Heartburn is one of the most frequent complaints among Italians living in London. It often begins as a mild discomfort after a heavy meal or a stressful day. But when it becomes something that wakes you up at night, limits what you can eat, or appears several times a week, it’s no longer “just a nuisance” — it’s your body signalling that something needs attention.
In most cases, the cause is gastro-oesophageal reflux, meaning stomach acid rises back into the oesophagus. Lifestyle can play a role, but very often there’s an underlying anatomical issue that can be effectively treated.
Signs that your reflux should not be ignored
Many patients tell me they have “got used” to their symptoms over the years. But the signs are clear:
• Burning behind the breastbone, especially after meals
• Persistent dry cough
• Morning hoarseness
• Slow digestion or sensation of food “stuck”
• Acid reflux when lying down
• Bitter taste or nighttime regurgitation
• Feeling of a lump in the throat or the need to clear it often
If one or more of these symptoms appear several times per week, it’s very likely that there is a mechanical cause: a weakened oesophageal valve, a hiatal hernia, hypersensitivity of the oesophagus, or inflammation already in progress.
Ignoring symptoms doesn’t help. Over time, reflux can worsen, become harder to control, and in more advanced cases cause inflammation or cellular changes that must be monitored.
The good news: today we can truly treat it
Modern medicine offers several solutions — and not all of them involve long-term medication.
Depending on your situation, the treatment plan may include:
• Targeted medical therapy to reduce acidity and protect the oesophagus
• Lifestyle adjustments, effective in milder cases
• Accurate assessment of hiatal hernia
• Minimally invasive procedures, such as laparoscopic surgery, which restore the natural anti-reflux barrier
The goal is not just to “switch off the symptom,” but to address the cause — restoring normal digestion and a quality of life many patients haven’t felt in years.
The advantage of being treated by an Italian surgeon in London
Many patients tell me the difference is the communication.
Explaining symptoms, understanding your options and making important decisions is much easier in your own language.
Having worked in London for years, I combine a modern, evidence-based surgical approach with clear, direct and reassuring communication.
No unnecessary jargon. No confusion. You fully understand what’s happening and what we can do to fix it.
This is why an increasing number of Italians — both self-pay and insured — come to me for diagnosis, treatment and follow-up.
When it’s time for a specialist evaluation
I always recommend a specialist consultation when:
• You often need antacids
• Heartburn wakes you up at night or limits your diet
• Reflux comes with cough or hoarseness
• You already have a diagnosis of hiatal hernia
• Symptoms affect your social life, work or sleep
• You have difficulty swallowing or feel food getting stuck
A complete evaluation — consultation, endoscopy, ultrasound, functional testing — allows us to identify the exact cause and set the right treatment plan.
Many patients tell me: “I wish I had acted sooner.”
And almost always, after proper treatment, they return to living completely normal lives.
Francesco Di Maggio
Consultant Upper Gastrointestinal Surgeon
Dottore London