Sliding Hiatal Hernia Treatments

A sliding hiatal hernia is a protrusion of part of your stomach into your chest area and into an opening in your diaphragm. The hernia slides back and forth between the stomach and the chest cavities. Small hiatal hernias may cause no symptoms, but larger ones may cause indigestion and chest pain.

Symptoms

• Symptoms of sliding hiatal hernias include belching, heartburn that is worse when lying down, chest pain and nausea. In cases where the protrusion becomes twisted, you may experience difficulty swallowing and severe chest pain.

Diagnosis

• Before a barium x-ray, you drink a chalky liquid that coats your upper digestive tract. This allows your doctor a clear view of your esophagus and stomach on an x-ray. In endoscopy, your doctor threads a flexible, lighted tube with and camera on the end down your throat into your stomach. This instrument allows your doctor to see protrusions or inflammation in your stomach and esophagus.

Medications

• Over-the-counter antacids, such as Mylanta and Maalox, may relieve heartburn pain and neutralize acid in the esophagus. H-2 blockers, such as Tagamet and Pepcid, reduce acid in your stomach by blocking histamine receptors. These medications are best taken before meals but can be taken after symptoms appear. H-2 blockers can interfere with other medications, so consult your doctor before taking them. Proton pump inhibitors, such as Nexium, and Prevacid, block acid formation, allowing the esophagus to heal. These drugs can be taken once a day over a longer period but are expensive.

Lifestyle Changes

• Avoid alcohol, caffeinated beverages and spicy foods, which cause excess acid production. If you are overweight, losing weight will reduce pressure on your stomach. Elevate your head in bed to prevent stomach acid from moving up your esophagus. Do not perform intensive exercises right after eating, and eat smaller meals to keep from distending your stomach.

Surgery

• When lifestyle changes or medications fail to provide relief, surgery may be recommended. During laparoscopic surgery, a surgeon makes small incisions in your abdomen and inserts instruments and a small camera. The surgeon performs the procedure using images from the camera. The surgery involves pushing the hernia or protrusion back down into your stomach and creating a smaller diaphragm opening. Surgery could also involve removal of the hernia sac. The laparoscopic surgery causes less pain and a shorter hospital stay than traditional surgery.