Our Summary
This study examined the effects of a hiatal hernia repair (HHR) procedure on patients who also underwent a sleeve gastrectomy (SG), a type of weight loss surgery. The research focuses on the potential link between hiatal hernias and gastroesophageal reflux disease (GERD), a condition that causes stomach acid to flow back into the esophagus, resulting in discomfort and potential damage.
Out of 590 patients who had the weight loss surgery, around 11% of them also had a simultaneous hernia repair. The researchers then followed up with these patients for an average of 3.7 years. They found that more than half of the patients had experienced reflux symptoms before their surgeries. After the surgeries, however, nearly 70% of these patients saw their symptoms completely disappear, and more than 75% of patients completely stopped using their medication for acid reflux. However, 20% of the patients who did not have reflux symptoms before the surgery developed GERD after their procedures.
The study concluded that combining a hernia repair with weight loss surgery could improve reflux symptoms for the majority of patients and reduce the need for acid reflux medication.
FAQs
- What is the potential link between hiatal hernias and gastroesophageal reflux disease (GERD)?
- How does combining a hiatal hernia repair with weight loss surgery affect reflux symptoms and the need for medication?
- What percentage of patients developed GERD after their weight loss surgery, even though they did not have reflux symptoms before the surgery?
Doctor’s Tip
Based on this research, a helpful tip that a doctor might tell a patient about hiatal hernia repair is to consider addressing the hernia during weight loss surgery if they are also experiencing symptoms of GERD. This combined approach may help improve reflux symptoms and reduce the need for medication in the long term. It’s important for patients to discuss their individual situation with their healthcare provider to determine the best course of action.
Suitable For
Patients who are typically recommended for hiatal hernia repair include those who experience symptoms of GERD, such as heartburn, regurgitation, chest pain, difficulty swallowing, and chronic cough. Additionally, patients with a large hiatal hernia, where the stomach protrudes into the chest cavity through the diaphragm, may also be candidates for surgery. Patients who have failed to find relief from conservative treatments, such as lifestyle modifications and medications, may be recommended for hiatal hernia repair to alleviate their symptoms and improve their quality of life.
Timeline
In summary, before the hiatal hernia repair, patients may experience symptoms of gastroesophageal reflux disease (GERD) such as heartburn, regurgitation, chest pain, and difficulty swallowing. After the surgery, patients may experience relief from these symptoms, with a majority seeing a complete resolution of their reflux symptoms and a decrease in the need for medication. However, a small percentage of patients may develop GERD after the surgery. Overall, the study suggests that combining a hernia repair with weight loss surgery can have positive effects on GERD symptoms for most patients.
What to Ask Your Doctor
Some questions a patient should ask their doctor about hiatal hernia repair include:
- What are the potential risks and complications associated with hiatal hernia repair surgery?
- How long is the recovery period after hiatal hernia repair surgery?
- Will I need to make any dietary or lifestyle changes after the surgery?
- How likely is it that my reflux symptoms will improve or worsen after hiatal hernia repair surgery?
- What is the success rate of hiatal hernia repair surgery in relieving symptoms of GERD?
- Are there any alternative treatments or procedures for hiatal hernia repair that I should consider?
- How experienced are you in performing hiatal hernia repair surgery?
- Will I need to undergo any additional tests or evaluations before the surgery?
- What is the long-term outlook for patients who undergo hiatal hernia repair surgery?
- Are there any specific post-operative care instructions I should follow to ensure the best possible outcome?
Reference
Authors: Kumar A, Madhav JV, Singla V, Monga S, Aggarwal S. Journal: Surg Laparosc Endosc Percutan Tech. 2023 Oct 1;33(5):435-439. doi: 10.1097/SLE.0000000000001216. PMID: 37671614