Hiatal Hernia Surgery: The Only Long-Term Repair for Acid Reflux

Written by Dr. James Buwen, FACOS | Medically Reviewed by Dr. Ajay Goyal, FACS on January 31, 2025

Estimated reading time: 4 minutes

Key Takeaways

Surgery is the Only Permanent Fix: While medications and lifestyle adjustments manage the symptoms (like heartburn and acid reflux), surgery is the only way to physically repair the anatomy and provide a long-term cure.
Minimally Invasive with Quick Recovery: Performed laparoscopically or robotically through tiny incisions, the procedure is often outpatient or requires just a single-night hospital stay. Most patients return to normal routines within a few days.
Dietary Adjustments are Required Temporarily: Patients must follow a soft diet for about two weeks post-surgery. Trigger foods—like caffeine, chocolate, and high-fat items—should be reintroduced gradually to prevent nighttime reflux.
Medication Reduction is Common: The vast majority of patients are able to successfully reduce or completely stop taking daily reflux medications like Nexium, Protonix, or Pepcid after recovery.

What is a Hiatal Hernia?

A hiatal hernia is a common digestive condition that affects many people in New Jersey, often requiring specialized treatment. A hiatal hernia occurs when the stomach muscle bulges up through the opening (hiatus) in the diaphragm muscle, leading to a rupture (hernia) into the esophageal hiatus, or a hiatal hernia. Typically, only the esophagus - the tube that connects the mouth to the stomach - passes through the diaphragm opening.

What is the Root Cause of Hiatal Hernia?

The root cause of hiatal hernia is difficult to determine. However, factors such as age, weakened muscles and when the pressure on the stomach increases due to obesity are key contributors. When a hiatal hernia occurs, it often causes heartburn or acid reflux. This is because the stomach acid can more easily flow up into the esophagus from the weakened barrier between the stomach and esophagus.

Minimally Invasive Hiatal Hernia Repair in New Jersey

While medication and lifestyle changes can help alleviate symptoms, hiatal hernia surgery is the only long-term treatment for the condition. Surgery, for people suffering from a hiatal hernia in New Jersey, brings the stomach back down into the abdominal cavity, and tightens the weakened muscle area. This allows the stomach to return to its normal spot in the body, minimizing reflux and heartburn by relieving the tightening around the stomach. In some cases, the surgeon may need to reinforce this repair with surgical mesh. This helps prevent the hernia from coming back in the future.

Additionally, your New Jersey Bariatric Center® surgeon might recommend performing an anti-reflux procedure called a Nissen Fundoplication at the same time to treat both the hernia and the reflux symptoms. This involves wrapping part of the stomach around itself to further prevent acid reflux and heartburn.

What to Expect: Recovery Timeline and Diet After Surgery

Surgery for hiatal hernia repair is minimally invasive, performed laparoscopically or robotically. It is either done on an outpatient basis (discharged + home same day) or after a short one night hospital stay. Patients are typically back to their normal routine within several days, and can eat a soft diet soon after surgery.

After surgery, to allow the area to heal, your surgeon will recommend a soft diet for about two weeks. Following this, it is recommended to avoid foods that trigger heartburn or reflux. Certain foods and drinks can relax the muscle that keeps the esophagus closed. And, when this muscle is relaxed, reflux is more likely, especially at night. These include caffeine, peppermint, chocolate, spicy foods and foods with a high fat content. Although you may eventually be able to have these foods without reflux symptoms, it is often a gradual process and not an overnight change.

Many patients are able to reduce or even stop taking anti-reflux medications such as Protonix (pantoprazole), Nexium (omeprazole), or Pepcid after the hiatal hernia procedure. In terms of side effects, most commonly, patients may experience bloating or inability to belch. Over time this can improve.

It is especially important to call your doctor if you have fever, persistent abdominal pain, or if you have difficulty swallowing after surgery.

Potential Risks and Complications of Reflux Surgery

Hiatal hernia surgery is minimally invasive through small incisions in the belly. Risks are similar to that of other abdominal surgeries, including bleeding, infection, and blood clot. There is a very small risk of damage to the esophagus or stomach during surgery. Also, after the surgery your surgeon will look at the repair from inside the stomach using an endoscopic camera as a final review.

Take the First Step Toward Lasting Relief

You don’t have to live with the daily discomfort of chronic acid reflux, chest tightness, and a reliance on daily medications. If lifestyle changes and antacids are no longer working, it is time to discuss a permanent, structural fix with a specialist.

At New Jersey Bariatric Center®, our board-certified surgeons specialize in minimally invasive laparoscopic and robotic hernia repairs designed to get you back to living life comfortably—and pain-free.

For questions about hiatal hernia, call 908-481-1270.

To request an appointment directly, click here.