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Hiatal Hernia Medication

  • Author: Waqar A Qureshi, MD; Chief Editor: Julian Katz, MD  more...
Updated: Jan 03, 2016

Medication Summary

Symptomatic acid reflux can be treated medically, either by neutralizing acid with antacids or blocking acid secretion with H2-receptor blocking drugs or the more potent PPIs. The treatment of GERD is discussed in Gastroesophageal Reflux Disease. Hiatal hernias, per se, only require attention if they are causing symptoms because of their size or if the patient is at risk of strangulation, in which case surgery may be indicated.

Contributor Information and Disclosures

Waqar A Qureshi, MD Professor of Medicine, Chief of Endoscopy, Department of Internal Medicine, Division of Gastroenterology, Baylor College of Medicine

Waqar A Qureshi, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Society for Gastrointestinal Endoscopy

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Julian Katz, MD Clinical Professor of Medicine, Drexel University College of Medicine

Julian Katz, MD is a member of the following medical societies: American College of Gastroenterology, American College of Physicians, American Gastroenterological Association, American Geriatrics Society, American Medical Association, American Society for Gastrointestinal Endoscopy, American Society of Law, Medicine & Ethics, American Trauma Society, Association of American Medical Colleges, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Additional Contributors

Vivek V Gumaste, MD Associate Professor of Medicine, Mount Sinai School of Medicine of New York University; Adjunct Clinical Assistant, Mount Sinai Hospital; Director, Division of Gastroenterology, City Hospital Center at Elmhurst; Program Director of GI Fellowship (Independent Program); Regional Director of Gastroenterology, Queens Health Network

Vivek V Gumaste, MD is a member of the following medical societies: American College of Gastroenterology, American Gastroenterological Association

Disclosure: Nothing to disclose.

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Hiatal hernia. Figure 1 shows the normal relationship of the gastroesophageal junction, stomach, esophagus, and diaphragm. Figure 2 shows a sliding hiatal hernia where the stomach immediately below the gastroesophageal junction is seen to prolapse through the diaphragmatic hiatus into the chest. Figure 3 shows a paraesophageal hernia in which the cardia or fundus of the stomach prolapses through the diaphragmatic hiatus, leaving the gastroesophageal junction within the esophageal cavity.
Anteroposterior (left and lateral views (right) on a chest radiograph showing a large hiatal hernia. Courtesy of David Y. Graham, MD.
Barium study shows a sliding hiatal hernia: The gastric folds can be seen extending above the diaphragm. Courtesy of David Y. Graham, MD.
A paraesophageal hernia is seen on an upper gastrointestinal series. Note that the gastroesophageal junction remains below the diaphragm. Courtesy of David Y. Graham, MD.
Paraesophageal hernia is seen on barium upper gastrointestinal series. The mucosal folds are seen going up into the chest, next to the esophagus. Courtesy of David Y. Graham, MD.
Barium radiograph view of a large paraesophageal hernia. Courtesy of David Y. Graham, MD.
A large paraesophageal hernia in which the entire stomach is seen in the chest cavity. Courtesy of David Y. Graham, MD.
Barium studies show gastric volvulus as the herniated stomach undergoes rotation. This situation requires surgical intervention. Courtesy of David Y. Graham, MD.
A retrograde view of a hiatal hernia seen at endoscopy shows the gastric folds to the left of the scope shaft extending up into the hernia. Courtesy of David Y. Graham, MD.
Inderpal S. Sarkaria, MD, discusses the options for paraesophageal hernia repair. Courtesy of Memorial Sloan-Kettering Cancer Center.
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