I have hiatius hernia and gerd which was very bad. the omeprazole really helped during the first few months that i took it, but i don't feel fully recovered. is surgery the next step?

Maybe: Depends on many things. First i would ask what is your Omeprazole dose. Increasing the dose or frequency of Omeprazole may be needed to control symptoms. For some people switching to a different medication such as Nexium or Dexilant (dexlansoprazole) may help. Next is the anatomy of the hiatal hernia - what type, how big, etc. Best to talk to your doc or a surgeon about this.

Maybe: Increasing the dose of Omeprazole sometimes helps especially if the main symptom is heartburn.

Depends: Usually, if medication helps the symptom, surgery is not necessary. If the hiatal hernia is large, something known as a paraesophageal hernia, surgery may be required even if symptoms are controlled with meds.