Hiatal Hernia Repair

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A hiatal hernia occurs when weakened muscle tissue allows the stomach to bulge through the diaphragm. While the specific causes of a hiatal hernia are unclear, some people believe that pressure on the surrounding muscles, such as when coughing, vomiting, or straining during a bowel movement or straining while lifting heavy objects can also cause the stomach to push up through the hiatus, thereby contributing to its formation. In addition, being born with an unusually large hiatus or an inherited weakness in the surrounding muscles may be the culprit.

The goals of hiatal hernia treatment are to relieve symptoms and prevent complications. Measures to reduce symptoms include: avoiding large or heavy meals, not lying down or bending over right after a meal, reducing weight and not smoking. If these measures do not control the symptoms or if there are complications, surgery may be required to repair the hernia.

Reducing the backflow of stomach contents into the esophagus (gastroesophageal reflux) will relieve pain. A doctor may also prescribe medications that neutralize stomach acid, decrease acid production, or strengthen the lower esophageal sphincter (the muscle that prevents acid from backing up into the esophagus).

A procedure called fundoplication is the most common type of surgery to repair a hiatal hernia. Be sure to tell your health care provider if you are,or could be, pregnant or if you are taking any drugs, supplements, or herbal remedies that you bought without a prescription. In addition, for several days prior to the surgery, the doctor may ask you to stop taking aspirin, ibuprofen (Advil, Motrin), vitamin E, and/or certain other drugs or supplements that could affect blood.

During the actual procedure, the surgeon will repair the hiatal hernia by stitching and tightening the opening in the diaphragm to keep anything from bulging through. Some surgeons also place a piece of mesh in the repaired area to make it more secure.

As with any surgery, there are risks. Since patients are placed under general anesthesia for this procedure, the risks of general anesthesia include: breathing problems (including pneumonia), heart problems and reactions to medications. The risks of this surgery include: bleeding, infection, and/or return of the hiatal hernia.

Sources:

Anti-Reflux Surgery. Web. www.nlm.nih.gov. Accessed 6 Nov. 11
http://www.nlm.nih.gov/medlineplus/ency/article/002925.htm

Hiatal Hernia Diet. Web. Hiatal-hernia.org. Accessed 6 Nov. 11
http://hiatal-hernia.org/diet.php

Reviewed November 8, 2011
by Michele Blacksberg RN
Edited by Jody Smith

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