Lifestyle Treatment and Medication

• Treating a minor hiatal hernia that causes symptoms is as simple as changing aspects of your lifestyle and day-to-day activities. If you're overweight, then losing weight can decrease the risk of acid reflux and heartburn as well as keep you healthy. Eating smaller meals also can help reduce the amount of pressure placed on your stomach and decrease this risk as well. If these remedies provide little relief, a number of medications can help combat the development and release of stomach acid.
  
  Over-the-counter antacids, such as Tums and Maalox, provide a short-term fix for unwanted acid reflux. They work by controlling the amount of acid in your stomach, decreasing the risk of it splashing back into the esophagus through the hernia.
  
  H-2 blockers, available via prescription and over the counter, are used to prevent acid from being released into the stomach by hindering the normal function of histamine receptors in the body. Examples include ranitidine and famotidine, which are the active ingredients in the over-the-counter medications Zantac and Pepcid, respectively. Although beneficial, they can cause side effects, such as dizziness, drowsiness, dry mouth and changes in normal bowel function.
  
  The best medications available for treating gastroesophageal reflux are called proton pump inhibitors, which include pantoprazole and esomeprazole. They are the most expensive option, and they work by blocking the production of acid, allowing sufficient time for the esophagus to heal. They can cause stomach pain, and so it is best to take the lowest dose possible.
  
  

Surgery

• When medication and lifestyle treatments prove to be ineffective, or if the hernia is severe enough to cause internal bleeding or other symptoms, such as shortness of breath and difficulty breathing, surgery is recommended to provide long-term relief. One method of surgically repairing a hiatal hernia is through removing the protruding portion of the stomach from the hole in the diaphragm, placing the stomach back in the abdomen and making the hole smaller. Other options include having the esophageal sphincter reconstructed and removing the hernia sac. Your doctor will decide which option is best for you. This surgery can be done through the abdomen (laparotomy) or through the chest wall (thoracotomy). The preferred method, however, is laparascopic surgery, which involves an incision in the abdominal wall and a small camera to seek out the hernia so it can be repaired while being viewed on a monitor. This is far less invasive and leaves minimal scarring. In the end, however, the method of surgery is dependent on the severity of your hernia and your doctor's recommendation.