What Size Hiatal Hernia Needs Surgery?

What Size Hiatal Hernia Needs Surgery

A hiatal hernia happens when your stomach moves up through your diaphragm into your chest. Surgery isn’t always necessary for hiatal hernias, but many wonder: what size hiatal hernia needs surgery?

This article will explore how doctors decide if surgery is necessary, focusing on the size of the hernia and other important factors. Understanding when surgical intervention is advised can help you discuss treatment options more confidently with your healthcare provider.

Understanding Hiatal Hernia

A hiatal hernia occurs when the upper part of your stomach bulges through an opening in your diaphragm, called the hiatus. This can be due to weakened muscle tissue, which can cause part of your stomach to move upward into your chest. It’s crucial not to dismiss any associated symptoms, as what might begin as an intermittent discomfort can progress and become a lifelong issue if left untreated.

The Common Causes & Symptoms

Hiatal hernias can be congenital or develop over time due to various reasons such as injury, age-related changes, or increased pressure on the stomach. Symptoms include:

If these symptoms persist, it’s important to consult a medical professional to determine the cause and appropriate treatment.

Types of Hiatal Hernias

The two primary forms are the sliding and paraesophageal hernias.

A sliding hernia is the more common, where the stomach and the lower esophagus slide into the chest.

A paraesophageal hernia is when part of the stomach squeezes into the chest alongside the esophagus.

Chiropractic Care as a Management Tool

Chiropractic care can relieve some hiatal hernia symptoms, particularly for sliding hernias.

Techniques such as diaphragmatic breathing exercises and spinal adjustments may help to reduce the stomach’s upward movement. However, it’s important to note that chiropractic care is not a cure but a complementary treatment to alleviate pain and discomfort.

What Size Hiatal Hernia Needs Surgery?

While conservative treatments are often sufficient, there comes a point where surgical intervention is necessary. The decision to opt for surgery is multifaceted and should be based on several considerations.

What Triggers The Decision for Surgery?

Surgery is typically recommended when symptoms are severe or when complications such as strangulation of the hernia, severe esophagitis, or narrowing of the esophagus (stricture) occur. Additionally, if quality of life is significantly impaired despite conservative management, surgery might be the best option.

Determining the Size Threshold

The size of a hiatal hernia can significantly impact the decision to have surgery. Generally, a paraesophageal hernia, considered larger and potentially more dangerous, often requires repair. However, the mere size of a hernia is not the only factor. The degree to which the size is causing symptoms and the patient’s overall health are also important factors in determining surgical candidacy.

The Surgical Procedure

When surgery is deemed necessary, there are several methods a surgeon may employ to repair the hernia. The two most usual surgeries for hiatal hernia are Nissen fundoplication and laparoscopic repair. These approaches have their own set of advantages and potential complications that need to be carefully weighed.

Different Surgical Techniques

Nissen fundoplication involves repairing the hernia with a procedure to prevent acid reflux, known as “wrapping” the stomach’s upper part around the esophagus’s lower portion. Laparoscopic repair is a minimally invasive technique that can offer shorter recovery times and less pain compared to traditional open surgery.

Risks and Complications

All surgeries carry risks, and hiatal hernia repair is no different. Complications like infection, bleeding, and bad reactions to anesthesia may occur. Lifestyle changes after surgery, such as dietary modifications and postural restrictions, are critical to avoid complications and ensure a successful outcome.

Preparing for Surgery and Recovery

The period leading up to surgery and the recovery afterward demand careful attention. Understanding what will happen during these stages can help alleviate concerns and better prepare for what’s ahead.

What to Expect Before Surgery

Before the operation, your surgeon will provide guidelines, including fasting and temporary cessation of certain medications. Understanding and addressing any existing health conditions that might affect the surgery or recovery is also important.

Recovery and Post-Surgery Lifestyle

Recovery can vary from person to person, but adherence to the prescribed post-surgical care plan is critical. This plan typically includes a phased approach to returning to normal activities, dietary changes to minimize irritation to the surgical site, and specifics about managing any lingering symptoms.

