Postoperative diet, activity, and optimal long-term follow-up

Are dietary restrictions and activity restrictions necessary following hiatal hernia repair? The question is simple and it seems the answer should be simple as well. However, a paucity of data exists to guide dietary advancement and activity restrictions following hiatal hernia repair. The same is true regarding recommendations for long-term follow-up of patients who have undergone a hiatal hernia repair. Therefore, the components of post-operative dietary recommendations following hiatal hernia repair vary significantly from one surgeon to another and one institution to another. The same is true regarding activity restriction recommendations following hiatal hernia repair. Despite the fact that variations exist regarding the specific postoperative recommendations following hiatal hernia repair, there is general agreement when it comes to the reasoning behind both dietary limitations and activity restrictions. The reasoning for postoperative dietary recommendations and the reasoning for postoperative activity restrictions will serve as the basis for discussion in this article. Examples of the management plans that we use at our institution will also be provided. Additionally, we will examine long-term follow-up recommendations following hiatal hernia repair, and the indications for pursuing additional evaluation. Special consideration will be given to the current recommendations regarding surveillance of Barrett's esophagus following hiatal hernia repair and fundoplication.