WHAT IS THE TREATMENT OF HIATUS HERNIA?
If you have no symptoms, in most cases you do not need any treatment. The hiatus hernia usually causes no harm. Occasionally, if you have a hernia which is at risk of complications, you may be offered surgery, even if you do not have any symptoms.
- If you have reflux symptoms, you should aim to lose weight if you are overweight.
- Avoid anything that causes pressure on your stomach, such as tight clothing and corsets.
- If you are a smoker you should aim to stop. If you drink a lot of alcohol, it also helps to cut down on alcohol.
- Raising the head end of the bed may help with symptoms at night.
- Avoiding eating your dinner too close to bedtime may also help with symptoms at night. Aim to have your dinner at least three hours before you go to bed ideally.
- Smaller meals may be helpful, as may avoiding foods which you find make the reflux worse.
If changing your lifestyle does not help, you may need medication. Medicines which reduce the action or production of stomach acid may help. The most effective medicines are proton pump inhibitors (PPIs). PPIs often used are omeprazole or lansoprazole. If these do not suit you, other pills such as ranitidine or antacids may be used. Recent studies have raised questions about whether long-term PPIs are linked to stomach cancer. More research is needed. The current advice is to take PPIs at the lowest dose and for the shortest period of time possible; some people find they can get by taking them occasionally rather than every day. However, if other medicines do not help and your symptoms cause persistent problems, you should carry on with them for as long as required.
Hiatal Hernia Surgery
Rarely, a hiatus hernia causes severe symptoms of reflux which are not helped so well with medication. Therefore, best surgery for hiatal hernia is occasionally advised. Surgery for acid reflux hiatal hernia may also be advisable if you cannot tolerate the medication for some reason. During this operation the stomach is put back into the correct position and the weakened diaphragm muscle around the lower gullet (oesophagus) is tightened. The operation is usually done these days using a laparoscope (a telescope inserted into the stomach). The operation quite often needs repeating in due course.
Laparoscopically performing this procedure is the latest advancement and best surgery for hiatal hernia and leads to a lot faster recovery time.