Hiatus Hernia Treatments

Lifestyle Changes

  • If you’re overweight, lose weight.
  • If you smoke, quit. Smoking increases the risks of acid reflux problems.
  • Eat small, frequent meals, rather than occasional large meals.
  • Don’t eat within three hours of bedtime.
  • Eat a diet low in carbohydrate and fat and avoid spicy foods, caffeine, fizzy drinks, alcohol, chocolate and acidic foods.
  • Wear loose-fitting, comfortable clothes.
  • Avoid bending over, abdominal exercises and tight belts.
  • Raise the head end of your bed by about 10 to 20cm with something sturdy and solid – don’t use extra pillows as this may put extra pressure on your stomach.
  • If you’re stressed, try relaxation techniques such as meditation, yoga and deep breathing, as your symptoms may worsen under stress.

Medicines

All these medicines work by preventing stomasch acid from refluxing into the oesophagus. They do not cure hitaus hernia, but they relieve the symptoms of acid reflux that are made worse by the hernia.

Gaviscon

Gaviscon works by forming a raft (thick layer) on top of the stomach contents soon after it has made contact with the stomach acid. The raft acts as a strong physical barrier and helps keep all the components of the stomach contents in the stomach where they work, not letting them seep back up into the oesophagus where they hurt.

Ranitidine

Ranitidine hydrochloride (brand names Zinetac or Zantac) is an H2 blocker that inhibits stomach acid production. It is generally available without prescription and can be purchased freely in supermarkets and drug stores. Whilst it reduces stomach acid production it is does not stop it entirely, so is most effective in people with mild or infrequent symptoms.

Proton Pump Inhibitor

Proton pump inhibitors, such as Omeprazole (brand names brand names: Losec, Prilosec, Zegerid, ocid, Lomac, Omepral, Omez) completely stop acid production and are extremely effective in relieving symptoms.

Motility Stimulant

Another type of medicine you may be prescribed is a motility stimulant, which helps stop your stomach contents coming back up into your oesophagus and quickens the rate at which your stomach empties.

Surgery

Very rarely, a hiatus hernia causes such severe symptoms or complications that your doctor will recommend surgery. This is more likely in patients with a rolling (rather than sliding) hiatus hernia. Surgery involves pushing the stomach back into the correct position, securing it and tightening the diaphragm around the lower part of the oesophagus. This prevents acid reflux and heartburn.

The procedure is usually done as keyhole surgery using a laparoscope – a small thin tube containing a camera. The recovery time is quicker than for open surgery, which is done through a cut in the abdomen.

The surgery requires a two to three day admission to hospital and recovery usually takes one week. Side-effects and complications are rare but can include:

  • pain when you swallow, which usually improves after one to three months
  • bloating from gas, especially after meals
  • difficulty burping or vomiting, which gradually improves
  • infection and bruising
  • long-term pain

It’s also possible that the hernia will return.