A hernia occurring at the hiatus is referred to as a hiatal hernia. The hiatus is the opening in the diaphragm where the esophagus travels through to reach the stomach. The stomach occasionally bulges through the opening and causes the condition. The condition alone does not cause complications but may produce acid reflux. When acid reflux is present, a person may suffer additional symptoms such as belching, heartburn and nausea. Not all hiatal hernias cause symptoms, and some people may not even realize they have the condition. The treatment approach depends on the severity of the hernia.
Lifestyle Changes
Simple lifestyle changes may decrease acid reflux, the most common symptom of a hiatal hernia. Patients are often advised to eat several small meals throughout the day instead of simply breakfast, lunch and dinner. Patients are encouraged to walk or to engage in other light physical activity after meals rather than lying down soon after eating.
A patient's bed should be elevated at night to decrease acid reflux, advises Penn State's Hershey Medical Center. Physical activity also is recommended because it promotes weight loss; obesity is a risk factor for hiatal hernias. Smoking cessation is recommended to decrease chronic coughing, which can lead to a hiatal hernia. Patients should avoid heavy lifting and straining.
Medications
Both over-the-counter medications and prescription drugs may aid in treatment of acid reflux. Immediate relief occurs when patients take antacids. Side effects of antacids include diarrhea and constipation, reports MayoClinic.com.
Long-term relief may require medications such as stomach acid neutralizers and protein pump inhibitors, which prevent the production of stomach acid. These drugs are available over-the-counter and in stronger prescription forms.
Surgery
Surgical repair of a hiatal hernia is rare, reports Penn State's Hershey Medical Center. Still, invasive procedures sometimes are the only option when medications or lifestyle changes don't work.
A strangulated hernia occurs when the protruding stomach portion has lost all blood flow. This creates an emergency situation and requires immediate correction. The hernia may also be extremely large and symptoms severe. In surgery, the stomach is often repositioned and the hiatus made smaller to prevent future hernias. Prevention cannot be guaranteed, however.
