Hiatal Hernia FAQ

The way we were designed, the stomach is supposed to be in the abdomen, the belly. Sometimes, however, the stomach can travel upward into the chest. This happens to millions of us and it is called a hiatal hernia. Most of us never have any symptoms. Sometimes a hiatal hernia can promote reflux of stomach contents and induce heart burn.

The overwhelming majority of people with heartburn and mild reflux are treated with medications and some minor changes in our diet and lifestyle: smaller meals, no alcohol or coffee, etc., as well as antacids and medicines to reduce acid formation in the stomach (think Tums and the purple pill).

Surgery for hiatal hernia problems is actually quite uncommon. Nonetheless symptoms can develop where the radical step of the surgery can be very very helpful. Most people with reflux and heartburn symptoms are managed with medicines and lifestyle changes. However, there are patients for whom medicine is not enough.

• When heartburn symptoms become unbearable or untreatable by medication surgery is sometimes considered.
• When reflux of stomach contents into the mouth or lungs interferes with breathing or sleep then surgery is sometimes considered.
• When a hiatal hernia become so large that food become stuck in the esophagus or the stomach and cannot go through, this will usually cause pain while eating and surgery is sometimes considered.

The surgery itself is done laparoscopically and the goal of the surgery is to return the stomach to the abdomen and relieve the symptoms. This operation is a big step but is very successful.

Dr. Gryska has performed many hundreds of laparoscopic hiatal hernia operations and has taught this operation to surgeons all over the United States and traveled to a total of 10 countries to teach fine details of this surgery learned from his experience. In fact, laparoscopic surgery to repair a hiatal hernia is now one of the most common operations that Dr. Gryska performs.

The laparoscopic approach to the hiatal hernia is now the standard of care in America and worldwide. The operation is safe, durable and very effective. In fact Dr. Gryska has published a scientific paper about the safety and durability of prosthetic repair of hiatal hernia. This paper can be found here.

The surgery itself takes 2 to 2.5 hours.

The procedure requires general anesthesia.

All patients stay overnight in the hospital, but usually just one night. The laparoscopic approach avoids the large incision and the pain that goes along with that incision. The hiatal hernia repair on the inside itself causes very little discomfort.

For a week after surgery, however, patients are required to be on an all-liquid diet. Everyone loses a few pounds, but normal eating afterwards usually restores normal weight.