“Does a hiatal hernia need surgery?”
I was diagnosed with a hiatal hernia. Does a hiatal hernia need surgery?
6 Answers
Dr. David Carlson
Surgeon
Hiatal hernias are very common. The great majority are a symptomatic or cause minimal symptoms. They do not require surgery. Some hiatal hernias do require surgery if they are symptomatic despite medical treatment.
A hiatal hernia occurs when the upper part of the stomach bulges through the natural defect in the diaphragm for the esophagus. They are vey common and the risk increases with age, obesity and smoking.
Patients with symptomatic hernia may have: severe acid reflux; non-cardiac chest pain, trouble swallowing. Asymptomatic hiatal hernias do not require surgery.
Patients with symptomatic hernia may have: severe acid reflux; non-cardiac chest pain, trouble swallowing. Asymptomatic hiatal hernias do not require surgery.
Typically we recommend hiatal hernia surgery if you are having symptoms caused by the hiatal hernia such as reflux or shortness of breath. Many are discovered incidentally. Rare but life threatening conditions may arise from a hiatal hernia if not repaired.
If there is pain.
It depends. If it is asymptomatic and small, not necessarily. If you have symptoms (heartburn, chest pain, regurgitation, swallowing issues) or endoscopy shows esophagitis or Barrett's esophagus or your reflux test is positive, then yes, recommendation is for surgical repair
Hiatal hernias require surgery if they are large or causing symptoms of complications that can’t be managed with medicine and lifestyle changes alone. Each hernia and patient is unique so it is important to review your case with your surgeon.
