Why Paraesophageal Hernias Are Especially Risky and How Houston Surgeons Repair Them

By Dr. Rizwan Chaudhry, MD, Board-Certified General Surgeon, Fellowship-Trained in Advanced Laparoscopic & Bariatric Surgery

Introduction

As a board-certified bariatric surgeon with fellowship training from the Mayo Clinic and Cleveland Clinic, I see firsthand how a paraesophageal hernia can threaten quality of life, especially in older adults. This condition occurs when part of the stomach slips next to the esophagus through an opening in the diaphragm, raising the risk of severe reflux, chest pain, and even life-threatening stomach twisting (volvulus).

I specialize in advanced, minimally invasive repairs tailored to each patient’s unique anatomy and health profile. Current guidelines recommend surgical treatment for symptomatic cases, and studies indicate that laparoscopic repair combined with techniques like fundoplication can improve outcomes while reducing recurrence rates. Surgical approaches continue to evolve, with a focus on safety and patient-centered recovery.

If you’re experiencing chest discomfort, regurgitation, difficulty swallowing, or concerns about potential complications, I want you to know that safe, effective treatment options are available.

What Is a Paraesophageal Hernia?

A paraesophageal hernia occurs when part of the stomach pushes up next to the esophagus through the diaphragm. Unlike a typical sliding hiatal hernia, the stomach sits beside the esophagus rather than moving up and down with swallowing. In my practice, I most commonly see this condition in older adults who are dealing with severe reflux and discomfort. Many patients are surprised to learn that a paraesophageal hernia can exist for years with only mild symptoms, yet it carries unique risks that set it apart from more common hiatal hernias.

Understanding this difference is crucial. Paraesophageal hernias can lead to more serious complications, which is why surgical repair is generally recommended for symptomatic cases. Studies from leading surgical societies emphasize that observation alone may not prevent future problems. My goal is to help you feel informed and empowered about your treatment options, cutting through medical jargon to explain exactly what’s happening in your body. Read more about hiatal hernia guidelines.

In my experience as a foregut surgeon here in Houston, many patients come in frustrated after years of reflux treatments that just haven’t helped. When I explain how a paraesophageal hernia is different—and that it doesn’t always cause obvious symptoms at first but can quietly create serious risks down the road—it’s often a lightbulb moment. My role is to cut through the confusion and help you understand what’s really going on inside your body, so you can make confident decisions about your care.

Symptoms, Complications & When to Worry

Most of my patients, especially seniors like Robert, come to me after months or years of heartburn, regurgitation, or chest discomfort that just won’t go away. Common symptoms of a paraesophageal hernia include:

• Persistent reflux or regurgitation
• Difficulty swallowing
• Chest pain or pressure
• Feeling full quickly after eating

The real concern—and the reason I recommend prompt evaluation for patients—is the risk of complications. A paraesophageal hernia can cause the stomach to twist (a condition called volvulus), which may block food or blood flow and become a surgical emergency. Research indicates that while some people with mild symptoms can be monitored, those with significant discomfort or warning signs should consider surgery to avoid life-threatening events.

In my experience, early intervention often leads to better outcomes and less anxiety for patients. If you’re tired of daily medication or worried about sudden emergencies, it’s important to know that help is available.
Learn more about symptoms and risks.

Many people tell me they’re anxious about whether ongoing reflux or swallowing trouble is really “that serious.” I always reassure them that it’s normal to worry, but as a surgeon who treats these cases every week, I know that listening to your symptoms—especially if anything feels suddenly worse—can be lifesaving. Proactive care can often help you avoid the big emergencies that cause the most fear.

Understanding Stomach Volvulus: A Serious Risk

One of the most serious risks with a paraesophageal hernia is stomach volvulus—when the stomach twists on itself. I’ve seen firsthand how this can cause sudden, severe pain, vomiting, and even block the blood supply to the stomach. For patients like Robert, who want to enjoy retirement without fear, this is often the tipping point for seeking surgical advice.

Stomach volvulus is rare but dangerous. Studies suggest that even with advances in care, emergency surgery for volvulus still carries higher risks than planned, minimally invasive repair. That’s why I always stress the importance of not ignoring symptoms like sudden chest pain or persistent vomiting. I prioritize patient education so you can recognize warning signs early. If you’re living with a large hiatal hernia and worried about complications, know that timely, expert care can make all the difference.
Read about gastric volvulus risks.

Having performed both planned and emergency operations for paraesophageal hernias, I can tell you there’s a world of difference in patient outcomes. Elective, minimally invasive surgery almost always means a smoother recovery and less risk, while waiting until a crisis can make things far tougher and more dangerous. My best advice: if you’re worried about sudden severe pain, don’t wait—reach out so we can address the issue before it turns into an emergency.

Why Advanced Surgical Expertise Matters for Paraesophageal Hernia Repair

Choosing the right surgeon for paraesophageal hernia repair is critical, especially for older patients who may have additional health concerns. Many of my patients are referred by gastroenterologists or primary care physicians because of my advanced training in minimally invasive and complex foregut surgery.

My fellowship training at the Mayo Clinic and Cleveland Clinic taught me that every patient’s anatomy and risk profile is unique. Research shows that laparoscopic (minimally invasive) repair is associated with fewer complications and faster recovery compared to traditional open surgery. This means less time in the hospital and a quicker return to normal activities.

I’ve helped many patients who were anxious about surgery safety, particularly those with multiple medical conditions or previous abdominal operations. My approach is always patient-centered: I coordinate closely with your other physicians and tailor the surgical plan to your specific needs and goals. See surgical guidelines.

