Table of ContentsView AllTable of ContentsRisk FactorsTreatmentHome RemediesOver-the-Counter MedicationsPrescriptionsSurgeriesComplementary MedicinePreparing for Your AppointmentFAQNext in Hiatal Hernia GuideCoping With a Hiatal Hernia
Table of ContentsView All
View All
Table of Contents
Risk Factors
Treatment
Home Remedies
Over-the-Counter Medications
Prescriptions
Surgeries
Complementary Medicine
Preparing for Your Appointment
FAQ
Next in Hiatal Hernia Guide
Ahiatal herniais a condition in which the upper part of your stomach bulges through an opening in your diaphragm.Different types of hiatal hernia, such as aparaesophagealhernia, can require different treatments. A sliding hiatal hernia is the most common type.
The diaphragm is the thin muscle that separates your chest from your abdomen. When part of the lower esophagus (the tube that runs from the mouth into the stomach) pokes into the chest through the diaphragm, stomach acid can come up into the esophagus, which can lead to heartburn andgastroesophageal reflux disease (GERD).
Symptoms may include:
Some people don’t experience any symptoms and won’t require treatment, but usually, hiatal hernia treatment involves lifestyle modifications and medication to relieve symptoms or, in some cases, surgery to repair the hernia.
This article discusses howhiatal herniasare treated, including at-home lifestyle changes and medications to improve symptoms. It also covers what procedures are available for more serious cases.
Laura Porter / Verywell
Risk Factors for Hiatal Hernia
Hiatal hernia and GERD are more common in people who are:
This may be due to excessive stress on the stomach (in the case of obesity) or weak supporting tissue between the esophagus and stomach.
How Is a Hiatal Hernia Treated?
Some people don’t experience symptoms or need treatment and most people get relief from lifestyle changes and medication. People with more serious conditions may need surgery. The treatment will depend on factors including the type of hiatal hernia. These types include:
A fourth type of hernia occurs when another organ, like the colon, pushes through into the thoracic cavity instead of the stomach.
Home Remedies and Lifestyle
To overcome reflux symptoms, you need to address the underlying causes. Several key lifestyle changes can help minimize your symptoms:
Hiatal Hernia Diet: What to Eat to Help Manage Symptoms
Over-the-counter (OTC) medication is a first-line defense against heartburn and acid reflux that occur with hiatal hernias. Some of the more commonly used medications includeantacids,Histamine 2 (H2) receptor blockers, andproton pump inhibitors (PPIs).
These medicines can be helpful in reducing symptoms as you work on addressing the root cause of your reflux and take steps to make lifestyle changes.
OTC drugs to treat acid reflux are considered safe for intermittent use but may cause problems if daily use is excessive. If OTC drugs aren’t relieving your symptoms, talk with your healthcare provider about other treatment options.
Antacids
H2 Receptor Blockers
H2 receptor blockers reduce the production of stomach acids, which can minimize reflux. H2 blockers available over the counter include such popular brands as:
Side effects include constipation, diarrhea, dry mouth, headaches, and ringing in the ears (tinnitus).
In 2020, the Food and Drug Administration (FDA) issued a recall of all medications containing the ingredient ranitidine, including Zantac.In 2021, the manufacturer released a new version of the drug, called Zantac 360, with a new active ingredient: famotidine.
Proton Pump Inhibitors
Proton pump inhibitors offer similar action to H2 blockers but are stronger and faster. They include Nexium (esomeprazole), Prevacid (lansoprazole), Pantoprazole (protonix), and Prilosec (omeprazole). PPIs are more typically used if an H2 blocker fails to provide relief.
Common side effects are similar to those of H2 receptor blockers and include headache, constipation, diarrhea, and flatulence.
If OTC medications aren’t effective in relieving your heartburn symptoms, you may need a stronger version. Your healthcare provider will determine whether a prescription-strength H2 blocker or PPI is an option for you.
