Hiatus hernia medical therapy

Jump to navigation Jump to search

Hiatus Hernia Microchapters


Patient Information


Historical Perspective




Differentiating Hiatus Hernia from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


Diagnostic Study of Choice

History and Symptoms

Physical Examination


Chest X Ray

Echocardiography or Ultrasound



Other Imaging Findings

Other Diagnostic Studies


Medical Therapy


Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hiatus hernia medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides


American Roentgen Ray Society Images of Hiatus hernia medical therapy

All Images
Echo & Ultrasound
CT Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hiatus hernia medical therapy

CDC on Hiatus hernia medical therapy

Hiatus hernia medical therapy in the news

Blogs on Hiatus hernia medical therapy

Directions to Hospitals Treating Hiatus hernia

Risk calculators and risk factors for Hiatus hernia medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]


In most cases, patients experience no discomfort and no treatment is required. However, when a hiatal hernia is large, it is likely to cause esophageal stricture which results in discomfort. Symptomatic patients benefit from not lying down immediately after meals and also benefit by elevating the head of their beds. If stress has been idetified as the major riskfactor, stress reduction techniques may be practiced, or if overweight, weight loss may be indicated. Certain medications causes lower esophageal sphincter (or LES to relax those medications should be avoided. Anti-acid drugs like proton pump inhibitors and H2 receptor blockers can be used to decrease the acid secretion.

Medical Therapy

Sliding hiatus hernia

Pharmacologic medical therapy is recommended among the patients with Sliding hiatus hernia when experince symptoms of gastroesophageal reflux disease (GERD) symptoms like:[1]

Lifestyle Modifications

Paraesophageal hernia 

  • Pharmacologic medical therapies for Paraesophageal hernia asymptomatic patients remain always  controversial.[10]


  1. 1.0 1.1 Hyun JJ, Bak YT (2011). "Clinical significance of hiatal hernia". Gut Liver. 5 (3): 267–77. doi:10.5009/gnl.2011.5.3.267. PMC 3166665. PMID 21927653.
  2. Piesman M, Hwang I, Maydonovitch C, Wong RK (2007). "Nocturnal reflux episodes following the administration of a standardized meal. Does timing matter?". Am. J. Gastroenterol. 102 (10): 2128–34. doi:10.1111/j.1572-0241.2007.01348.x. PMID 17573791.
  3. Kaltenbach T, Crockett S, Gerson LB (2006). "Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach". Arch. Intern. Med. 166 (9): 965–71. doi:10.1001/archinte.166.9.965. PMID 16682569.
  4. Pandolfino JE (February 2007). "Hiatal hernia and the treatment of Acid-related disorders". Gastroenterol Hepatol (N Y). 3 (2): 92–4. PMC 3099358. PMID 21960816.
  5. Sontag SJ (1990). "The medical management of reflux esophagitis. Role of antacids and acid inhibition". Gastroenterol. Clin. North Am. 19 (3): 683–712. PMID 1977703.
  6. Pandolfino JE (February 2007). "Hiatal hernia and the treatment of Acid-related disorders". Gastroenterol Hepatol (N Y). 3 (2): 92–4. PMC 3099358. PMID 21960816.
  7. Komazawa Y, Adachi K, Mihara T, Ono M, Kawamura A, Fujishiro H, Kinoshita Y (2003). "Tolerance to famotidine and ranitidine treatment after 14 days of administration in healthy subjects without Helicobacter pylori infection". J. Gastroenterol. Hepatol. 18 (6): 678–82. PMID 12753150.
  8. Inadomi JM, Jamal R, Murata GH, Hoffman RM, Lavezo LA, Vigil JM, Swanson KM, Sonnenberg A (2001). "Step-down management of gastroesophageal reflux disease". Gastroenterology. 121 (5): 1095–100. PMID 11677201.
  9. Inadomi JM, McIntyre L, Bernard L, Fendrick AM (2003). "Step-down from multiple- to single-dose proton pump inhibitors (PPIs): a prospective study of patients with heartburn or acid regurgitation completely relieved with PPIs". Am. J. Gastroenterol. 98 (9): 1940–4. doi:10.1111/j.1572-0241.2003.07665.x. PMID 14499769.
  10. Davis SS (2008). "Current controversies in paraesophageal hernia repair". Surg. Clin. North Am. 88 (5): 959–78, vi. doi:10.1016/j.suc.2008.05.005. PMID 18790148.