Some patients will not have to receive treatment if they are not experiencing bothersome symptoms. However, if symptoms do occur, there are several possible treatment options.
Medications are often considered first. There are a few different options:
- H-2 receptor blockers: These drugs reduce acid production in the stomach. Examples include cimetidine, ranitidine, and nizatidine.
- Antacids: These medications work to neutralize acid in the stomach. It is important to use them exactly as directed as overuse may cause kidney problems and diarrhea.
- Proton pump inhibitors: If H-2 receptor blockers are not effective, this type of medication might be considered. They block acid production so that the esophagus has time to heal. Examples include omeprazole and lansoprazole.
When medications are not helpful, patients might benefit from surgery. Surgery might also be considered if the patient has narrowing of the esophagus or severe inflammation due to their hiatal hernia.
The surgery involves pulling the stomach into the abdomen. The diaphragm opening is also made smaller to reduce the risk of the stomach pushing through again. In some cases, surgery may also include removing the hernia sac or reconstructing an esophageal sphincter.
When a hiatal hernia is small, it often does not cause issues. However, should symptoms occur, it is important to see a doctor promptly to determine the proper treatment.