Surgery for a hiatal hernia is indicated if it has turned into a paraesophageal hernia and is causing symptoms that cannot be treated with medications or lifestyle changes.A paraesophageal hernia occurs when a hiatal hernia worsens and larger portions of the stomach begin to enter the chest cavity.
Surgery is also considered for sliding hernias if it’s associated with GERD. In this type of hernia, the stomach intermittently slides up into the chest through a small opening in the diaphragm.
A paraesophageal hernia has an increased risk of serious complications. These includevolvulus(a condition where the stomach twists more than 180 degrees) and strangulation (where blood circulation is cut off). Both are considered medical emergencies.
Paraesophageal hernias tend to be progressive, so it’s best to treat them sooner rather than later.
Open or Laparoscopic Repair
Either a transthoracic (“open”) or transabdominal (laparoscopic, or “keyhole”) surgery may be used to repair a paraesophageal hernia.
Nissen Fundoplication
Nissen fundoplicationis performed laparoscopically. The aim of the surgery is to tightly wrap the upper part of the stomach (called the fundus) around the esophagus and secure it in place with stitches or staples so that it’s held upright and supported.
If performed correctly, fundoplication can realign the LES into a position where it functions normally. Partial fundoplication, like a Toupet procedure, is an option. So is the transoral incisionless fundoplication (TIF), which is performed according to the same principles as a laparoscopic procedure.
Nissen fundoplication is considered safe and effective. It has less than 1% risk of mortality and an efficacy rate of 89.5% over 10 years.
Bloating, vomiting, burping, and difficulty swallowing are common postoperative side effects that tend to resolve on their own within two to four weeks.
How effective is hiatal hernia surgery?Researchers estimate that about 50% of patients undergoing laparoscopic repair experience small anatomic recurrences at long-term follow-up.
How effective is hiatal hernia surgery?
Researchers estimate that about 50% of patients undergoing laparoscopic repair experience small anatomic recurrences at long-term follow-up.
Hiatal Hernia Doctor Discussion GuideGet our printable guide for your next doctor’s appointment to help you ask the right questions.Download PDFEmail AddressSign UpThank you, {{form.email}}, for signing up.There was an error. Please try again.
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Complementary and Alternative Medicine (CAM)
In addition to antacids and acid blockers, some complementary therapies may provide some relief from acute reflux symptoms.
Licorice
Licorice, derived from thelicorice root, has long beenused to treat heartburnand other gastrointestinal symptoms. While research remains lacking, some studies have suggested that it has its place alongside traditional acid-blocking medications.
A 2013 study showed that the combined use of a licorice root extract and a prescription-strength PPI (pantoprazole) resulted in fewer symptoms of heartburn, chest pain, and abdominal swelling compared to using a PPI alone.
Licorice tea is one of the more common forms used. Another, known asdeglycyrrhizinatedlicorice (DGL), is available as a nutritional supplement and may be more tolerable due to the removal of glycyrrhizin (a substance known to lower blood potassium levels).
Ginger
Ginger is another popular option that may help alleviate heartburn symptoms. Ginger root is rich in antioxidants and contains compounds believed to reduce gastric contractions and, thus, lessen the likelihood of acid reflux.
However, if used in excess, ginger may have the opposite effect.
A 2014 study from Stanford University reported that, while ginger extract or powder form may relieve spasms and improvegastrointestinal motility, daily doses of higher than 5 grams could actually increase the risk of heartburn and abdominal discomfort.
Ginger can be purchased as a tea or in powder, capsule, or liquid formulations.
As with any CAM options, it’s best to discuss licorice and ginger with your healthcare provider before trying them.
Your initial appointment is usually with a general practitioner, such as an internist or family practitioner. If surgery is needed to repair your hernia, you will likely be referred to agastroenterologist—a doctor who specializes in digestive conditions.
