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Hernia, hiatus - Treating a hiatus hernia

NHS Choices Medical Reference

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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

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

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

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

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

Surgery is an option if medication does not relieve symptoms.

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). See useful links for more information on laparoscopy.

The operation is not complicated and most patients go home the same day.

Medical Review: July 06, 2009
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