HomeSurgery ArticlesWhat Size Hiatal Hernia Needs Surgery?

What Size Hiatal Hernia Needs Surgery?

A hiatal hernia is quite a prevalent issue, particularly among those over 50. This issue entails the top section of the stomach protruding through the diaphragm – the muscle that separates the chest cavity from the abdomen. Surgery is not always necessarily required for this condition; in this blog, we will explore when such action should be taken and what size hernia necessitates surgery.

The size of a hiatal hernia is essential in deciding whether surgery must be done. A minor hiatal hernia may not produce any symptoms and may not need attention. On the other hand, a large hiatal hernia can cause considerable discomfort and may necessitate surgical intervention. An upper endoscopy or a barium swallow test are used to measure the size of a hiatal hernia, typically expressed in centimeters.

What Size Hiatal Hernia Needs Surgery?

A hiatal hernia that is less than 2 centimeters in size is usually asymptomatic and does not require surgery. On the other hand, larger hernias – measuring more than 2 centimeters – may result in symptoms or complications, making surgical intervention advisable.

When determining the best course of action for a hiatal hernia, various factors should be taken into consideration, such as size, intensity of symptoms, and any potential complications. Typically, operations are recommended for hiatal hernias more than five centimeters in diameter; these tend to cause greater levels of suffering and potential health risks.

Determining the Need for Surgery in Hiatal Hernias of Varying Sizes

Surgery may be recommended for hiatal hernias greater than 2 centimeters in size that cause symptoms, such as heartburn or chest pain. Also, it may be needed should complications arise, like dysphagia (difficulty swallowing), esophageal dysmotility (when the esophagus does not perform correctly) or a bleeding disorder. This kind of surgery is normally conducted with general anesthesia, however occasionally local anesthetic with sedation might be chosen. Laparoscopic surgery is usually preferred by surgeons; in this case a thin tube with a camera attached is placed through an incision to view inside the body so the hernia can be repaired.

Surgery is typically recommended for hiatal hernias that have been present for over 50 years. It has been proven to boost quality of life and alleviate symptoms in this demographic.

Symptoms of Hiatal Hernia

Hiatal hernia symptoms can come in many forms, depending on the size and severity of the condition. These can include:

  • Heartburn is an uncomfortable burning feeling in the chest. It is caused by stomach acid travelling up towards the throat. Heartburn can be painful and occur after eating a meal or drinking certain beverages, such as coffee or alcohol.
  • Acid reflux, also known as gastroesophageal reflux disease (GERD), is a condition in which acid backs up from the stomach into the esophagus. It can cause a burning feeling in the chest, pain and discomfort, and may even lead to vomiting.
  • Chest discomfort can be an indicator of trouble. It could be an indication of a medical problem that requires professional attention. Experiencing chest pain should prompt a person to take the necessary steps for proper diagnosis and treatment.
  • Swallowing can sometimes be a difficult task. It’s problematic when there is an inability to swallow food, liquid or other materials. Any of these can be hard to get down without discomfort or pain.
  • Breathing difficulties are a common complaint, with people feeling a tightness in their chest and struggling to get enough air. Those who experience this feel as though they can’t get enough oxygen, leading to breathlessness or an inability to inhale deeply. These symptoms are typically caused by shortness of breath.
  • Expelling vomit or being nauseous can be unpleasant experiences, particularly if it is frequent. Sufferers may find themselves feeling sick and having an urge to vomit regularly.

If you have any of these symptoms, it is important to get a medical examination. Your doctor might suggest examinations to decide the extent of your hiatal hernia and whether an operation is required.

Treatment Approaches Based on the Size of Hiatal Hernias: Surgical Perspectives

When it comes to hiatal hernias, the size is an important factor in deciding on an appropriate treatment approach. In certain instances, surgery may be needed to ease symptoms and protect against potential complications. Now let’s examine how surgical options can vary depending on the size of hiatal hernias.

