Hiatal Hernia Treatment

Hiatal hernias are usually treated only when there are symptoms. When GERD is present, the following measures may help:

Weight Loss

For people who are obese, losing weight may relieve symptoms.

Dietary Changes

Avoid foods that can relax the muscle that controls the opening between the esophagus and the stomach including:

• Chocolate
• Peppermint
• Fatty foods
• Coffee
• Alcoholic beverages

Avoid foods and beverages that can irritate the internal lining of the esophagus, such as:

• Caffeine
• Citrus fruits and juices
• Tomato products
• Hot peppers
• Carbonated beverages

To minimize acid reflux:

• Consume smaller meals 4-6 times a day versus three large meals.
• Avoid drinking large amounts of fluids with meals.
• Do not eat within 2-3 hours of bedtime.

Smoking Cessation

If you smoke, quit. Smoking weakens the lower esophageal sphincter, a muscle that controls the opening between the esophagus and the stomach.

Reduce Pressure on Your Abdomen

• Wear clothes and belts that are loose around your waist.
• Avoid stooping or bending after meals, which puts increased pressure on the abdomen.

Elevation

Elevating the head of the bed on 6-inch blocks or sleeping on a specially designed wedge reduces heartburn. This position helps prevent stomach contents from refluxing backward into the esophagus.

Antacids

Antacids can neutralize acid and temporarily relieve heartburn.

Prescription Medications

For chronic reflux and heartburn, several types of medications may be prescribed to reduce acid in the stomach. These include:

• H2 blockers such as:
  • Cimetidine
  • Famotidine
  • Nizatidine
  • Ranitidine
• Proton pump inhibitors such as:
  • Omeprazole
  • Esomeprazole
  • Lansoprazole
  • Pantoprazole
  • Rabeprazole

Surgery

Surgery may be needed if:

• You have severe GERD symptoms that do not respond to other treatments.
• The hernia is at risk for twisting, which could cut off the blood supply to part of the stomach and cause that part to die.