Hiatal hernia surgery will only be an option if the stomach actually comes out through the diaphragm and is positioned inside the chest cavity. In fact, the majority of individuals with this disorder have been able to control their symptoms by using medications and changing their lifestyles. Nevertheless, surgery becomes a must if the symptoms are extremely severe in cases of chronic acid reflux, esophagitis, difficulty in breathing, or strangulation.
However, surgery is only half of the solution. Therefore, it is equally important to be aware of life after hiatal hernia surgery. A surgical operation recovery does not end with discharge from the hospital. It is a continuous process that includes diet changes, gradually increasing physical activity, symptom monitoring, and implementing lifestyle changes to facilitate healing and prevent recurrence.
This in-depth guide covers the questions regarding the post-hiatal hernia surgery period, such as recovery time, diet, allowed physical activities, changes in symptoms, emotional adjustment, and long-term prognosis.
Understanding Hiatal Hernia Surgery
Before we get to the recovery stage, it is worth briefly understanding what a hiatal hernia is and the reasons for surgery. A hiatus hernia occurs when a portion of the stomach pushes upward through the diaphragm and into the chest cavity. If after several other treatments have failed to relieve symptoms like reflux, chest pain, and difficulty in swallowing, then the surgery is the first option.
Surgery can fix a hiatal hernia in several ways. It can simply push the stomach back into the abdomen and significantly reduce the opening in the diaphragm. There can also be other parts of the surgery, like repairing the esophageal sphincter or removing hernial sacs.
Not every patient with a hiatal hernia needs surgery. Surgery is generally reserved only for those patients with the most severe cases of hiatal hernia who have not responded well to other treatments. This operation is successful in approximately 90 percent of cases. But about 30 percent of patients will see reflux symptoms coming back.
Immediately After Hiatal Hernia Surgery
The primary goals of the post-operative phase following hiatal hernia surgery are healing and recuperation. Most patients will get a minimally invasive laparoscopic procedure since it allows for a faster recovery than open surgery.
The patient is expected to remain in the hospital for one or two days after the procedure while the medical staff keeps an eye on their condition and ensures their comfort.
A gradual shift from fluids to soft foods and finally to a regular diet is the focus of the first few weeks of recuperation. This is a crucial phase of the healing process because it allows the new surgical repair to develop without stress, even though it is only temporary.
Managing Pain After Surgery
The level of pain or discomfort after surgery varies between individuals. One may still have some pain after discharge from the hospital, and during that period, pain medication is normally necessary. A few months of soreness, tightness, or muscle aches around the area of the incisions is quite normal.
This pain, however, can sometimes last as long as six months or even more. It is not common to associate such pain with any problem in the healing process. The swallowing of large pills may be difficult during the first few weeks after surgery. Should there be a need to make a change in the prescription, changing from tablets to liquid or chewable tablets may be necessary if large tablets were taken before surgery.
Pills are not supposed to be crushed except when a pharmacist or a healthcare provider has informed that it is safe to do so, since some medications may lose their potency or even cause harm when crushed. After surgery, one normally does not need to take anti-reflux medications that one was on before surgery. Nevertheless, if symptoms of reflux return at any point during the healing period, the doctor should be contacted for a check-up.
Medications are to be used strictly according to the instructions and only when necessary. Inform the healthcare professional if the pain medication prescribed does not help enough. It is not advisable to drive or consume alcoholic beverages while on prescription pain medications, as these drugs may cause drowsiness, and alcohol may increase this effect.
With the progress of healing, pain gradually diminishes, and the need for potent pain medication also decreases. Generally, minor aches and pains can be effectively handled by taking over-the-counter painkillers like acetaminophen or ibuprofen, only if the doctor permits this. The instructions for stopping the use of prescription pain medicines should be strictly followed.
You must not take more medicine than the recommended amount. Follow the dosage instructions on the medicine label or those given by the healthcare provider.
Life After Hiatal Hernia Surgery: Dietary Restrictions
One of the major points to consider after a hiatal hernia surgery is dietary progression. Your body, in fact, needs time to get used to the newly changed anatomical area. Besides, a well-thought-out diet becomes the key to success.
Phase 1 (Week 1)
Clear liquids and liquids. After surgery, you will be on a liquid diet. This will include broth, juice, water, and protein shakes. This is to avoid putting any strain on the surgical area.
Phase 2 (Weeks 2-4)
Soft foods. You will begin to introduce soft, pureed, or blended foods. Consider scrambled eggs, yogurt, cooked vegetables, and soft fruits.
Phase 3 (Weeks 4-6)
Solid foods. You will begin to introduce solid foods. To avoid putting any strain on your stomach, it is essential to chew your food thoroughly and eat frequent meals.
Adherence to these restrictions following hiatal hernia surgery is more than just avoiding discomfort. It is essential to protect the newly repaired area.
Although most pre-surgery dietary restrictions regarding acid reflux will no longer be a consideration, a healthy diet is always essential for maintaining your well-being.
