Hiatal hernias are a common condition affecting approximately 20% of the U.S. population. Often, people don’t realize they have one until a test finds it. A common question many people ask after their diagnosis is, ‘What size of hiatal hernia requires surgery?’
Indeed, the size of the hiatal hernia is one thing doctors consider when they decide if surgery is necessary or not. But at the same time, it is not the only thing.
In this blog, we’ll address common questions about hiatal hernias and surgery to help you make informed decisions.
What is Hiatal Hernia?
The diaphragm (a muscular wall that separates your chest from your abdomen) has a small opening called the hiatus, which allows the esophagus to pass through and connect to the stomach. In a hiatal hernia, the stomach bulges through this opening into the chest.
There are four main types of hiatal hernia:
- Type 1 – Sliding Hiatal Hernia
This is the most common type. Through the hiatus, the stomach and the lower part of the esophagus slide up into the chest. - Type 2, 3, and 4 – Paraesophageal Hernia
This is less common but more serious. In this type, part of the stomach pushes through the hiatus and sits next to the esophagus, which can lead to complications.
When Does a Hiatal Hernia Need Surgery?
It is also important to remember that not all hiatal hernias require surgery. Many people with small hernias can manage their symptoms with lifestyle changes, medications, or other non-surgical treatments.
However, surgery may be needed in certain situations, especially when the hernia is large or causing significant problems.
Factors Apart from Size Indicating Hiatal Hernia Surgery Need
The size of a hiatal hernia is often measured in centimeters (cm). Generally, hernias larger than 7 cm (2.8 inches) are considered large and may require surgery.
Size alone doesn’t always mean someone needs surgery. Oftentimes, there are other important factors that also play a role, including:
- Symptoms
If you have severe symptoms like chronic acid reflux, difficulty swallowing, chest pain, or vomiting, surgery might be recommended, even if the hernia isn’t very large. - Complications
Large hernia can sometimes lead to complications like strangulation (where the blood supply to the stomach is cut off) or volvulus (twisting of the stomach). These are medical emergencies and require immediate surgery. - Failed Non-Surgical Treatments
If lifestyle changes and medications haven’t been able to control your symptoms, surgery might be the next step.
When to Consider Surgery for Hiatal Hernia?
If you have been diagnosed with a hiatal hernia and are experiencing severe symptoms, or if your doctor has told you that your hernia is large, it’s important to discuss your options. Surgery can provide long-term relief and prevent complications, especially for larger hernias.
Final Word
While not all hiatal hernias need surgery, larger hernias (typically over 7 cm) or those causing significant symptoms often do. If you’re struggling with a hiatal hernia and think surgery might be the right option for you, don’t hesitate to reach out.
At NOVA Bariatrics and General Surgery, we’re here to help you take the next step toward better health. Contact us today at (469) 639-0953 or visit our website to learn more about your options and how we can support you on your journey.
