June 25, 2020

Why It’s Important to Get Your Hiatal Hernia Fixed Right the First Time

Choose the best hernia center to avoid long-term pain and recurrence

hiatal hernia illustration

Imagine having just a 50/50 chance of getting rid of your pain the first time you go in for surgery.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

That’s the situation facing most hernia sufferers who require surgery. This is a get-it-right-the-first-time situation or else you’re back at square one.

Now, double down on this scenario for seniors who are suffering from a specific type of hernia. Hiatal hernias are most often found in people in their 70s and 80s. Many are treated with medication but, in the tougher cases, doctors recommend surgery.

“The absolute best time to get your hernia fixed, with the best chance of a great result, is the first time you get it fixed,” says general surgeon Michael Rosen, MD. “You want to go to somebody who’s a specialist and knows all the options. This will decrease the chances of complications like chronic pain or a recurrence of the hernia.”

Hernias are a hole in something that allows things to poke through that typically shouldn’t. Hiatal hernias are located in the diaphragm where the esophagus joins the stomach and they typically cause heartburn and reflux. If the hernia just makes you uncomfortable, your doctor will treat it with medications.

More serious hiatal hernias, also known as paraesophageal hernias, become larger over time and the stomach starts to rise farther into the chest. This sometimes causes significant chest pain after eating and can even cause weight loss and bleeding.

“In those cases, surgery is usually needed,” says Dr. Rosen. “It’s best to ask your doctor about treatment as soon as a hernia begins to cause discomfort.”

Why that first surgery is crucial

So why is that first surgery so important?

Advertisement

An unsuccessful surgery is frustrating for the surgeon, but even more so for the patient because of the resulting poor quality of life. Plus, the symptoms bothering you in the first place can return. Risks associated with remedial surgery include recurrent heartburn, difficulty with swallowing, increased bowel symptoms and nerve damage.

“Working with an experienced surgeon is best for any hernia patient, but surgeries for recurrent hernias, especially in older patients, are even more complex and challenging,” says Dr. Rosen.

If you reach the point where you need hernia surgery, it’s important to go to a comprehensive hernia center to get the best treatment. With expertise in both minimally invasive surgery and large comprehensive surgery, a dedicated hernia center helps ensure the operation is done right the first time.

“Advances in minimally invasive surgery mean that, for many patients, hernia surgery is no longer a major operation that puts you in the hospital for a week to 10 days,” says Dr. Rosen. “Patients now typically go home within a couple of days.”

No way to prevent hernias, but good general health can help

In most patients, the cause of a hernia is not known but an injury, straining or weakness in the area may contribute. Two other types of hernias can impact the elderly but are no more likely to occur later in life than at a younger age.

1. Inguinal hernias

These hernias occur in the groin and are more common in men. They are typically associated with heavy lifting, constipation and prostate issues that cause urination difficulty or increases in abdominal pressure.

Advertisement

“They can cause a lot of pain and discomfort,” says Dr. Rosen. “There is no way to prevent any hernia and not doing heavy lifting wouldn’t prevent them.”

Once you notice a bulge in your groin that causes discomfort, it’s time to go see a physician.

“Once you have a hole there, it will never go away on its own,” says Dr. Rosen. “Most of these hernias can now be fixed using minimally invasive techniques with decreased post-op pain. They can help you return to regular activity levels a lot quicker.”

2. Ventral hernias

Ventral hernias occur in the abdomen and also exhibit a bulge and pain. These will not go away and there’s no way to prevent them. These hernias are more common in people who have obesity, diabetes or chronic smoking habits, but being in good health reduces the chances of those complications.

“Sometimes doctors perform these surgeries laparoscopically and sometimes they reconstruct the entire abdominal wall. The latter provides two advantages,” says Dr. Rosen. “It improves your functional outcome because you get your core muscles back, plus it improves the cosmetics because you end up with a flatter abdomen.”​

Related Articles

A vaccine syringe in front of a passport for international travel.
December 5, 2023
Which Vaccines Are Required To Travel?

Plan early — getting the right vaccines can help you stay healthy on your travels

Person overheated lying on chair on the beach; heart rythym next to him
December 5, 2023
How the Heat Can Affect Your Heart

Sizzling temperatures force your heart to work much harder

nocovaine needle entering mouth with dental mirror
December 4, 2023
How Long Does Novocaine Last?

The numbness and tingling should wear off in about two hours

bearded man sitting crosslegged holding clock in one hand, calendar in other
December 4, 2023
Are Bare Minimum Mondays Good for Your Mental Health?

Rethinking your Mondays might make the ‘Sunday scaries’ a thing of the past

A sad couple standing on each side of a large broken heart
December 4, 2023
Yes, You Can Die From a Broken Heart — But No, It’s Not Likely at All

The emotional toll of loss and other strong emotions can have life-threatening physical effects

Closeup of shingles virus presenting on shoulder of person
December 4, 2023
Is the Shingles Vaccine Worthwhile?

It’s 97% effective in preventing shingles in people between the ages of 50 and 69

Notes taped to window of possible new year's resolutions with hand in foreground holding marker.
December 1, 2023
How To Keep Your New Year’s Resolutions

Pick specific, measurable goals, but also be open to changing them if need be

person holding a thermometer with stress thought bubbles above head
December 1, 2023
Yes, There Is Such a Thing as Stress Sickness

From nausea, weight gain and eczema, stress can affect your immune system in many ways

Trending Topics

group of hands holding different beverages
November 14, 2023
10 Myths About Drinking Alcohol You Should Stop Repeating

Coffee won’t cure a hangover and you definitely shouldn’t mix your cocktail with an energy drink

Person applies moisturizer as part of their skin care routine after a shower.
November 10, 2023
Korean Skin Care Routines: What You Need To Know

Focus on the philosophy — replenishing and respecting your skin — not necessarily the steps

glass of cherry juice with cherries on table
November 8, 2023
Sleepy Girl Mocktail: What’s in It and Does It Really Make You Sleep Better?

This social media sleep hack with tart cherry juice and magnesium could be worth a try

Ad