I'm looking for some information please. I'm a 37 year old female and I had an endoscopy on Nov 30 due to bad abdominal cramping, nausea, persistent heartburn. The surgeon told me that I have a "very large hiatal hernia" and also chronic oesophagitis and chronic gastritis, which are a result of the hernia. He suggested that I have the hiatal hernia repaired and also undergo the Nissen Funduplication. I was not told what the size of the hernia is, just that it was larger than what he usually sees and treats with medicine. 

I'm taking PPI (Topzole 40 mg) in the mornings, but it just helps to keep the acid reflux at bay. The pain behind my breast bone (which I've always written off as being panic attacks) is still there. I wake up in the morning with nausea and stomach cramps and barely 5 minutes after eating something, I'm doubling over with the worst stomach cramps and a while later the nausea flares up again. The pain and nausea are really taking over my life at the moment, but I'm at the same time very scared for the Nissen procedure.

I've noticed before that eating dinner after 6pm gives me heartburn or acid reflux at night, so we now eat at 6pm and I then go to bed around 9pm and I manage to sleep fine. I sometimes wake up with a sore throat and hoarseness, which is apparently from the reflux during the night.

The bad stomach cramps had me go to my GP yesterday, who suggested that I get a second opinion, as the hernia repair and Nissen procedure is not really effective if the hernia is under 4cm. Unfortunately that means that I'll have to have another endoscopy, because we need to determine the exact size. 

My questions that I have though...

1. Should the Hernia be bigger than 4cm and the second specialist also suggests that I have the repair done - is the surgery a good idea? A colleague told me that she regrets doing the surgery, because apart from the post-operative pain, she still has pain behind her breast bone/upper stomach (but no more heartburn or reflux). This has scared me. I don't know how big her hernia was though. I know of other people who are living with a hiatal hernia and they treat symptoms with PPIs and they're fine. But they don't double over with stomach cramps after meals or if that happens, incidents are not often and most definately not daily.

2. Should the hernia be smaller than the 4cm, what do I do then? Do I still brave the surgery? Or do I continue to live as I'm living now with countless medications and this severe cramping and nausea every day?

Where will one make a final decision between symptoms getting worse daily with medicine not really making a dent in it - or doing the surgery, taking a week or so with pain and the strict diet afterwards. I'm really scared and at a loss - a painful one. 

Any advice and/or similar experience will be highly appreciated.