If your hiatus hernia doesn't cause any symptoms, there's 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 (gullet) and reduce the amount of stomach acid that's 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 reach the oesophagus and stomach, they help to neutralise the acid (make it less acidic).
Antacid medicines don't work for everyone. They're 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're 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're usually the first treatment for gastro-oesophageal reflux disease (GORD), which can be a symptom of hiatus hernia. Prescribed drugs include omeprazole, lansoprazole, rabeprazole and esomeprazole.
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 may be an option in some cases of hiatus hernia if medication doesn't relieve your symptoms. Surgery may also be recommended for cases of GORD that do not respond to other treatments.
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 most commonly performed using laparoscopy (the least invasive technique, where several small incisions are made in your abdomen). See the Health A-Z topic about Laparoscopy for more information about this procedure.
The operation isn't complicated. Most people go home after an overnight stay.
See GORD - treatment for more information about the surgery used to treat this condition.
