In most cases, small hernias do not cause symptoms or require treatment. A large hernia may require treatment with medications or surgery.
For people with a large hiatal hernia, repair surgery is sometimes the best option when medications and lifestyle changes have been ineffective. Repair surgery initially involves pulling your stomach down into your abdomen (reduction) and can be combined with other surgeries such as those for gastroesophageal reflux disease (GERD). Based on the cause of your symptoms, your doctor may recommend one of the following additional surgical options after reduction.
Fundoplication. The top part of the stomach is wrapped around the bottom part of the esophagus to strengthen it. The defect in the diaphragm also is closed.
Gastropexy. The stomach is attached to the abdominal wall, if it moves around easily after reduction.
Esophagectomy. The surgeon removes most of your esophagus and attaches your stomach to the remaining portion.
Dec. 08, 2011
- Brady MF. Hiatal hernia. In: Ferri FF. Ferri's Clinical Advisor 2012: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05611-3..C2009-0-38601-8--TOP&isbn=978-0-323-05611-3&uniqId=291436269-101. Accessed Oct. 17, 2011.
- Jeyarajah R, et al. Abdominal hernias and gastric volvulus. In: Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Oct. 17, 2011.
- Keifer D. Gastroesophageal reflux disease. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/162991320-4/0/1494/0.html. Accessed Oct. 17, 2011.
- Heartburn or gastroesophageal reflux disease (GERD). The American College of Gastroenterology. http://www.acg.gi.org/patients/women/whatisgerd.asp. Accessed Oct. 17, 2011.
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