Medication
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.
Media Gallery
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Hiatal Hernia. Figure 1 shows the normal relationship of the gastroesophageal (GE) junction, stomach, esophagus, and diaphragm. Figure 2 shows a sliding hiatal hernia, in which the stomach immediately below the GE 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 GE junction within the esophageal cavity.
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Hiatal Hernia. These anteroposterior (left) and lateral views (right) on a chest radiograph showing a large hiatal hernia. Courtesy of David Y Graham, MD.
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Hiatal Hernia. This barium study shows a sliding hiatal hernia: The gastric folds can be seen extending above the diaphragm. GE = gastroesophageal. Courtesy of David Y Graham, MD.
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Hiatal Hernia. A paraesophageal hernia is seen on an upper gastrointestinal radiograph series. Note that the gastroesophageal (GE) junction remains below the diaphragm. Courtesy of David Y Graham, MD.
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Hiatal Hernia. A paraesophageal hernia is seen on a barium upper gastrointestinal radiograph series. The mucosal folds are seen going up into the chest, next to the esophagus. GE = gastroesophageal. Courtesy of David Y Graham, MD.
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Hiatal Hernia. This image is a barium radiograph view of a large paraesophageal hernia. GE = gastroesophageal. Courtesy of David Y Graham, MD.
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Hiatal Hernia. This barium radiograph shows a large paraesophageal hernia in which the entire stomach is seen in the chest cavity. Courtesy of David Y Graham, MD.
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Hiatal Hernia. These barium studies show gastric volvulus as the herniated stomach undergoes rotation. This situation requires surgical intervention. Courtesy of David Y Graham, MD.
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Hiatal Hernia. 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.
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Hiatal Hernia. Inderpal S Sarkaria, MD, discusses the options for paraesophageal hernia repair. Courtesy of Memorial Sloan-Kettering Cancer Center.
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Hiatal Hernia. This image shows a Linx device in place during laparoscopic surgery. Courtesy of Shawn S Groth, MD, MS, FACS.
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Hiatal Hernia. This image demonstrates a Linx device in place on x-ray. Courtesy of Shawn S Groth, MD, MS, FACS.
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