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Treatments and drugs
By Mayo Clinic staffMost people with hiatal hernia don't experience any signs or symptoms, and won't need treatment. If you experience signs and symptoms, such as recurrent heartburn and acid reflux, you may require treatment, which can include medications or surgery.
Medications for heartburn
If you experience heartburn and acid reflux, your doctor may recommend medications, such as:
- Antacids that neutralize stomach acid. Over-the-counter antacids, such as Maalox, Mylanta, Gelusil, Rolaids and Tums, may provide quick relief. But antacids alone won't heal an inflamed esophagus damaged by stomach acid. Overuse of some antacids can cause side effects, such as diarrhea or constipation.
- Medications to reduce acid production. Called H-2-receptor blockers, these medications include cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR) or ranitidine (Zantac 75). H-2-receptor blockers don't act as quickly as antacids, but they provide longer relief. Stronger versions of these medications are available in prescription form.
- Medications that block acid production and heal the esophagus. Proton pump inhibitors block acid production and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24HR) and omeprazole (Prilosec OTC). Stronger versions of these medications are available in prescription form.
Surgery to repair a hiatal hernia
In a small number of cases, a hiatal hernia may require surgery. Surgery is generally reserved for emergency situations and for people who aren't helped by medications to relieve heartburn and acid reflux. Hiatal hernia repair surgery is often combined with surgery for gastroesophageal reflux disease.
An operation for a hiatal hernia may involve pulling your stomach down into your abdomen and making the opening in your diaphragm smaller, reconstructing a weak esophageal sphincter, or removal of the hernia sac. In some cases, this is done using a single incision in your chest wall (thoracotomy) or abdomen (laparotomy). In other cases, your surgeon may insert a tiny camera and special surgical tools through several small incisions in your abdomen. The operation is then performed while your surgeon views images from inside your body that are displayed on a video monitor (laparoscopic surgery).
- Brady M. Hiatal hernia. In: Ferri FF. Ferri's Clinical Advisor 2010. Philadelphia, Pa.: Elsevier; 2009. http://www.mdconsult.com/das/book/body/162991320-4/0/2088/0.html. Accessed Sept. 30, 2009.
- Jeyarajah R, et al. Abdominal hernias and gastric volvulus. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2006. http://www.mdconsult.com/das/book/body/162991320-4/0/1389/0.html. Accessed Sept. 30, 2009.
- Keifer D. Gastroesophageal reflux disease. In: Rakel, D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/162991320-4/0/1494/0.html. Accessed Sept. 30, 2009.
- Kahrilas PJ. Hiatus hernia. http://www.uptodate.com/home/index.html. Accessed Sept. 30, 2009.
- The word on GERD. American College of Gastroenterology. http://www.acg.gi.org/patient/gerd/word.asp. Accessed Sept. 30, 2009.
- Picco MF (expert opinion). Mayo Clinic, Jacksonville, Fla. Oct. 6, 2009.
