Prevention

It is difficult to prevent hiatal hernias. However, you can reduce your risk by maintaining a healthy weight and not smoking. To prevent hernias associated with increased abdominal pressure, avoid activities that cause abdominal strain, especially heavy lifting. If you frequently need to strain when you move your bowels, speak to your doctor. Your doctor may prescribe stool-softening medication or suggest that you modify your diet to include more high-fiber foods.

Treatment

Most hiatal hernias do not require treatment. When a hiatal hernia is associated with reflux symptoms, such as heartburn, you should eat smaller, more frequent meals; avoid eating for at least two hours before going to bed; and sit up for at least one hour after eating. If lifestyle changes do not relieve the symptoms, your doctor will suggest antacids or acid blockers. Many products are on the market, including both over-the-counter and prescription medications. Fewer than 5% of people require surgery. You may need surgery to repair the hernia if you have persistent reflux symptoms or inflammation of the esophagus (esophagitis) that is not healing with medication. Your doctor may advise surgery for a paraesophageal hernia that has a risk of incarcerating.