A hiatal hernia occurs when a portion of the stomach pushes through an opening in the diaphragm into the chest, causing symptoms like acid reflux. Surgery repositions the stomach and tightens this opening. While recovery timelines vary, a general progression can be expected.
Immediate Post-Surgery Period
After hiatal hernia surgery, patients wake in a post-anesthesia care unit where vital signs are monitored. Most individuals can expect a hospital stay of one to two nights.
Patients often experience mild to moderate pain at incision sites, and sometimes shoulder pain from gas introduced during laparoscopic procedures. A liquid-only diet is prescribed immediately after surgery to prevent nausea and reduce pressure on the healing area.
Early mobility is encouraged, with patients advised to walk shortly after surgery to help prevent blood clots and promote recovery. Light activity like walking is beneficial.
First Few Weeks of Recovery
The recovery process continues at home, typically spanning the first 4 to 6 weeks after discharge. During this time, the diet gradually progresses from clear liquids to full liquids within the first few days, then to soft foods, such as pureed vegetables, plain yogurt, scrambled eggs, and mashed potatoes, for the next two to three weeks. This gradual transition helps accommodate swelling around the esophagus, which can make swallowing feel tight initially.
Pain management at home typically involves prescribed medications, and over-the-counter options like ibuprofen can help with discomfort. Patients should avoid heavy lifting, generally anything over 10 pounds (4.5 kilograms), and strenuous activities during these weeks to allow the surgical site to heal properly. Bending at the waist should also be limited to prevent strain on the abdomen.
Common sensations during this period include bloating and discomfort, which can be managed by eating smaller, more frequent meals and avoiding carbonated beverages, chewing gum, or drinking through straws, as these can introduce excess air. Constipation is also a frequent occurrence due to anesthesia and pain medications, and increasing fluid intake and fiber can help.
Full Return to Normal Activities
The timeline for a full return to normal activities varies, with many patients resuming most daily routines within three to four weeks. Those with less physically demanding jobs may return to work within two weeks, while others might need up to four to six weeks. For jobs requiring heavy lifting or strenuous physical labor, a return to full duties may take up to three months or even longer.
Light exercise like walking can be resumed almost immediately, but more vigorous activities such as jogging, cycling, or swimming are typically cleared after about a month. Strenuous exercises, including heavy weight lifting or contact sports, should be avoided for three to five to six months to ensure the diaphragm muscles have fully healed and strengthened. It is important to listen to one’s body and avoid any activity that causes pain or discomfort, as this can hinder the healing process.
When to Seek Medical Attention
While hiatal hernia surgery is generally considered safe, it is important to be aware of certain warning signs that may indicate complications and require prompt medical attention. Patients should contact their healthcare provider immediately if they experience a fever of 100.5°F (38°C) or higher, persistent or worsening severe pain, or shaking chills.
Other symptoms that warrant medical consultation include continuous nausea or vomiting, difficulty swallowing that persists or worsens, or any signs of infection at the incision sites, such as increasing redness, swelling, or discharge that looks like pus or smells bad. Shortness of breath or increased abdominal swelling should also be reported to a medical professional.