Swallowing Changes After Surgery
Swallowing difficulties are the most common sequelae of hiatal hernia repair (such as Nissen fundoplication), and esophageal changes are also usually transient. However, the surgery that is very effective gives the patient tightness and swelling from the hiatus reconstructed and the gastroesophageal wrap initially.
About 40% to 70% of patients have frequent, usually transient, difficulty swallowing. It is usually a feeling that the food gets stuck or passes slowly through the esophagus, and it is typically within the first 6 to 8 weeks when the swelling goes down.
Tips for Success
- Eat Slow and Small: Eat 6-8 small meals instead of three large meals.
- Chew Thoroughly: Chew your food until it is a pureed consistency.
- Avoid Trigger Foods: Avoid carbonated drinks, dry bread, rice, pasta, and hard meats at first.
- Upright Position: Sit up for at least 30 minutes to 1 hour after meals
Managing Constipation After Hiatal Surgery
How long it takes a person to get over constipation after surgery will vary from one person to another. For a few, it may only be a matter of days before their bowel movements get back to normal again.
For others, particularly those who use opioid painkillers, the problem can continue for longer, even up to a week or more. Besides that, although the effects of general anesthesia usually disappear very quickly, its influence on the bowel can be felt for a couple of days.
The main thing is to fix the problem immediately rather than just waiting for the problem to disappear on its own.
When the pain medicine leads to constipation, the doctor can suggest some treatments or medications that will help to offset the negative effects of opioids on the bowel.
There are a number of over-the-counter (OTC) products that can be used to alleviate constipation. It is a good practice to consult your doctor before using any new medication, especially after surgery.
Life After Hiatal Hernia Surgery: Getting Back to Physical Activity
Coming back to exercise is a significant concern for many patients. An active life is not only feasible after surgery but is also recommended in most instances. Yet, the recovery process should be done in a systematic manner to return to exercise to avoid any complications in the surgical area.
First 2-4 Weeks
Walking is highly recommended during this phase. Gentle and routine walks can help in increasing circulation, digestion, and preventing complications following surgery.
Weeks 4-6
Aerobic exercises can be initiated during this phase. These may include cycling on a stationary bicycle or using an elliptical trainer, as long as these activities are done at a comfortable pace.
Work Life After Hiatal Hernia Surgery
Returning to work is one more aspect to chat with a physician about, along with the work type and the physical requirements linked to it. When one goes back to work, it is different from person to person and hinges upon the recovery progress.
People who have physically demanding jobs, such as frequent moving, bending, or heavy lifting (over 10 lbs), are usually advised to resume restricted or light-duty work. In most cases, patients working with light-duty needs require approximately eight weeks.
Traveling After Surgery
Air travel should be deferred until after the first postoperative visit with the surgeon. During this visit, an imaging scan is usually done to evaluate for pneumothorax, or collapsed lung.
The surgeon will determine when it is safe to travel by air, depending on the progress of recovery and the imaging scan.
Life Expectancy After Hiatal Hernia Surgery
The operation itself is not going to directly affect the life expectancy of a patient. It's a measure for enhancing the patient's quality of life after the hiatal hernia surgery.
The long-term consequence of the operation is very positive; the vast majority of patients indicate a significant improvement in their health.
Conclusion
In summary, life after hiatal hernia surgery could be a period of getting used to and healing before returning to normal activities. The initial few weeks of recovery might be a period where you have to be patient and stick to the prescribed diet and level of activity; nevertheless, the majority of patients experience excellent relief from the symptoms that adversely affect their life.
Hiatal hernia surgery can be a very efficient method for symptom management if you comply with the postoperative care instructions and lead a healthy lifestyle.
Frequently Asked Questions
How long does it take to heal completely after surgery for a hiatal hernia?
It takes about four to six weeks for the initial healing process, but the body may take three months to heal completely.
Will the acid reflux problem be resolved completely after surgery?
Yes, many patients experience relief, but some may still require medications.
Is it normal to have difficulty swallowing after surgery?
Yes, it is normal to have some difficulty swallowing, but this will resolve once the swelling goes down.
When can normal foods be started?
Most patients can start eating normally after four to six weeks.
Can a hiatal hernia recur after surgery?
Yes, but it is not very common if lifestyle changes are made.
References
- Memorial Sloan Kettering Cancer Center. https://www.mskcc.org/cancer-care/patient-education/what-expect-after-your-nissen-fundoplication-hiatal-hernia-surgery
- Healthline. https://www.healthline.com/health/hiatal-hernia-surgery#recovery
- Dr Samir Rahmani. https://www.drsamirrahmani.com/english/what-is-life-after-hiatal-hernia-surgery/
- Laparoscopic Surgery India. https://www.laparoscopicsurgeryindia.com/blog/your-guide-to-a-smooth-recovery-from-hiatal-hernia-operation/