Hiatal hernias of a smaller size that don’t cause major symptoms can be managed without surgery. Simple lifestyle changes like keeping a healthy weight, watching certain foods, raising the head during sleep and quitting smoking should be made. Medication such as antacids, H2 blockers or proton pump inhibitors can also help reduce acid production and provide relief from discomfort.

In cases where the hiatal hernia is large or causing significant symptoms, surgery may become necessary. The intent of an operation in this situation would be to repair the hernia and return the stomach and esophagus to their natural configuration.

It’s vital to take into account the individual patient’s condition, symptoms, and general wellbeing when making a decision about surgery. It is equally important to ensure adequate monitoring and follow-up of the designated course of action. A healthcare expert should be consulted before any steps are taken.

Surgical Options for Various Sizes of Hiatal Hernias

The size of a hiatal hernia plays a role in determining the surgical option best suited for treating it. When considering a procedure, doctors evaluate both the size of the hernia and the accompanying symptoms to decide on an appropriate approach. To gain greater insight into the various surgical options available, let’s take a look at those typically used to treat hiatal hernias of various sizes.

In cases of small hiatal hernias that do not trigger significant symptoms, surgery may not be a necessity. Rather, lifestyle changes and medications may be enough to effectively regulate symptoms. If the hernia increases in size or its effects become serious, doctors may advise for a surgical procedure.

In cases of moderate-sized hiatal hernias, laparoscopic fundoplication and mesh reinforcement are common procedures. Fundoplication involves wrapping the upper stomach around the lower esophagus to help strengthen the sphincter and minimize acid reflux. Mesh reinforcement repairs the hernia and provides extra stability. Both interventions are useful in reducing symptoms associated with this condition.

In cases where hiatal hernias are larger or have caused complications, such as gastric volvulus (twisting), open surgery may be required. This technique requires a more extensive abdominal incision to reach the hernia and complete its repair; however, it grants the surgeon better visibility and dexterity during the procedure, making it suitable for complex cases.

The selection of laparoscopic or open surgery is contingent upon a number of factors such as the hernia size and complexity, the patient’s general health, and the skill level of the doctor. There are pros and cons to each strategy, and it is up to the doctor to evaluate every situation in order to make the ideal surgical choice.

It’s important to bear in mind that the judgement to go ahead with surgery is a joint operation between the patient and their medical team. The surgeon will take into account the patient’s individual circumstances, signs, and past medical record when recommending the best course of action. After surgery, satisfactory post-surgery care and scheduled follow-ups are vital to ensure a successful treatment outcome.


In summary, the size of a hiatal hernia can determine if surgery is needed. While smaller hernias may not warrant treatment, those that are larger may cause symptoms or complications necessitating surgery. If you are having symptoms associated with hiatal hernia or have been diagnosed with one, it is important to visit a doctor and weigh your treatment options.


1. What is the estimated duration of healing after a hiatal hernia operation?

The amount of time needed for recuperation following hiatal hernia surgery is contingent on the procedure performed. Usually, patients spend between one and two days in the hospital and require a few weeks to make a complete recovery.

2. What are the potential dangers associated with an operation that is aimed at treating a hiatal hernia?

Surgery for hiatal hernia carries some risks, such as bleeding, infection, or adverse reactions to anesthesia. Despite this, the success rate is usually high and most patients have successful outcomes.

3. Is it possible to treat a hiatal hernia without the use of surgery?

In many cases, hiatal hernias can be managed through modification of lifestyle and medication. Nonetheless, if the hernia is resulting in troublesome symptoms or issues, then surgery may be required.

4. What is laparoscopic hiatal hernia surgery?

Laparoscopic hiatal hernia surgery is a minimally invasive operation that repairs the hernia through small incisions and a camera. Typically, this procedure causes less pain and results in a shorter recovery period than open surgery.

5. Do insurance companies reimburse hiatal hernia surgery?

It’s important to check with your insurance provider to confirm the extent of your coverage and any associated out-of-pocket expenses for hiatal hernia surgery if it is medically necessary.

- Advertisement -spot_img