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 which is the muscle layer between the belly and chest. When this happens, the stomach can move around and may even twist on itself.
To repair this hernia, the enlarged opening in the diaphragm is made smaller and, in some cases, the top of the stomach is wrapped around the bottom of the esophagus to anchor the stomach. This is called fundoplication.
Care of Incisions
Your incisions will be swollen, pink, and may be numb and bruised with a small amount of clear pink drainage. This is normal.
After 2 days, you may shower and gently wash them 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 longer.
Check incision daily for signs of infection.
- Increased redness and warmth at the incision site
- Pus-like drainage
- Excess swelling or bleeding
- 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.
Pain Relief
Expect to have some pain from the surgery. Pain pills will be prescribed by your doctor.
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.
Prevent Constipation
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.
Diet
- You will be on a pureed diet for 2 weeks.
- Once on solid food, chew your food well.
- Prevent swallowing excess air. Do not use straws. Do not chew gum or tobacco. Avoid foods that cause gas.
- See Nutrition Facts for You: After Nissen Fundoplication PI 397, and Pureed Diet PI 275
Activities
- Walk 3 times a day.
- Nothing strenuous until okayed by your doctor.
- For the first 4-6 weeks, do not lift more than 20 pounds.
- After 4 weeks, you will be able to slowly increase your level of activity.
- Do not drive for 1 week or while you are taking narcotic pain pills.
- Check with your doctor before going back to work.
- Wear loose clothing around your waist.
When to Call the Doctor
- Problems swallowing
- Pain with swallowing
- Feeling that food is getting stuck
- Nausea or vomiting
- Bloating
- Pain not controlled with pain pills
- Increased redness or warmth around the incision
- Pus-like drainage from the incision
- Excess swelling or bleeding from the site.
- Temperature greater than 100.4°F by mouth, for two readings taken 4 hours apart.
Phone Numbers
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
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 05/03/2012
Copyright © 05/03/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5848
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