Treatment

Most people with a 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 need medication or surgery.

Medications

If you experience heartburn and acid reflux, your doctor may recommend:

• Antacids that neutralize stomach acid. Antacids, such as Mylanta, Rolaids and Tums, may provide quick relief. Overuse of some antacids can cause side effects, such as diarrhea or sometimes kidney problems.
• Medications to reduce acid production. These medications — known as H-2-receptor blockers — include cimetidine (Tagamet HB), famotidine (Pepcid AC) and nizatidine (Axid AR). Stronger versions are available by prescription.
• Medications that block acid production and heal the esophagus. These medications — known as proton pump inhibitors — are stronger acid blockers than H-2-receptor blockers and allow time for damaged esophageal tissue to heal. Over-the-counter proton pump inhibitors include lansoprazole (Prevacid 24HR) and omeprazole (Prilosec, Zegerid). Stronger versions are available in prescription form.

Surgery

Sometimes a hiatal hernia requires surgery. Surgery is generally used for people who aren't helped by medications to relieve heartburn and acid reflux, or have complications such as severe inflammation or narrowing of the esophagus.

Surgery to repair a hiatal hernia may involve pulling your stomach down into your abdomen and making the opening in your diaphragm smaller or reconstructing an esophageal sphincter. In some cases, hiatal hernia surgery is combined with weight-loss surgery, such as a sleeve gastrectomy.

Surgery may be performed using a single incision in your chest wall (thoracotomy) or using a minimally invasive technique called laparoscopy. In laparoscopic surgery, your surgeon inserts 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.