How You Can Prepare
What to Expect
A healthcare provider will perform a physical exam, take a health history, and ask questions about your symptoms, such as:
Questions to Ask Your Healthcare Provider
Some questions to consider asking, depending on your health history, include:
When meeting with your healthcare provider, you may think of additional questions to ask.
Summary
A hiatal hernia is a common condition that can cause heartburn and other GERD-like symptoms. Your healthcare provider may suggest lifestyle changes, OTC antacids, or prescription medications to reduce your symptoms.
For a more severe case, known as paraesophageal hernia, surgery may be needed to prevent serious complications.
Frequently Asked Questions
Let your healthcare provider know if you’re having persistent symptoms, whether your symptoms get worse, or if they return despite treatment. If you’re experiencing chest pain, which can also be a symptom of a heart attack, seek emergency care.
Both laparoscopic and open repairsurgeriescan take two to three hours.
Coping With a Hiatal Hernia
20 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Medline Plus.Hiatal hernia.Sfara A, Dumitrascu DL.The management of hiatal hernia: an update on diagnosis and treatment.Med Pharm Rep. 2019 Oct;92(4):321-325. doi:10.15386/mpr-1323.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for GER & GERD.Argyrou A, Legaki E, Koutserimpas C, et al.Risk factors for gastroesophageal reflux disease and analysis of genetic contributors.WJCC. 2018;6(8):176-182. doi:10.12998/wjcc.v6.i8.176Cedars-Sinai.Hiatal Hernia.National Institute of Diabetes and Digestive and Kidney Diseases.Eating, diet, and nutrition for GER and GERD.National Institute of Diabetes and Digestive and Kidney Diseases.Smoking and the Digestive System.U.S. Food and Drug Administration.FDA requests removal of all ranitidine products (Zantac) from the market.April 1, 2020.Sanofi.Zantac information.Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).Guidelines for the Management of Hiatal Hernia.UConn Health Esophageal Disease Center.Hiatal & paraesophageal hernias.Lee DP, Chang KJ.Endoscopic Management of GERD.Dig Dis Sci.2022 May;67(5):1455-1468. doi:10.1007/s10620-022-07390-2.Maret-Ouda J, Yanes M, Konings P, Brusselaers N, Lagergren J.Mortality from laparoscopic antireflux surgery in a nationwide cohort of the working-age population.British Journal of Surgery. 2016;103(7):863-870. doi:10.1002/bjs.10141Moore M, Afaneh C, Benhuri D, Antonacci C, Abelson J, Zarnegar R.Gastroesophageal reflux disease: A review of surgical decision making.World Journal of Gastrointestinal Surgery. 2016;8(1):77-83. doi:10.4240/wjgs.v8.i1.77Chang CG, Thackeray L.Laparoscopic Hiatal Hernia Repair in 221 Patients: Outcomes and Experience.JSLS. 2016;20(1):e2015.00104. doi:10.4293/JSLS.2015.00104Di Pierro F, Gatti M, Rapacioli G.Outcomes in patients with nonerosive reflux disease treated with a proton pump inhibitor and alginic acid ± glycyrrhetinic acid and anthocyanosides.Clin Exp Gastroenterol.2013; 6:27-33. doi:10.2147/CEG.S42512.Yeh A, Golianu B.Integrative treatment of reflux and functional dyspepsia in children.Children(Basel). 2014;1(2):119-33. doi:10.3390/children1020119Johns Hopkins Medicine.Hiatal hernia.Mount Sinai.Hiatal Hernia.U.S. National Library of Medicine. MedlinePlus.Anti-reflux surgery.
