A hiatal hernia--an opening in the diaphragm large enough to allow the stomach to push up through it--may cause chest pain, burping, nausea and heartburn due to food and stomach acid backing up in the esophagus, according to MayoClinic.com. Surgical repair may be performed through an incision in the abdomen or chest, or it may be done laparoscopically through several small incisions using a tiny video camera and special instruments. Surgery may involve tightening the opening, removing the hernia sac or strengthening the weak portion of the esophagus.
Dysphagia
During the first 3 months after surgery, the patient may have pain and difficulty when swallowing, a condition called dysphagia, according to the National Institutes of Health. The symptoms are due to muscle spasms that occur after swallowing, a rare complication except in children with brain and neurological defects, according to the University of Maryland Medical Center. More commonly, dysphagia is caused by the stomach fundus being wrapped too tightly around the esophagus, which may be corrected by enlarging the esophagus in a separate procedure. Drinking clear liquids for the first 2 weeks after surgery and slowly advancing to a soft diet helps to minimize dysphagia, according to the National Institutes of Health.
Abdominal Symptoms
Following surgery for a hiatal hernia, patients may experience new symptoms such as bloating, gagging or vomiting for the first several weeks because of a temporary slowing of the intestines, according to the University of Maryland Medical Center. Temporary symptoms can be relieved by consuming a liquid diet and walking to relieve gas pains. If the symptoms continue beyond a few weeks, they may be caused by an obstruction in the bowels. In addition, approximately 15 percent of patients continue to have gastroesophageal reflux symptoms after surgery and continue to need medication.
Treatment Failure
Surgical treatment fails in 30 percent of patients 5 years postoperatively and in 63 percent after 10 years, according to the University of Maryland Medical Center. Failure may be due to a tight wrap during surgery, breakdown of the closure, slippage or hiatal hernia. Repeat operations are successful in 70 percent of patients but may cause more complications such as spleen or liver damage.
