Seven Hiatal Hernia Treatments

Often, hiatal hernias do not require treatment. However, if you have symptoms such as gastrosophageal reflux (GERD) associated with a hiatal hernia may be treated.

Lifestyle changes for hiatal hernias

If you have mild acid reflux, diet and lifestyle changes are often the first treatment.

  1. Avoid foods in your diet that may trigger reflux symptoms including fatty foods, spicy foods, caffeine, chocolate, alcohol, or peppermint.
  2. Avoid large meals and eating late at night.
  3. Raise the head of your bed (put a foam wedge under the mattress, or wood blocks under the frame – using extra pillows does not help).
  4. Lose weight, quit smoking, wear loose clothing, and chew sugarless gum to increase saliva production.

Medication for hiatal hernias

Over-the-counter antacids (such as Tums, Maalox, Mylanta) are used for short-term relief of acid reflux.

  1. Histamine agonists (such as ranitidine [Zantac], famotidine [Pepcid], cimetidine [Tagamet], and nizatidine [Axid]) reduce acid production and are also available over-the-counter or by prescription.
  2. For more severe cases, you may be prescribed proton pump inhibitors (PPIs) such as omeprazole (Prilosec), esomeprazole (Nexium), or lansoprazole (Prevacid).

Surgery for hiatal hernia

Hiatal hernias rarely require surgery. If you have a hiatal hernia and symptoms are severe or the acid reflux causes damage to your esophagus, a surgery called a fundoplication may be necessary. This procedure, which can be done laproscopically, fixes the hiatal hernia and strengthens the muscle of the diaphragm to prevent the hernia from returning.

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Medically reviewed by John A. Daller, MD; American Board of Surgery with subspecialty certification in surgical critical care


UpToDate. Patient information: Acid reflux (gastroesophageal reflux disease) in adults (Beyond the Basics).