Is is possible to repair a hiatal hernia to reduce acid reflux? I was told if this was done I wouldn't be able to vomit (if needed). Is this true?
Most patients with hiatal hernias do not have any symptoms. However, patients with a hiatal hernia and associated reflux may be treated with hiatal hernia repair. The operation will repair the hiatal hernia by pulling the stomach down out of the chest, closing the hole in the diaphragm, and then creating a new valve at the lower esophageal sphincter to prevent reflux.
The operation is performed laparoscopically with five small incisions. The operation is performed as an overnight stay in the hospital. Postoperative discomfort is minimal. Patients are able to live their life free of reflux symptoms and no longer require their antacid medications. The majority of patients find the operation to be life-changing for the better. A frequent response following the surgery is "I forgot what it feels like to not have reflux"
The new valve that is created at the lower esophageal sphincter is made out of the patient's upper stomach (fundus). The valve functions by closing when the pressure in the abdomen or stomach increases and effectively stops reflux of acid, bile or other substances. Side effects of the procedure are a reduced ability to burp and vomit. While most patients will be able to pass small amounts of air, they will not be able to release large amounts of gas when burping. Additionally, most patients will not be able to effectively vomit after the surgery. Although vomiting is rarely desirable, when the patient attempts to vomit only a small amount of gastric contents will be expelled. I generally recommend that patients who have undergone this procedure to take an anti-emetic medication when they feel that they have developed a stomach virus or the flu in order to prevent vomiting. In the hundreds of hiatal hernia repairs that I have performed, I have not seen a problem arise from a patients not being able to vomit. The benefits of the surgery far outweigh the side effects.
I would be happy to see you at the Hernia Center if you desire an evaluation.
Is it normal to have burping and food coming back up 6 months after a hiatal hernia surgery (stomach and part of the intestine was up in the chest cavity)? The next checkup is in November, should I call for an earlier appointment? Food seems to stay down OK for breakfast but by lunchtime the burping and food coming back up occurs. Nexium is still used to control the acid reflux.
Thank you for your help.
Following a successful hiatal hernia repair, patients should not experience heartburn or regurgitation. If you are having problems six months after surgery, I would recommend that you contact your physician.
Burping may be related to swallowing of air related to carbonated beverages, chewing gum or drinking straws. These activities should be avoided.
An upper GI series (barium swallow) is an easy test to evaluate the staus of your hiatal hernia repair.
If you desire an additional opinion, I would be happy to review your prior operative report, endoscopies, x-rays etc. and see you in consultation.