I suffer from reflux, underwent an upper GI series, and have been told that I have a paraesophageal hiatal hernia. I have an appointment with a gastroenterologist, but my internist said that I might need surgery. My symptoms aren't that bad. Should I be concerned?
Hiatal hernias are defects in the diaphragm that allow the stomach to slide up into the chest. While they can cause heartburn, generally this is controlled with medications and surgery is not needed. The stomach moves up through the diaphragm right underneath the esophagus. That type of hernia is called a sliding hiatal hernia. The much rarer type, paraesophageal hernia, occurs when the stomach goes through the diaphragm next to the esophagus. Paraesophageal hernias generally tend to enlarge with time, and sometimes the entire stomach is found within the chest. Most patients with a paraesophageal hernia remain asymptomatic. In this type of hernia, symptoms from acid reflux usually do not occur. Instead, the most commo...
Fundoplication; Anti-reflux surgery
Expectations after surgery
Hiatal hernia repair is a safe, effective operation. Reflux is greatly reduced or eliminated in 95% of patients.
Patients who have laparoscopic surgery typically spend 1 to 3 days in hospital. Those who have open surgery may spent 2 to 6 days in the hospital after the procedure.
During surgery, a tube was placed into the stomach through the nose and throat (nasogastric tube). Some surgeons like to leave the tube in for a few days after the procedure, while others do not.
Eat small, frequent meals after the surgery and avoid gas-producing foods.
Most patients go back to work in 2-3 weeks for laparoscopic surgery, or 4-6 weeks after open surgery.
My doctor has recommended that I have my hiatal hernia repaired. I am waiting to see a surgeon. Is this a good idea, and what should I ask the surgeon?
Although rarely necessary, at times, surgical repair of a hiatal hernia is the right choice in patients with gastroesophageal reflux disease . There are two types of hiatal hernia. In the much more common, sliding hernia, in which the stomach slides below the esophagus into the chest, medical therapy usually is very effective. The paraesophageal hernia, in which the stomach herniates next to the esophagus, is usually managed surgery. This is because of the potentially life-threatening complication of strangulation. When surgery is considered, it is best to see a surgeon that performs the procedure laparoscopically, if it is possible. Laparoscopic anti-reflux surgery involves reinforcing the valve between the esophagus and the stomach by wrapping the upper portion of the stomach around the lowest portion of the esophagus. Using on...
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