Paraesophageal Hernia Repair
A paraesophageal hernia occurs when more than 1/3 of the stomach has slipped (moved) into the
chest. The stomach pushes up through the opening in the diaphragm. The diaphragm is the
muscle layer between the belly and chest. When this happens, the stomach can move around and
may even twist on itself. This may cause chest pain, reflux, stomach pain, make it hard to
swallow, and cause shortness of breath. When you start having symptoms surgery is
Most paraesophageal hernias can be repaired laparoscopically (with about 5 very small incisions)
through the abdomen. During surgery the stomach is moved back into its correct position. The
enlarged hole in the diaphragm is made smaller. This is so the stomach cannot slip back up into
the chest space. In some cases, the top of the stomach (fundus) is wrapped around the bottom of
the esophagus to anchor the stomach in place. This makes it even harder for the stomach to
move back up into the chest space. This is called fundoplication.
Care of Incisions
After surgery your incisions will be swollen, pink, and may be numb and bruised. You may have
a small amount of clear pink drainage. This is normal and may last for a few days to weeks.
After 2 days, you may shower and gently wash your incisions with a mild soap and water. Do
not use soaps with lotion or heavy fragrance. They can disrupt new skin growth.
Do not put lotions, powders, or ointments on the wounds.
Do not swim or soak in a bathtub or hot tub until they are healed. This may be 2 weeks or
Check incision daily for signs of infection.
ξ Increased redness and warmth at the incision site
ξ Pus-like drainage
ξ Excess swelling or bleeding
ξ Temperature by mouth greater than 100.4° F, for two readings taken 4 hours apart
If there is drainage from your wounds, wear a Band-Aid® until it stops. Change the dressing at
least daily and more often as needed.
ξ It is important to walk. You should walk 3-4 times each day.
ξ Nothing strenuous until okayed by your doctor.
ξ For the first 4-6 weeks, do not lift more than 20 pounds.
ξ After 4 weeks, you will be able to slowly increase your level of activity.
ξ Check with your doctor before going back to work.
ξ Wear loose clothing around your waist.
ξ Avoid activities that will make you contract your stomach muscles, such as pulling and
Avoid sexual activity for 2 weeks after surgery.
Do not drive until after your follow up visit and discuss with your doctor. You must be off all
pain medicine before you can start driving.
Expect to have some pain from the surgery. Pain pills will be prescribed by your doctor.
Be sure to drink at least 6-8 glasses of fluid each day. If you are taking pain pills every 4-6
hours, you may need to take over-the-counter stool softeners (docusate sodium) and/or a fiber
laxative (Benefiber®) to keep stool moving easily. Talk to your nurse or doctor if you are having
problems with bowel movements.
If you had a laparoscopic repair, you may have shoulder pain from gas in your belly that presses
on your diaphragm. This pain can be relieved by getting up and walking. Your nurses will
discuss this with you.
Diet and Nutrition
You will not be able to eat and drink your normal foods for the first 4-6 weeks after surgery.
Common side effects with this surgery are:
ξ Feeling full.
ξ Difficulty swallowing.
ξ Dumping syndrome: when food moves through the intestines too fast causing cramping
pain, nausea, diarrhea and other abdominal discomfort.
To help with this, you may go home on a full liquid diet (strained soups, milk, pudding and
cream of wheat) or an esophageal soft diet (bland, low fat, soft foods).
ξ See Health Facts for You: Diet after Fundoplication #397, and Dysphagia Pureed Diet
Examples of an esophageal soft diet include:
ξ Milk, yogurt, and cottage cheese
ξ Scrambled eggs
ξ Meatloaf, moist casseroles
ξ Pasta dishes
ξ Mash potatoes
Other tips to reduce discomfort with eating include:
ξ Eating 6-8 small meals each day
ξ Taking small bites and chewing well before swallowing
ξ Drinking fluid between meals
ξ Eating foods that are soft and easy to chew
ξ Foods high in sugar – can cause dumping syndrome.
ξ Foods that are tough, crunchy, chewy, and fruits and vegetables with string, seeds, and
ξ Do not drink fluids with your meal; this will cause you to feel full.
ξ Do not use straws. Do not chew gum or tobacco. Avoid foods that cause gas.
When to Call the Doctor
ξ Problems swallowing
ξ Pain with swallowing
ξ Feeling that food is getting stuck
ξ Nausea or vomiting
ξ Pain not controlled with pain pills
ξ Increased redness or warmth around the incision
ξ Pus-like drainage from the incision
ξ Excess swelling or bleeding from the site
ξ Temperature greater than 100.4°F by mouth, for two readings taken 4 hours apart
Surgery Clinic, Mon-Fri: 8:00 – 4:30: (608) 263-7502
After hours, weekends, and holidays: call this number and a paging operator will answer. Ask
for the doctor on call for Dr. _____________________________. Leave your name and phone
number with the area code. The doctor will call you back.
Toll Free: 1-800-323-8942
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 4/2015 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5848