20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Medline Plus.Hiatal hernia.Sfara A, Dumitrascu DL.The management of hiatal hernia: an update on diagnosis and treatment.Med Pharm Rep. 2019 Oct;92(4):321-325. doi:10.15386/mpr-1323.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for GER & GERD.Argyrou A, Legaki E, Koutserimpas C, et al.Risk factors for gastroesophageal reflux disease and analysis of genetic contributors.WJCC. 2018;6(8):176-182. doi:10.12998/wjcc.v6.i8.176Cedars-Sinai.Hiatal Hernia.National Institute of Diabetes and Digestive and Kidney Diseases.Eating, diet, and nutrition for GER and GERD.National Institute of Diabetes and Digestive and Kidney Diseases.Smoking and the Digestive System.U.S. Food and Drug Administration.FDA requests removal of all ranitidine products (Zantac) from the market.April 1, 2020.Sanofi.Zantac information.Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).Guidelines for the Management of Hiatal Hernia.UConn Health Esophageal Disease Center.Hiatal & paraesophageal hernias.Lee DP, Chang KJ.Endoscopic Management of GERD.Dig Dis Sci.2022 May;67(5):1455-1468. doi:10.1007/s10620-022-07390-2.Maret-Ouda J, Yanes M, Konings P, Brusselaers N, Lagergren J.Mortality from laparoscopic antireflux surgery in a nationwide cohort of the working-age population.British Journal of Surgery. 2016;103(7):863-870. doi:10.1002/bjs.10141Moore M, Afaneh C, Benhuri D, Antonacci C, Abelson J, Zarnegar R.Gastroesophageal reflux disease: A review of surgical decision making.World Journal of Gastrointestinal Surgery. 2016;8(1):77-83. doi:10.4240/wjgs.v8.i1.77Chang CG, Thackeray L.Laparoscopic Hiatal Hernia Repair in 221 Patients: Outcomes and Experience.JSLS. 2016;20(1):e2015.00104. doi:10.4293/JSLS.2015.00104Di Pierro F, Gatti M, Rapacioli G.Outcomes in patients with nonerosive reflux disease treated with a proton pump inhibitor and alginic acid ± glycyrrhetinic acid and anthocyanosides.Clin Exp Gastroenterol.2013; 6:27-33. doi:10.2147/CEG.S42512.Yeh A, Golianu B.Integrative treatment of reflux and functional dyspepsia in children.Children(Basel). 2014;1(2):119-33. doi:10.3390/children1020119Johns Hopkins Medicine.Hiatal hernia.Mount Sinai.Hiatal Hernia.U.S. National Library of Medicine. MedlinePlus.Anti-reflux surgery.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Medline Plus.Hiatal hernia.Sfara A, Dumitrascu DL.The management of hiatal hernia: an update on diagnosis and treatment.Med Pharm Rep. 2019 Oct;92(4):321-325. doi:10.15386/mpr-1323.National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for GER & GERD.Argyrou A, Legaki E, Koutserimpas C, et al.Risk factors for gastroesophageal reflux disease and analysis of genetic contributors.WJCC. 2018;6(8):176-182. doi:10.12998/wjcc.v6.i8.176Cedars-Sinai.Hiatal Hernia.National Institute of Diabetes and Digestive and Kidney Diseases.Eating, diet, and nutrition for GER and GERD.National Institute of Diabetes and Digestive and Kidney Diseases.Smoking and the Digestive System.U.S. Food and Drug Administration.FDA requests removal of all ranitidine products (Zantac) from the market.April 1, 2020.Sanofi.Zantac information.Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).Guidelines for the Management of Hiatal Hernia.UConn Health Esophageal Disease Center.Hiatal & paraesophageal hernias.Lee DP, Chang KJ.Endoscopic Management of GERD.Dig Dis Sci.2022 May;67(5):1455-1468. doi:10.1007/s10620-022-07390-2.Maret-Ouda J, Yanes M, Konings P, Brusselaers N, Lagergren J.Mortality from laparoscopic antireflux surgery in a nationwide cohort of the working-age population.British Journal of Surgery. 2016;103(7):863-870. doi:10.1002/bjs.10141Moore M, Afaneh C, Benhuri D, Antonacci C, Abelson J, Zarnegar R.Gastroesophageal reflux disease: A review of surgical decision making.World Journal of Gastrointestinal Surgery. 2016;8(1):77-83. doi:10.4240/wjgs.v8.i1.77Chang CG, Thackeray L.Laparoscopic Hiatal Hernia Repair in 221 Patients: Outcomes and Experience.JSLS. 2016;20(1):e2015.00104. doi:10.4293/JSLS.2015.00104Di Pierro F, Gatti M, Rapacioli G.Outcomes in patients with nonerosive reflux disease treated with a proton pump inhibitor and alginic acid ± glycyrrhetinic acid and anthocyanosides.Clin Exp Gastroenterol.2013; 6:27-33. doi:10.2147/CEG.S42512.Yeh A, Golianu B.Integrative treatment of reflux and functional dyspepsia in children.Children(Basel). 2014;1(2):119-33. doi:10.3390/children1020119Johns Hopkins Medicine.Hiatal hernia.Mount Sinai.Hiatal Hernia.U.S. National Library of Medicine. MedlinePlus.Anti-reflux surgery.
