Hiatal Hernia Surgery: Recovery

Performed using minimally-invasive techniques, hiatal hernia surgery is not only successful in relieving symptoms, it’s well-tolerated, and recovery is relatively quick. That said, significant lifestyle adjustments will need to be made as your body heals.

Since the period of rehabilitation is essential to that success, it’s critical to have an understanding of what to expect and what you can do to promote complete, safe recovery.

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Surgery Follow-Up

Though individual cases vary, you’ll need at least one night in the hospital after hiatal hernia surgery, and it typically takes three to four weeks to see total rehabilitation. While you likely won’t need physical therapy afterward, you and the medical team will need to work together to ensure the best possible outcome.

What should you keep in mind about follow up? Here’s a quick breakdown:

  • Initial follow-up appointment: Barring any complications, the first follow-up appointment occurs two to three weeks following surgery. At this point, the doctor will need to ensure that the hernia has healed properly and that there are no other issues.
  • Watch for complications: Call your doctor if you have a high fever (a temperature of 100.5 F or 38 C), chronic nausea and/or vomiting, shaking, chills, abdominal and chest pains, or difficulty swallowing or eating. Also, watch for signs of infection on your incisions such as redness, swelling, and drainage.
  • Breathing exercises: In order to help promote healing, your doctor may ask you to use a device called an incentive spirometer, which helps you exercise your lungs. You’ll get specific instructions, but regular daily use is recommended until you’re back to your normal activities.
  • Continued observation: In more complicated cases, a secondary follow-up appointment will be needed at six months following the surgery. In rarer cases, long-term complications can arise, or the treatment doesn’t succeed in relieving symptoms. This requires a more prolonged approach.

Never hesitate to call 911 if you’re feeling severe symptoms; though chances of life-threatening complications are very low, it’s important to be vigilant.

Recovery Timeline

Since hiatal hernia surgery occurs on the diaphragm, near the esophagus, recovery means making very significant lifestyle changes, including a specific, post-operative diet. These help ensure that everything heals correctly, while lowering the chance of recurrence or other complications.

Like all surgeries, you’ll need to be extra careful in the immediate post-operative period, so make sure to arrange for someone to drive you home from the hospital.

Recovery from this procedure occurs in stages. Here’s what a typical timeline looks like:

  • The first 24 to 48 hours: You can’t take baths, and you should wait to take a shower for at least a day. Fatigue is common, but you’ll be encouraged to take walks and perform light exercise. During this time, you’ll need to abstain from sex, and should not drive or lift anything heavier than 10 pounds. In some cases, you’ll often need to continue daily use of the incentive spirometer, and will be on an all-liquid diet.
  • At two weeks: By the time of the first check-up, and depending on the scope of the treatment, most discomfort will start passing (though full results can take up to 10 to 12 weeks). At this point, you can start driving (so long as you aren’t taking prescription pain medication) and return to sexual activity. 
  • Four to six weeks: Aside from those whose jobs require heavy lifting or physical labor, most are able to go back to work. Depending on the scale and scope of the surgery, most return to normal activities, including baths. At this point, use of the spirometer will no longer be necessary, and you’ll be able to return to diet that features solid foods. 
  • Three months: The expectation is that you can return to heavy lifting exercises at this point, and those working more physically demanding jobs are able to return to work.  

Make sure to remain communicative with your doctor as you recover and be sure to get clearance before resuming or starting new activities.

Coping With Recovery

There are two major challenges that hiatal hernia surgery patients face after treatment—pain management and the post-operative diet. With regards to managing discomfort following the operation, here’s what you need to know:

  • Pain medications may be prescribed to treat pain associated with the surgery. You’ll want to wean yourself off of the prescription medications. Follow guidelines for use carefully: never take them on an empty stomach and be aware of the side-effects of this drug, including constipation, for which your doctor may recommend you take fiber supplements or laxatives.
  • Over-the-counter medicines, especially non-steroidal anti-inflammatory (NSAID) drugs like Motrin, Advil, or others, may also be recommended to help you get off the prescribed pain medications.
  • Heating pads, so long as they are not applied directly to the skin, can help ease some of the pain and discomfort, especially in the earlier going. This, along with warm showers, stimulates positive blood circulation to affected areas.

Post-Operative Diet

A critical aspect of recovery from this surgery requires adherence to a careful, post-operative diet for four to six weeks. These are individualized, and you’ll receive counseling about this from your doctor or a nutritionist. Typically it progresses in three stages:

  • Stage one: This is a clear liquid diet, in which you’ll take protein supplements and can only drink clear beverages, such as tea, apple juice, broth, and Jello. Abstain from carbonated sodas or pops throughout the duration of the diet.
  • Stage two: Once ready, you’ll transition to a diet that includes full-liquids, such as cream of wheat, milk, and soups that are strained. You’ll want to avoid large meals, and focus on six or so smaller ones throughout the day.
  • Stage three: Before you can return to normal eating, you’ll have to follow what’s called a “soft-esophageal diet.” This means the gradual introduction of low-salt, soft foods like scrambled eggs, cottage cheese, soft casseroles and meatballs, fish, and mashed potatoes, among others.  

As with all aspects of recovery, be mindful of how you’re feeling as you’re working through the post-operative diet, and let your doctor know if you’re experiencing any issues.

Wound Care

Critical to successful recovery is proper care for the surgical incisions as they heal. The priority, of course, is to avoid infections. So what does wound care look like for hiatal hernia surgery? Here’s a quick breakdown:

  • Cleaning: Once it’s OK to shower—about 24 to 36 hours after you’re home—it’s a good idea to clean the incisions. At this point, it’s OK to remove any gauze or bandages. Steri-strips, another kind of adhesive, may also be used; these can get wet, and should flake off on their own.
  • Substances to avoid: Unless directed by your doctor, do not apply ointments or other medications on incisions.
  • Sutures: Used more often in larger scale surgeries, these may be used to close up incisions in the chest. Typically, you’ll need to come back to the doctor to have these removed.

Throughout the recovery period, be mindful of how your incisions are healing, and don’t hesitate to call for help if you’re seeing signs of infection.

A Word From Verywell

While there’s no doubt that hiatal hernia surgery is a significant undertaking—one that can cause stress or anxiety—it’s also true that this procedure is ultimately very successful in resolving symptoms, such as those from gastroesophageal reflux disease (GERD).

If you’re considering this option or are planning on it, know that today’s techniques and technologies have made it safer and more effective than ever before. Also, remember that you’re not alone on your health journey: alongside your doctors and medical staff, your family and loved ones are there to provide you support. This surgery very well may be the first step towards brighter, healthier days ahead.

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Article Sources
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  2. Larowe E, Reddy R. Preparing for your transthoracic hiatal hernia repair pre and post-operative information. Michigan Medicine. 2017.

  3. University Hospitals. Hiatal hernia surgery recovery: Nissen fundoplication & paraesophageal hernias. 2020.