For those individuals who don't have any symptoms, they don't require any treatment for their hiatal hernia. For others, lifestyle changes and medications will control their symptoms. It is only for a minority of patients who experience severe symptoms of reflux despite lifestyle changes and medications, or who develop complications such as stricture, bleeding or an obstruction, will surgery be considered.

Lifestyle changes for a hiatal hernia include diet modification, not smoking, avoiding alcohol, and taking measures to reduce acid reflux during the day and acid reflux at night.

Medications include taking antacids, H2 Antagonists, and Proton Pump Inhibitors.

During hiatal hernia repair surgery, the stomach and lower esophagus are placed back into the abdominal cavity, and the hiatus (the opening in the diaphram where the esophagus and stomach join) is tightened. The upper part of the stomach (fundus) may be wrapped around the esophagus (fundoplication) to reduce acid reflux.

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