How to Repair a Hiatal Hernia after Gastric Sleeve Surgery

Definition of Hiatal Hernia

A hiatal hernia is a condition where part of the stomach protrudes through an opening in the diaphragm, the sheet of muscle that separates the chest from the abdomen. This opening, known as the hiatus, allows the passage of the esophagus into the stomach. In some individuals, the hiatus becomes weakened or enlarged, allowing the stomach to push upward through it.

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Causes of Hiatal Hernia after Gastric Sleeve Surgery

Gastric sleeve surgery involves removing a large portion of the stomach, leaving a narrow tubular sleeve. This alteration to the stomach’s anatomy can increase the risk of developing a hiatal hernia due to weakened stomach muscles and increased abdominal pressure.

Symptoms of Hiatal Hernia

A hiatal hernia may not always present symptoms. However, when present, symptoms may include:

• Heartburn and acid reflux
• Difficulty swallowing
• Chest pain or pressure
• Bloating and gas
• Nausea and vomiting
• Hoarseness or cough

Complications of Hiatal Hernia

Left untreated, a hiatal hernia can lead to serious complications. These include:

• Gastroesophageal reflux disease (GERD), a condition where stomach acid regularly flows back into the esophagus, causing inflammation and discomfort
• Barrett’s esophagus, a precancerous condition of the esophageal lining
• Esophageal cancer
• Strangulation, which occurs when the hernia twists and cuts off blood supply to the stomach
• Lung damage due to acid reflux

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Treatment Options

The appropriate treatment for a hiatal hernia after gastric sleeve surgery depends on the severity of symptoms, the size of the hernia, and the patient’s overall health. Treatment options include:

Lifestyle Modifications:

• Maintaining a healthy weight
• Elevating the head of the bed during sleep
• Avoiding tight-fitting clothing
• Quitting smoking

Medications:

• Proton pump inhibitors to reduce stomach acid production
• Antacids to neutralize stomach acid

Endoscopic Procedures:

• Esophageal dilation, where a small balloon is inserted into the esophagus to stretch it
• Fundoplication, where the upper part of the stomach is wrapped around the lower part of the esophagus to create a valve

Surgical Repair:

• Hiatal hernia repair surgery, which involves repositioning the stomach and reinforcing the hiatus
• Gastric bypass surgery, which may be performed if other treatments fail or if additional weight loss is necessary

Recovery from Surgery

Recovery from hiatal hernia repair surgery typically involves:

• Rest
• Pain management medication
• Liquid or soft diet
• Gradual return to activities

How To Fix Hiatal Hernia After Gastric Sleeve

Prognosis

With appropriate treatment, most patients with a hiatal hernia after gastric sleeve surgery experience symptom relief. However, it is important to note that there is a small chance of recurrence, especially if the patient experiences rapid weight gain or if the underlying cause of the hernia is not addressed.