A hiatal hernia comes about when your stomach bulges through an opening in the diaphragm into your chest. While you can treat mild cases of this condition with medication, you will have to undergo hiatal hernia surgery if your body fails to respond to treatment.
Any medical issue that requires surgery can make you nervous. Therefore, work with an experienced surgeon like Dr. Adam Harris to have the surgery done right the first time and avoid long-term pain or hernia reoccurrence. Here is a detailed guide aimed at giving you a deeper look into this condition. Read on to gain more insights.
Causes of Hiatus Hernia
The condition can affect people of both sex and all ages, but it frequently develops at 50 years old. In fact, 60% of adults above 60 years will experience symptoms of hiatus hernia. It happens due to age-related changes in the diaphragm.
Some people naturally have a huge hiatus which increases the risks. Other times it can occur due to injuries and lifestyle behaviors like smoking. Increased pressure in the abdominal cavity causes hiatus hernia too. Weakness in the lower part of the esophagus, liver, gallbladder, kidneys, colon, or rectum can cause pressure. It mainly happens due to vomiting, straining during bowel movements, heavy lifting, or coughing. You are at a higher risk if you are obese or pregnant. Some hiatus hernia symptoms include;
• Belching or bloating
• Bad breathe
• Problems with swallowing
• Stomach discomforts
• Chest pains
The Condition’s Diagnosis
If you experience any of the above symptoms, you will need to undergo various tests to determine if you have a hiatus hernia. One major test done is the barium swallow. During the test, you drink a special liquid that coats your digestive tract lining to help see the problem. The doctor will then take X-rays to determine if you have a hernia and how big it is and whether it has caused a twist in the stomach.
Alternatively, they may decide to perform endoscopy tests. It involves inserting a narrow tube with a camera and light into your esophagus to examine your upper digestive tract. Other psychiatrists will even conduct a pH test to assess the acid level in the digestive tract.
For patients experiencing vomiting symptoms, a gastric emptying study is necessary to determine how fast food leaves the stomach. It helps establish whether there are other causes of the symptoms rather than hiatus hernia. An esophageal manometry test involves measuring muscle contractions as you swallow. It also tests for any forces exerted by your esophagus muscles.
When to Go For Hiatal Hernia Surgery
Not all hiatus hernias conditions require surgery. However, if the symptoms interrupt your life quality, you may need to find a great hiatal hernia surgeon to correct the issue. You can also reach out to Dr. Adam Harris if you experience symptoms like breeding, scarring, or ulcers. Although the condition isn’t an emergency, you need immediate medical attention in case a hernia becomes strangulated. It happens when the tissues that move up the diaphragm receive insufficient blood flow. When neglected, it could lead to tissue death or stomach perforation.
Types of Surgeries Involved
There are three types of surgery used to correct this condition, all done under general anesthesia, and they take between two to three hours. Laparoscopic repair is the most common surgery for a hiatus hernia. It’s a minimally invasive surgery, and your doctor only needs to make few tiny incisions at the abdomen area. They then insert a laparoscope, which transmits images of your internal organs. The doctor will put back your stomach in the abdominal cavity as guided by the surgical instrument. Afterward, the surgeon tightens back the sphincter to prevent hernia reoccurrence. This type of surgery results in minimal infections, it’s less painful, the procedure and the recovery time are quicker. It has a success rate of about 90 to 95%.
Alternatively, your hiatal hernia surgeon can decide to perform the open repair surgery. It’s more invasive compared to the laparoscopic. The surgeon makes a larger cut into the abdomen then puts the stomach back in place. They then manually warp the upper section around the esophagus to tighten the stomach opening and prevents acid reflux. The doctor might also insert a tube into your stomach to hold it in place. You will get back to the hospital to remove the tube after about two to four weeks.
Endoluminal fundoplication is a pretty new procedure that is less invasive than laparoscopic. The surgeon won’t have to make an incision in your abdomen. Instead, they insert an endoscope down the throat. They then insert small chips into the area where your stomach meets the esophagus to prevent acid backup.
How to Prepare for Hiatal Hernia Surgery
When you are diagnosed with a hiatus hernia that requires surgery, your doctor should inform you of what you need to do before the surgery. The preparation may involve taking a two or three miles walk each day to boost fitness. Also, refrain from smoking for about four weeks before surgery. Try doing some breathing exercises several times daily.
Give your doctor a complete account of ay medications you are taking, including supplements and over-the-counter pills. You might need to stop taking any medicine that can affect the body’s clotting ability a week before surgery.
Since the procedure involves manipulating the stomach, you need to follow some dietary guidelines. Your surgeon may ask you not to drink or eat anything eight hours before the surgery since it can be dangerous to have a full stomach during anesthesia. Your doctor may also put you on a low or liquid, or less sugar diet ten days before the procedure.
The Recovery Process of Hiatal Hernia Surgery
After hiatal hernia surgery, especially if the surgeon performs the laparoscopic repair, most people won’t feel much pain, but you might have discomfort in the abdominal and chest areas. They should fade away within 48 hours, but you can treat the discomforts with over-the-counter medications like ibuprofen. You can go home after the surgery, but some patients might stay for a night at the hospital.
After surgery, the doctor will advise you on how to clean the incision area with water and soap. You should also avoid taking baths, pools, or bathtubs, but instead, stick to showers. When possible, walk around to prevent blood clotting in your legs. The surgeon will also guide you through some coughing and breathing exercises to strengthen the diaphragm. Avoid drinking through a straw, and don’t drive for about seven to ten days after the surgery. You shouldn’t also lift heavy objects for about two to three weeks.
After the surgery, eat four to six light meals rather than three large meals. Immediately after the procedure, start with a liquid diet, then proceed gradually to soft foods like scrambled eggs, smoothies, soups, and mashed potatoes. Avoid food that can cause gas like beans, cabbage, cauliflower, or corn. Don’t take alcohol, carbonated drinks, citrus, or tomato products. You can return to your regular diet three to six weeks after surgery.
As long as your job isn’t strenuous, you can resume within six to eight weeks. However, for more physically demanding jobs, it takes about three months before going back to work. Note that open surgery may require a lengthier recovery time. You should start driving once you finish your narcotic drug dose. When you fully recover, any heartburn or nausea symptoms should subside.
Tips to Prevent Hiatal Hernia
Although you might not avoid the risks of hiatus hernia completely, there are a few lifestyle changes that you can make to minimize the risk. If you are overweight, shed off some weight. Always stay hydrated, eat slowly, and ensure that your meal provides enough dietary fiber. It will help prevent straining during bowel movements. It’s also a good idea that you get help while lifting heavy objects.
Wear loose clothes, avoid putting on tight belts to prevent pressure on the abdomen. Eat your last meal of the day at least three hours before bed, and use a pillow that raises your head at about six inches off the bed to prevent acid reflux while sleeping. Don’t overeat, and exercise moderately for about 20 minutes daily. Avoid eating before exercises and bending in the next two to three hours after a meal. Limit fried foods intake, and instead, you can use a tiny amount of healthy cooking oils like olive and coconut oils.
Hiatal hernias are very common, but most people won’t even experience the symptoms. However, in some cases, it can cause acid reflux and discomfort that you can correct with surgery or any of the above-outlined lifestyle changes. When you opt for hiatal hernia surgery, always choose the best hernia center to fix the problem and decrease the chances of complications. Go to a specialist who knows all the best possible surgical options to suggest the best solution based on your condition’s severity. If you need to talk to a professional about your situation, reach out to General Surgeon Dr. Adam Harris Hiatal Hernia Mayo Clinic trained surgeon and schedule an appointment.