What's going on
Your diaphragm is the dome-shaped muscle that separates your chest from your belly. Your esophagus passes through a small opening in it, called the hiatus, to reach the stomach.
Over time, from age, weight, pregnancy, coughing or lifting, that opening can stretch. Part of the stomach then slides up into the chest. In a sliding hernia, the junction moves up. In a paraesophageal hernia, a larger part of the stomach rolls up next to the esophagus.
Signs to watch
- Heartburn and regurgitation (a hiatal hernia knocks the reflux valve out of position)
- Chest pressure or fullness after eating
- Getting full after only a few bites
- Food sticking, or trouble swallowing
- Shortness of breath after meals, when the hernia is large
- Low iron or anemia, from slow bleeding in the trapped stomach
Does it need to be fixed?
Not always. A small sliding hernia that causes no symptoms is often left alone. If it causes reflux, we treat the reflux first.
Repair is usually recommended when:
- Reflux symptoms continue despite medication
- The hernia is large or paraesophageal, even with mild symptoms, because these can get stuck
- You have trouble swallowing, anemia, or pain after eating
How the repair works
Almost all hiatal hernia repairs are done laparoscopically or robotically, through a few small incisions.
What recovery looks like
Most patients stay one night.
A liquid then soft diet while the repair heals. Walk daily, no heavy lifting.
Gradually back to normal food and activity. Most people are back to desk work in 1 to 2 weeks.
Check-ins to make sure the stomach stays where it belongs.
Common questions
I was told I have a "small hiatal hernia." Should I worry?
Usually not. Small hernias are very common, especially after 50. If you don't have symptoms, it often needs nothing.
Can a hiatal hernia come back?
Yes, especially very large ones. Careful technique, sometimes mesh, and treating contributing factors like weight lower that risk.
Will I still have reflux after the repair?
The anti-reflux step added during repair is designed to stop it. Most patients come off their medication.
What tests will I need?
Usually an upper endoscopy and an X-ray swallow study or CT scan, so we know the size and type of hernia.
General information to help you understand your options. It isn't a diagnosis. The right plan for you comes from an in-person visit.