simple and stress-free.
Our service is provided at no cost to you. We receive a commission from the insurer you choose, but this does not affect the price you pay.
Will my private medical insurance cover a hiatus hernia if I've had heartburn before?
This is a crucial point. If you have sought medical advice or treatment for heartburn symptoms before taking out your policy, an insurer will almost certainly classify the hiatus hernia as a pre-existing condition and exclude it from cover. This is because heartburn is a primary symptom. Insurers look at both formal diagnoses and symptoms when applying exclusions.
Can I get private health cover if I already have a hiatus hernia diagnosis?
Yes, you can still get private health cover, but the policy will exclude the hiatus hernia and any related conditions. However, the policy would still provide valuable cover for new, unrelated acute conditions that might arise in the future, giving you peace of mind for other health concerns.
How much does PMI cost to cover conditions like a hiatus hernia?
The cost of a private medical insurance policy varies widely based on your age, location, the level of cover you choose, and your underwriting type. A basic policy might start from £40-£50 per month, while a comprehensive plan with full outpatient cover and a choice of all UK hospitals could be over £100 per month. The best way to get an accurate figure is to get a tailored quote.
Don't let the discomfort of a hiatus hernia and long waiting lists hold you back. Take the first step towards faster treatment and a better quality of life.
Contact WeCovr today for a free, no-obligation quote and let our expert advisors help you navigate your private healthcare options.
Sources
- Department for Transport (DfT): Road safety and transport statistics.
- DVLA / DVSA: UK vehicle and driving regulatory guidance.
- Association of British Insurers (ABI): Motor insurance market and claims publications.
- Financial Conduct Authority (FCA): Insurance conduct and consumer information guidance.