Preventing Hernia Recurrence

Post-surgery, it’s vital to follow all instructions your medical team provides. Doing so can significantly reduce the risk of a hiatal hernia returning, which may require further surgery and prolonged recovery.

The Role of Chiropractic Care Post-Surgery

After undergoing surgery for a hiatal hernia, you might wonder about the role chiropractic care can play in your continued well-being. Chiropractors can provide supportive care post-surgery, relieving discomfort, aiding in mobility, and supporting overall health, provided it is done in collaboration with and under your surgeon’s guidance.

Benefits and Limitations of Post-Surgery Chiropractic Care

  • Supportive to Recovery: Chiropractic care can aid post-surgical recovery by reducing pain and improving mobility.
  • Non-Invasive: It offers a non-invasive option for pain management and mobility enhancement after surgery.
  • Limits and Contraindications: Must be cautiously approached; certain manipulations may not be advisable in the immediate postoperative period.
  • Coordination with Medical Care: Chiropractic treatments should be coordinated with the surgeon’s advice to avoid any interventions that could compromise surgical outcomes.
  • Customized Care Plans: Treatments are personalized based on individual recovery timelines and health status to ensure safety and effectiveness.

A Team Approach to Recovery

Collaboration between your chiropractor and surgical team can offer a holistic approach to your recovery. This ensures that any treatments or adjustments made by your chiropractor are compatible with your current health status and align with the goals of the surgical intervention.

What to Avoid After Hiatal Hernia Surgery?

After hiatal hernia surgery, following your surgeon’s instructions carefully is essential to avoid any complications or setbacks in your recovery. Some common things to avoid after surgery include:

  • Lifting heavy objects: To prevent strain on the surgical site and potential damage to the repair.
  • Straining during bowel movements: This can also strain the surgical site and cause discomfort.
  • Avoid chocolates: Chocolates can relax the lower esophageal sphincter, increasing the possibility of acid reflux, which should be minimized during post-operative recovery.

Your doctor may recommend stool softeners to prevent this.

  • Smoking: It can increase the risk of complications and delay healing.
  • Certain foods: Your doctor may advise avoiding spicy, acidic, or carbonated foods that can trigger acid reflux.

The Role of Chiropractic Care Post-Surgery

Following surgery, chiropractic care can still support your recovery, helping to manage any residual pain or discomfort and promoting musculoskeletal health.

Collaborating for Holistic Care

Chiropractors and surgeons can collaborate to offer a comprehensive approach to patient care. While the chiropractor provides post-operative support, the surgeon oversees the healing process, ensuring the best possible outcomes.


Can chiropractic care cure a hiatal hernia?

No, chiropractic care cannot cure a hiatal hernia. It can, however, alleviate some symptoms associated with hiatal hernias, such as discomfort or acid reflux, by helping to realign the stomach and improve digestive function through specific spinal manipulations.

What specific chiropractic techniques are used for hiatal hernia patients?

Chiropractic techniques that may benefit individuals with hiatal hernias include gentle upper back and neck adjustments and a specialized maneuver designed to push the stomach downwards, away from the diaphragm gently. Always ensure these techniques are performed by a trained and experienced chiropractor.

Can chiropractic care prevent a hiatal hernia from worsening?

While chiropractic care cannot prevent a hiatal hernia from worsening, it may contribute to an overall healthier lifestyle that supports the management of hiatal hernia symptoms. Following a comprehensive care plan that includes dietary changes, weight management, and avoiding activities that increase abdominal pressure is important.

Final Talk

Not all hiatal hernias require surgery, but it’s crucial to consider surgery for larger hernias or when symptoms persist and impact your quality of life. Remember, preventive measures and post-operative care are key to a successful recovery and reducing the risk of recurrence. For ongoing support and more information on health issues and how chiropractic care can help, keep visiting CHIROPRIC.

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