Hiatal Hernia Surgery And Training

Hello docs! I’ve had a hiatal hernia for 2 years now. I tried medication and, while it did help with reflux to an extend, it did not help other symptoms, such as halitosis, at all. So I finally made an appointment for surgery. Now, the surgeon does not lift and he even specifically told me he doesn’t know anything about lifting. That being said, he did say that high intra-abdominal pressure (so, training) is going to make it way more likely for the hernia to re-appear. He also recommended that for about 2 months after the surgery (laparoscopic surgery), I should not train at all, and even then, not train with weights higher than my bodyweight. Of course, this seems very arbitrary and I don’t care much for the recommendation, but I’m just giving context. Now, I do have 2 specific questions:

  1. With symptoms such as halitosis not getting better from medication and such, would you consider surgery to be a good way to fix the symptom? I know you’re going to say that the hernia and halitosis may be unrelated, however I know exactly when the hernia happened, and the halitosis started around that period, so I’m fairly certain that they are related

  2. What would be your general training recommendations post-op? I’m not trying to actively go against my surgeon, but since he doesn’t know anything about lifting, I am trying to at least meet him half-way, and start training sooner.

Thank you!

  1. I have no idea, unfortunately.

  2. There are no evidence-based guidelines for training recommendations after a hiatal hernia repair. We would just be making it up. If I were in this situation, once cleared for general physical activity (which should not be very long), initiating bodyweight activity like walking, calisthenic/bodyweight movements, and gradually introducing low-load activities from there over the subsequent weeks.

Thank you Dr. Baraki. Would you recommend that I limit my intra-abdominal pressure as much as possible post op? Meaning, training without using valsalva, or using as little as possible at least.

This seems reasonable in the immediate early post-op phase, but again – this is not based on direct evidence. I am not a surgeon and do not manage these cases routinely.