Treatment for hiatus, or hiatal, hernia includes lifestyle modifications, smoking cessation and medication to manage symptoms; in some people, surgery may be indicated, according to Cleveland Clinic. Patients requiring surgery generally have severe gastroesophageal reflux, or GERD, symptoms or hernias that are complicated by the presence of paraesophageal hernias.
Many people with hiatal hernia require no treatment, since they experience no symptoms, advises Cleveland Clinic. However, mild symptoms like stomach discomfort, bloating and heartburn can be treated successfully with lifestyle changes, such as losing weight if needed and eating smaller portions of food. Limiting acidic or fatty foods can also help to control symptoms, as can avoiding alcoholic beverages and caffeine. Avoiding food for up to 4 hours before bedtime and forgoing snacking at bedtime may also help.
Those with symptomatic hiatal hernias can also elevate the heads of their beds by 6 inches; this helps keep the contents of the stomach from backing up into the neck, according to Cleveland Clinic. Taking over-the-counter medications such as antacids and histamine-2 blockers such as Zantac or Pepcid AC, may also help. Cessation of smoking is generally recommended for the hiatal hernia sufferer.
Surgery may become necessary when the hiatal hernia is accompanied by GERD or when a strangulated hernia or obstruction occurs, according to the Cleveland Clinic.