Published on: 2025-06-22 | Written by: Dr. Mohamed Raafat, Consultant Cardiothoracic Surgeon
Hiatal hernia is a common condition affecting both the digestive and respiratory systems, in which part of the stomach moves up into the chest through an opening in the diaphragm. Many wonder: is surgery always necessary?
Dr. Mohamed Rafat, Consultant in Cardiothoracic Surgery, explains when surgical intervention becomes the best treatment option for a hiatal hernia.
It’s a condition where part of the stomach protrudes through the diaphragm into the chest cavity. Symptoms vary depending on the size of the hernia and may include:
Heartburn
Difficulty swallowing
Chest or abdominal pain
Chronic acid reflux
Shortness of breath
According to Dr. Mohamed Rafat, not all cases require surgery. In mild cases, lifestyle changes and medication can be sufficient, such as:
Avoiding fatty meals
Sleeping with head elevation
Steering clear of foods that trigger reflux
However, surgery may be necessary in cases such as:
Large or sliding hernias
Poor response to medication
Complications like ulcers, bleeding, or breathing issues
Stomach twisting due to the hernia (a medical emergency)
Dr. Mohamed Rafat often performs hiatal hernia repair using laparoscopic techniques, which involve small incisions and offer:
Minimally invasive intervention
Short recovery period
Less postoperative pain
Long-lasting, effective results
The procedure includes:
Repositioning the stomach into the abdomen
Tightening the diaphragm opening
In some cases, reinforcing the area with a surgical mesh
Dr. Mohamed Rafat notes that most patients return to normal activities within two weeks, with recommendations such as:
Eating smaller meals
Avoiding bending or lifting heavy objects
Regular follow-up with the doctor
Dr. Mohamed Rafat advises seeking medical attention if you experience:
Persistent symptoms despite medication
Difficulty breathing or swallowing
Frequent acid reflux
Severe chest or abdominal pain