Medical Treatment of Hiatal Hernia

Abstract

Generally the initial treatment for symptomatic, uncomplicated hiatal hernia should be a trial of medical therapy. An ulcer-type regimen is instituted to inhibit reflux of gastric juice into the esophagus and reduce gastric hyperacidity. Other objectives are reduction of intra-abdominal pressure and control of aerophagy. Esophagoscopy is an important part of management. Coexisting chronic peptic ulcer of the esophagus, stomach or duodenum or gastric hyperacidity may tip the scales in favor of surgical repair of the hernia.