Can My Hiatal Hernia Heal on Its Own?

More than half of Americans over age 50 have a condition known as a hiatal hernia. With a hiatal hernia, part of your stomach has pushed itself upward into your chest cavity, bulging through the diaphragm and affecting your esophagus. 

Only about 9% of people with a hiatal hernia experience any symptoms, which can include regurgitation, gastroesophageal reflux disease (GERD), chronic cough, or asthma.

You may have been born with a hiatal hernia. More likely, though, it developed with age. Anything that adds pressure to your stomach can also cause a hiatal hernia, including pregnancy and obesity.

While you may wish a hiatal hernia would go away on its own, it won’t. If you don’t have symptoms, though, you don’t need to do anything. In general, asymptomatic hiatal hernias only become symptomatic and require surgery at a rate of about 1% per year.

At Slim Vegas Bariatric & General Surgery in Las Vegas, Nevada, fellowship-trained bariatric specialist Jon Williams, MD, diagnoses and treats hiatal hernias. Here’s what you need to know about managing this condition.

Change behaviors and diet

If you have mild symptoms, you may be able to manage your hiatal hernia with lifestyle changes. To reduce the secretion of gastric acid in to your chest and throat (heartburn), try:

• Losing weight
• Raising the head of your bed by 4-6 inches 
• Avoiding heavy meals 2-3 hours before bedtime
• Eating 4-5 small meals daily rather than three large ones

Also avoid foods that worsen GERD, such as tomatoes, onions, chocolate, carbonated beverages, spicy foods, caffeine, citrus, and alcohol. Eat plenty of fibrous whole foods and drink water to avoid constipation, which can worsen the hernia and symptoms. 

Exercise may also help reduce hiatal hernia symptoms. Avoid tight-fitting clothing, which may add pressure to your stomach. If you’re a smoker, quit.

Try medications

Medications that control GERD may give you some relief. Some choices include proton-pump inhibitors, such as:

• Omeprazole
• Esomeprazole
• Lansoprazole
• Pantoprazole 
• Rabeprazole
• Dexlansoprazole 

If you experience side effects from these drugs, such as headaches or nausea, you might try prescription-strength H-2 blockers, including famotidine and nizatidine, which generally have a low side-effect profile.

See a specialist about surgery

If lifestyle changes and medications don’t bring relief, or if your symptoms are severe, surgery is the only way to fix your hiatal hernia. A surgery known as fundoplication replaces your stomach in its original position and minimizes the opening in the diaphragm to prevent a recurrence. 

During the procedure, Dr. Williams also wraps the upper part of your stomach around your esophagus and secures it with stitches. He takes this step to create pressure at the base of your esophagus to prevent acid from traveling back up the esophagus and creating heartburn and other symptoms.

Hiatal hernia surgery is major surgery that requires a hospital stay and general anesthesia. If you’re a candidate for hiatal hernia repair, we give you preparation instructions as well as instructions for after-care. The surgery itself usually takes 2-3 hours.

After you recover, we work with you to ensure that you don’t develop another hernia by minimizing your risk factors. This may include helping you lose weight and designing a diet that minimizes heartburn.

Do you suffer from chronic heartburn, or has your doctor recommended that you undergo hiatal hernia surgery? Contact Slim Vegas by phone or online today.