Stephen J. Schueler, M.D.

Overview Incidence Risk Factors Symptoms Evaluation Treatment questions for doctor specialist Home Care warning signs Complications Underlying Cause Anatomy

Hiatal Hernia Treatment

Treatment for hiatal hernia is usually directed at controlling symptoms of acid reflux. Less commonly, hiatal hernia may cause chest or abdominal discomfort.

Treatment for hiatal hernia usually includes antacids, acid blockers, and proton pump inhibitors. Those with more severe symptoms of hiatal hernia, or those who fail to respond to medications, may be candidates for surgery.

Treatment for hiatal hernia may include:

Surgical procedures for persistent symptoms of acid reflux include:
  • Laparoscopic fundoplication:
    • Minimally invasive surgery: performed using laparoscopy
    • This procedure tightens the lower esophageal sphincter, allowing this valve to keep stomach acid where it belongs.
    • Over 90 percent of people having this procedure have satisfactory results.
  • Endoscopic fundoplication:
    • Involves using tiny stitches to tighten the lower esophagus.
    • This operation may be performed from inside the esophagus using an endoscope.
  • Endoscopic radiofrequency ablation:
    • Also known as the Stretta procedure
    • May be performed as outpatient surgery
    • May be performed in as little as 45 minutes using conscious sedation
    • Lower incidence of side effects as compared to other anti-reflux surgery.
    • Uses a radiofrequency probe placed inside the esophagus by a procedure that is identical to upper GI endoscopy.
    • Like a microwave, this device heats the tissues of the valve, causing them to scar and close tighter.

Hiatal Hernia Questions For Doctor

The following are some important questions to ask before and after the treatment of hiatal hernia.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • What else can I do to reduce my risk for complications?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Hiatal Hernia Specialist

Physicians from the following specialties evaluate and treat hiatal hernias:

Continue to Hiatal Hernia Home Care

Last Updated: Dec 15, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Hiatal Hernia References
  1. Gorenstein A, Cohen AJ, Cordova Z, Witzling M, Krutman B, Serour F. Hiatal hernia in pediatric gastroesophageal reflux. J Pediatr Gastroenterol Nutr. 2001 Nov;33(5):554-7. [11740228]
  2. Jones MP, Sloan SS, Rabine JC, Ebert CC, Huang CF, Kahrilas PJ. Hiatal hernia size is the dominant determinant of esophagitis presence and severity in gastroesophageal reflux disease. Am J Gastroenterol. 2001 Jun;96(6):1711-7. [1141981]
  3. Leeder PC, Smith G, Dehn TC. Laparoscopic management of large paraesophageal hiatal hernia. Surg Endosc. 2003 Sep;17(9):1372-5. [12820060]
  4. Puri V, Kakarlapudi GV, Awad ZT, Filipi CJ. Hiatal hernia recurrence: 2004. Hernia. 2004 Dec;8(4):311-7. [15300469]
  5. Wu AH, Tseng CC, Bernstein L. Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma. Cancer. 2003 Sep 1;98(5):940-8. [12942560]
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