Hiatal Hernia Surgery Specialist in Sydney
What is a hiatal hernia?
A hiatal hernia occurs when part of the stomach is pushed up into the chest cavity, through the diaphragm. (The diaphragm is the main muscle for breathing. It is also the muscle wall that separates the chest and abdomen.) It’s not exactly clear what causes a hiatal hernia, but it is relatively common after the age of 50. Some patients with hiatal hernia experience symptoms, while others have none.
What are the symptoms of a hiatal hernia?
Signs and symptoms of a hiatal hernia include:
- Acid reflux – This is caused by the backflow of stomach acid into the oesophagus, and may be experienced as heartburn. If you have a hiatal hernia, antacid medication may not always relieve your heartburn.
- Chest pain – A hiatal hernia may cause chest pain that is felt behind the breastbone. (Note: it is important to seek immediate medical care for chest pain, as it could be caused by a heart attack or other serious emergency).
- Dysphagia – Dysphagia is difficulty in swallowing, or the impression of food sticking in the chest area.
- Regurgitation – This is when stomach contents come back up into the mouth. It is likely to have an unpleasant, acidic taste.
- Upper abdominal pain.
- Vomiting of blood or passing of black stool.
- Anaemia - Anaemia is a shortage of healthy, oxygen-carrying red blood cells, and could make you feel tired or weak.
How is a hiatal hernia diagnosed?
A hiatal hernia may be diagnosed on an X-Ray or CT-scan, or during a gastroscopy.
How is a hiatal hernia treated?
Hiatal hernias may be treated with lifestyle changes, medication or surgery. However, not every hiatal hernia needs treatment. If it is not causing symptoms, a hiatal hernia may be safely observed.
What sort of lifestyle changes could help to improve my symptoms?
There are several lifestyle changes that could help control the symptoms of a hiatus hernia. These include:
- Avoiding large meals.
- Avoiding foods that are prone to cause heartburn, such as tomatoes, alcohol, chocolate, garlic, onion, coffee and fatty or fried foods.
- Avoiding foods that are prone to cause heartburn, such as tomatoes, alcohol, chocolate, garlic, onion, coffee and fatty or fried foods.
- Elevating the head of your bed by around 30 degrees.
- Giving up smoking.
- Losing weight.
What medications are used to treat a hiatal hernia?
Medications for hiatal hernia include:
- Antacids – These help to neutralise stomach acids and relieve heartburn quickly, although their effect is relatively short-lived.
- H2-receptor blockers – These decrease the amount of acid produced by the stomach, and have a longer-lasting effect than antacids.
- Proton pump inhibitors (PPI’s) – These medications dramatically reduce stomach acid production and are highly effective at treating hiatal hernia symptoms.
When is surgery needed for a hiatal hernia?
Surgery may be recommended if:
- Symptoms are severe and interfere with quality of life.
- Symptoms do not respond to other treatments.
- The hiatal hernia is at risk of becoming strangulated. (Strangulation of a hernia occurs if it twists, so that the blood supply is blocked. Strangulation of a hiatal hernia would cut off the stomach’s blood supply, which could be life-threatening.)
What type of surgery is done to repair a hiatal hernia?
During laparoscopic (or keyhole) surgery for a hiatal hernia, the stomach is pulled back into the abdomen. The top part of the stomach (called the fundus) is then wrapped around the lower part of the oesophagus, to create a valve which prevents acid from leaking up into the oesophagus. This procedure is called a fundoplication.
What can I expect after hiatal hernia surgery?
After laparoscopic hernia repair and fundoplication, most patients will experience transient discomfort, rather than severe pain. During surgical recovery, it is important to:
- Avoid any heavy lifting for 2 to 3 weeks.
- Avoid driving for 7 to 10 days.
- Maintain a soft diet for 3 weeks.
- Have small, frequent meals.
You could expect to return to work within 2 to 3 weeks, or whenever you feel well enough, and should be ready to resume your regular diet between 3 and 6 weeks after surgery.