As someone with extensive experience in complex foregut repairs, I know there’s no “one-size-fits-all.” Some patients need more advanced techniques—especially if they’ve had previous surgeries, have large hernias, or multiple health issues. My team and I use the latest minimally invasive methods so you can recover faster and get back to your life here in Houston with confidence.

Treatment Options: Surgery & Recovery

When it comes to treating a paraesophageal hernia, surgery is generally recommended for those with symptoms or complications. In my practice, I offer minimally invasive laparoscopic repair, which involves gently moving the stomach back into place and repairing the opening in the diaphragm. For many patients, I also perform a fundoplication (wrapping the top of the stomach around the esophagus) to help prevent reflux, and sometimes a gastropexy (securing the stomach to the abdominal wall) to reduce the risk of recurrence.

The use of mesh to reinforce the repair is still debated among experts, and I always discuss the pros and cons with my patients. Studies indicate that mesh may lower recurrence in select cases, but it can also introduce risks, so I individualize this decision for each person.

Recovery after laparoscopic surgery is typically faster and less painful than open surgery. Most of my patients are up and walking the same day, and many go home within 24–48 hours. I coordinate follow-up care with your physicians to ensure a smooth recovery and lasting results. If you’re ready to move beyond daily medications and constant worry, advanced surgical options are available right here in Houston.
Explore surgical options and recovery.

If you’ve felt stuck—cycling through antacids, changing diet after diet, and still not feeling better—it’s normal to wonder if surgery might finally provide relief. I see a lot of patients from Sugar Land or Clear Lake who are surprised by how quickly they’re back on their feet after minimally invasive surgery, and how much better they feel living without constant reflux or worry. Every person’s journey is different, but my role is to make sure your treatment plan fits your life, your goals, and your comfort level.

Dr. Chaudhry: Houston’s Foregut Surgery Specialist

As a board-certified general surgeon with advanced fellowship training, I’ve dedicated my career to helping patients with complex foregut conditions—including paraesophageal and large hiatal hernias. My experience at the Mayo Clinic and Cleveland Clinic, combined with years of serving patients, means you receive world-class care close to home.

I understand that for seniors like Robert, the idea of surgery can be daunting. That’s why I focus on clear communication, patient-first care, and a judgment-free environment. My team and I are committed to supporting you every step of the way, from your first consultation to long-term follow-up.

Many patients come to Advanced Houston Surgical after being told elsewhere that their case is too complex. I take pride in offering solutions for even the most challenging hernias, always prioritizing safety and quality of life. If you’re looking for a surgeon who listens, explains, and delivers advanced care, you’re in the right place.
Learn about foregut surgery expertise.

Community Voices Online

As a surgeon dedicated to patient-first, judgment-free care, I believe that every person deserves compassion, clear communication, and advanced expertise—whether they’re facing a paraesophageal hernia, complex revisional surgery, or another foregut condition. It’s always meaningful to see our local community recognize this approach. One Google review shared online highlights the experience many people have with our practice:

Feedback like this reinforces my commitment to combining world-class training from the Mayo Clinic and Cleveland Clinic with personalized, long-term support for every individual we serve in Houston and surrounding communities.

Read verified testimonials

Read the full review on Google

Conclusion

In summary, paraesophageal hernia is a serious condition that can lead to life-threatening complications if left untreated, especially for seniors. The most important takeaways are that timely, expert evaluation and minimally invasive surgical repair can significantly reduce risks and improve quality of life. My approach is always patient-first, with care tailored to your unique needs and coordinated with your physicians. As a board-certified general surgeon with Mayo Clinic and Cleveland Clinic fellowship training, I am committed to providing safe, advanced solutions so you can enjoy retirement with confidence and peace of mind.

If you’re ready to take control of your health, schedule your consultation to discuss your options and start your journey toward lasting relief.

This article is for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

Please note: Advanced Houston Surgical does not offer or recruit for clinical trials. References to research are citations of published medical studies only.

Frequently Asked Questions

What is a paraesophageal hernia, and why is it risky?

A paraesophageal hernia occurs when part of the stomach pushes up next to the esophagus through the diaphragm. Unlike typical hiatal hernias, this type can cause the stomach to twist, leading to serious complications like obstruction or reduced blood flow. That’s why I recommend prompt evaluation and, for most symptomatic patients, surgical repair to prevent emergencies.

Where can I get expert paraesophageal hernia care in Houston?

I provide comprehensive evaluation and advanced surgical repair for paraesophageal hernias at my practice, serving patients from across the Greater Houston area. My care is tailored to your needs, and I coordinate closely with your local physicians to ensure a smooth experience from consultation through recovery.

I’m worried about surgery at my age—how safe is it?

It’s completely normal to feel anxious about surgery, especially as a senior. Studies show that minimally invasive (laparoscopic) repair is generally well-tolerated and associated with fewer complications and faster recovery than open surgery. I always individualize your care plan and work closely with your other physicians to maximize safety.

What is recovery like after minimally invasive hernia repair?

Most of my patients are up and walking the same day and can return home within 24–48 hours after laparoscopic repair. Recovery is typically smoother and less painful than with open surgery. I provide detailed instructions and ongoing support to help you get back to your normal activities as quickly and safely as possible.

Are there alternatives if I’m not ready for surgery?

For patients with mild or no symptoms, observation may be appropriate, and I’m happy to discuss non-surgical management. However, if you’re experiencing significant discomfort or complications, surgery is usually recommended. My goal is to help you understand all your options so you can make the best decision for your health and lifestyle.