A hiatal hernia happens when a section of the stomach pushes through the diaphragm and into the chest cavity. Hiatal hernias do not always cause symptoms, but some people may experience heartburn as acid moves up from their stomach.

There are two types of hiatal hernias: sliding and paraesophageal (or rolling). More than 80% of hiatal hernias are sliding, which means that parts of the stomach and esophagus move in and out of the chest area.

About 5–15% of hiatal hernias are rolling hernias. These happen when part of the stomach pushes up through the hole in the diaphragm next to the esophagus.

This article will explain whether it is possible for people to treat a hiatal hernia by themselves. It will also explain what might happen if a person does not seek medical treatment.

a woman wearing a blue sweater is touching her chest in painShare on Pinterest
SCIENCE PHOTO LIBRARY/Getty Images

It is not possible for a person to make a hiatal hernia go away without medical care. However, hiatal hernias do not require treatment if they are not causing a person to experience symptoms.

If the hernia is asymptomatic and not causing any complications, the person may need to use a method that doctors call watchful waiting. This approach involves closely monitoring any symptoms as and when they occur.

Asymptomatic hiatal hernias become symptomatic and require reparative procedures at a rate of 1% per year.

However, a person can take steps to manage the symptoms of a hiatal hernia or help prevent it from reoccurring in the future.

A person should contact a medical professional before making any behavioral changes or trying any over-the-counter medications, including those that this article mentions.

The symptoms of a hiatal hernia may temporarily subside without treatment, especially if a person has a sliding hiatal hernia.

However, people with paraesophageal hiatal hernias are at risk of developing a complication known as a strangulated hernia. This complication occurs when the blood supply to the hernia becomes cut off, and it can lead to sepsis or even death.

The only treatment that can get rid of a paraesophageal hernia is surgery.

Therefore, anyone who suspects that they have a hernia should seek medical attention rather than trying to remedy it at home.

People with hiatal hernias may experience symptoms of gastrointestinal reflux disease (GERD) because of acid rising from their intestines. The first line of management for these symptoms involves dietary and behavioral changes.

Acid reflux can cause long-term damage to the esophagus, which has no protection against stomach acid. Therefore, it is important to treat symptoms instead of trying to live with them, even if they feel manageable.

Diet

Some diet-related tips that can help reduce gastric acid secretion include:

  • losing weight if a person is overweight or has obesity
  • raising the head of the bed by 8 inches before sleeping
  • avoiding eating within 2–3 hours of going to bed, as lying down on a full stomach can increase the severity of symptoms
  • eating regular small meals throughout the day rather than three large meals
  • avoiding foods that may trigger the condition, such as:
    • chocolate
    • alcohol
    • caffeine
    • spicy foods
    • citrus
    • carbonated beverages

Learn more about what to eat with a hiatal hernia here.

Exercise

A person may find that adjusting their posture and exercise routine can help relieve symptoms of a hiatal hernia.

For example, they should avoid lifting anything heavy and doing any activities that strain their abdominal muscles.

However, low impact exercises that do not strain the stomach, such as swimming and walking, may be beneficial for a person with a hiatal hernia.

Learn about exercises for people with a hiatal hernia here.

Other tips for managing symptoms

A person can amend their habits and behaviors in other ways to manage the symptoms of a hiatal hernia.

For instance, they can try:

  • elevating their head while sleeping
  • quitting smoking, to prevent irritation of the digestive system
  • taking steps to promote healthy bowel movements, such as staying hydrating and eating enough fiber, to avoid having to strain
  • refraining from wearing tight clothing that may restrict mobility and increase pressure around the abdomen

If lifestyle adjustments prove ineffective, a person can discuss medication options with a doctor.

Over-the-counter (OTC) medications

A person may wish to try using OTC medications to alleviate acid reflux that has occurred due to a hiatal hernia.

Antacids, such as Gaviscon or Tums, may help alleviate GERD symptoms. These can interact with other medications, so it is important to seek the advice of a pharmacist or another medical professional before taking them.

Prescription medications

A doctor may prescribe either histamine-2 receptor antagonists (H2RAs) or proton pump inhibitors (PPIs) to treat the symptoms of a hiatal hernia.

H2RAs block histamine, which is responsible for causing some cells in the stomach to create additional acid. Examples include:

PPIs are a common treatment option for people with GERD. The duration of the treatment plan may vary according to the size of the hernia.

PPIs block an enzyme necessary for acid secretion and include:

Surgery

The authors of a 2019 article note that most people experiencing paraesophageal hiatal hernias will get limited or no relief from medications and that the main treatment for these hernias is surgery.

Surgery may be laparoscopic, meaning that it uses small incisions and cameras to carry out the procedure. It will involve moving the portion of the stomach that has protruded through the diaphragm back to its correct position. The surgeon may also tighten the hiatal opening to prevent the hernia from reoccurring.

Learn more about surgery for hiatal hernias here.

A person should seek medical attention for a hiatal hernia if their symptoms become unmanageable or do not resolve after a few weeks.

They can also speak with a medical professional if they are looking to try new treatment methods to ease the symptoms of a hernia.

A strangulated hernia is a medical emergency, so it is important to get immediate medical care if a person with a hernia has any of the following symptoms:

  • severe or sharp pain
  • vomiting
  • bloody stools
  • constipation
  • malaise with or without a fever
  • a burning or hot sensation around the site of the hernia

It is not possible to fix a hiatal hernia at home, but a person can take steps to minimize and treat existing symptoms and to prevent the hernia from recurring.

These may include lifestyle changes, such as modifying the diet and starting a suitable exercise regimen, and OTC medications.

It is important to discuss any changes with a healthcare professional before implementing them.