Medline Plus.Hiatal hernia.
Sfara A, Dumitrascu DL.The management of hiatal hernia: an update on diagnosis and treatment.Med Pharm Rep. 2019 Oct;92(4):321-325. doi:10.15386/mpr-1323.
National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for GER & GERD.
Argyrou A, Legaki E, Koutserimpas C, et al.Risk factors for gastroesophageal reflux disease and analysis of genetic contributors.WJCC. 2018;6(8):176-182. doi:10.12998/wjcc.v6.i8.176
Cedars-Sinai.Hiatal Hernia.
National Institute of Diabetes and Digestive and Kidney Diseases.Eating, diet, and nutrition for GER and GERD.
National Institute of Diabetes and Digestive and Kidney Diseases.Smoking and the Digestive System.
U.S. Food and Drug Administration.FDA requests removal of all ranitidine products (Zantac) from the market.April 1, 2020.
Sanofi.Zantac information.
Society of American Gastrointestinal and Endoscopic Surgeons (SAGES).Guidelines for the Management of Hiatal Hernia.
UConn Health Esophageal Disease Center.Hiatal & paraesophageal hernias.
Lee DP, Chang KJ.Endoscopic Management of GERD.Dig Dis Sci.2022 May;67(5):1455-1468. doi:10.1007/s10620-022-07390-2.
Maret-Ouda J, Yanes M, Konings P, Brusselaers N, Lagergren J.Mortality from laparoscopic antireflux surgery in a nationwide cohort of the working-age population.British Journal of Surgery. 2016;103(7):863-870. doi:10.1002/bjs.10141
Moore M, Afaneh C, Benhuri D, Antonacci C, Abelson J, Zarnegar R.Gastroesophageal reflux disease: A review of surgical decision making.World Journal of Gastrointestinal Surgery. 2016;8(1):77-83. doi:10.4240/wjgs.v8.i1.77
Chang CG, Thackeray L.Laparoscopic Hiatal Hernia Repair in 221 Patients: Outcomes and Experience.JSLS. 2016;20(1):e2015.00104. doi:10.4293/JSLS.2015.00104
Di Pierro F, Gatti M, Rapacioli G.Outcomes in patients with nonerosive reflux disease treated with a proton pump inhibitor and alginic acid ± glycyrrhetinic acid and anthocyanosides.Clin Exp Gastroenterol.2013; 6:27-33. doi:10.2147/CEG.S42512.
Yeh A, Golianu B.Integrative treatment of reflux and functional dyspepsia in children.Children(Basel). 2014;1(2):119-33. doi:10.3390/children1020119
Johns Hopkins Medicine.Hiatal hernia.
Mount Sinai.Hiatal Hernia.
U.S. National Library of Medicine. MedlinePlus.Anti-reflux surgery.
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