If your hiatus hernia does not cause any symptoms, there is no need for treatment. If you have symptoms, antacid medicines and a change of lifestyle are the preferred treatments.
Treatment aims to prevent stomach acid from flowing back into the oesophagus, improve the clearance of food from the oesophagus and reduce the amount of stomach acid produced.
Antacid medicines can relieve some of the symptoms of hiatus hernia. Antacids come in liquid or tablet form and are swallowed or chewed. When they get to the oesophagus and stomach, they help neutralise the acid (make it less acidic).
Antacid medicines do not work for everyone. They are not a long-term solution if symptoms persist and cause extreme pain and discomfort.
Alginates contain a foaming agent, which forms a layer that floats on top of your stomach contents. This prevents stomach acid from flowing back into the oesophagus and protects your oesophagus lining.
Acid-suppressing medicines reduce the amount of acid produced by your stomach. They are called histamine receptor blockers, or H2 antagonists, and include cimetidine, famotidine and ranitidine.
Proton pump inhibitors
Proton pump inhibitors (PPIs) reduce the amount of acid produced by your stomach. They are usually the first treatment for gastro-oesophageal reflux disease (GORD), which can be a symptom of hiatus hernia.
Motility stimulants, such as domperidone and metoclopramide, speed up the rate at which your stomach empties. They also improve the squeezing of the sphincter muscle, to help stop stomach contents being brought back up into your oesophagus. They can cause side effects, so only take them when needed.
Surgery may be an option in some cases of hiatus hernia if medication does not relieve your symptoms. Surgery may also be recommended for cases of GORD that do not respond to other treatments.
During surgery, the stomach is put back into the correct position and the diaphragm around the lower part of the oesophagus is tightened. Surgery is commonly performed using laparoscopy (the least invasive technique, where only a small incision is made in your abdomen).
The operation is not complicated and most people go home the same day.