Sliding (Type I) Hiatal Hernia - how it is treated.

A hiatal hernia occurs when the upper part of your stomach bulges through the diaphragm into your chest. This can cause symptoms like heartburn, acid reflux, and difficulty swallowing.

Your doctor may use the following to diagnose a hiatal hernia:

• Endoscopy: A camera inserted through the mouth to view the esophagus and stomach.

• Barium Swallow X-ray: You drink a chalky liquid, and X-rays show the stomach and esophagus.

• Esophageal Manometry: Measures esophageal muscle function.

• pH Monitoring: Checks for acid reflux.

Treatment Options

Treatment depends on the type and severity of the hernia. Many people manage symptoms with lifestyle changes or medications, while surgery is reserved for severe cases.

1. Lifestyle Changes:

   • Diet: Eat smaller, more frequent meals. Avoid trigger foods like spicy, fatty, or acidic foods (e.g., citrus, tomatoes, chocolate, caffeine).

   • Weight Management: Losing weight can reduce pressure on the stomach.

   • Posture: Avoid lying down for 2–3 hours after eating; elevate the head of your bed by 6–8 inches.

   • Avoid Triggers: Quit smoking, reduce alcohol, and avoid tight clothing that presses on the abdomen.

2. Medications:

   • Antacids: Neutralize stomach acid

   • H2 Blockers: Reduce acid production

   • Proton Pump Inhibitors (PPIs): Stronger acid reducers

   • Prokinetics: Help improve stomach emptying (used less commonly).

3. Surgery (for severe cases):

   • Hiatal Hernia Repair: The stomach is pulled back into place, and the hiatus is tightened.

   • Nissen Fundoplication: The stomach is wrapped around the esophagus to strengthen the lower esophageal sphincter.

     
     

Treatment of Hiatal Hernia

Living with a Hiatal Hernia

• Follow your doctor’s advice and take prescribed medications.

• Track symptoms and avoid known triggers.

• Maintain a healthy weight and avoid heavy lifting.

• Attend regular check-ups, especially if symptoms worsen.