Hiatal (Nissen Fundoplication, Paraesophageal) Hernias
What to Expect
Expect stay in the hospital one to two days after this procedure. On the morning after your procedure you will get a swallowing study to make sure everything is in the proper place. After that, you will start on a liquid diet.
This surgical procedure does require diet restrictions after surgery. You will need to stay on a liquid/soft diet for approximately 3 weeks after surgery. During that time, you can try or experiment with eating soft, mushy foods like tuna, mashed potatoes, eggs, cottage cheese, and thick soups. The reason for liquids is that there will be some swelling in your esophagus where your hernia was repaired. You may also notice that swallowing feels a little "tight" – this will improves as the swelling goes down. With time, you will be able to digest foods normally. ALSO, DO NOT DRINK CARBONATED BEVERAGES FOR THREE WEEKS.
Some patients find that their appetite is poor or that foods don't taste well after surgery. This is a normal result of the stress of surgery and manipulation inside the belly — your appetite should return in several weeks. If you do not eat, this is OK; the most important thing is to drink liquids. If you find you are persistently nauseated or unable to take in liquids, contact our office and let us know.
It is OK to shower starting around 36 hours after surgery. If you have little patches of white gauze or band-aides on the incisions, take off the gauze/band-aides before showering.
You might see little pieces of tape (called steri-strips) directly attached to your skin. It is OK to get these little tapes wet in the shower. The tapes will begin to peel up on the ends 7 – 10 days after surgery — at this point they have done their job and it is OK for you to peel them the rest of the way off if you wish. You do not have to have them on when you come for your postoperative visit.
No baths, pools or hot tubs for two weeks.
We try to close your incisions to leave the smallest possible scar. Do not put any ointment or other medication on your incisions — it will not make them "heal better."
There are no significant restrictions on activity after surgery. That means it is OK to walk, climb stairs, have sexual intercourse, mow the lawn, or exercise as long as it doesn't hurt. In fact, returning to normal activity as soon as possible will most likely enhance your recovery. However, if it doesn't feel good, don't do it. Take it easy and let the pain be your guide. Avoid heavy lifting to aide in the healing of your incisions.
You may also feel easily fatigued and "washed out" for a week or two following the surgery. These factors will put some limitations on your activity, but you will not cause any damage even if some soreness is experienced.
Everyone has different motivations toward their job, and thus everyone returns to work at different times. As a rough guide, most people take at least 1 – 2 weeks off prior to returning to work. If you need particular documentation for your job, call the office.
You will usually be able drive when you have not needed the narcotic (prescription) pain medications for two days.
The first bowel movement may occur anywhere from 1 – 5 days after surgery — as long as you are not nauseated or having abdominal pain this variation is acceptable. Remember that it is very common to pass a lot more gas from your rectum than you used to — this is because you will not be able to really belch. Some patients also find that they have diarrhea or "loose bowels" for the first days after their hernia repair — in the vast majority of cases, the bowel function normalizes with time. Constipation may also be common due to the pain medication. We recommend taking Milk of Magnesia (2 tablespoons; twice a day) while taking the pain pills to avoid constipation.
When to call
Call your surgeon's office if any of the following occur:
- Fever to 100.4 or greater
- Shaking chills
- Pain that increases over time
- Redness, warmth, or pus draining from incision sites
- Persistent nausea or inability to take in liquids