Treatment of Hiatal Hernia
Medical / Pharmacological Treatment
As previously mentioned, a hiatal hernia may cause certain symptoms such as heartburn and acid reflux. In cases where the hiatal hernia does not pose a serious risk to the patient, the physician may simply prescribe medications to reduce or eliminate the symptoms. Among the medications prescribed by Professor Aayed Alqahtani to patients are the following:
Antacids
Antacids work by neutralizing stomach acid, which causes heartburn. The physician may prescribe types containing aluminum hydroxide or magnesium hydroxide. It is important to note that these medications should not be overused to avoid issues such as constipation or diarrhea.
H2 Receptor Blockers
H2 Receptor Blockers reduce stomach acid production, helping to alleviate symptoms. Examples of these medications include:
Famotidine
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Nizatidine
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Cimetidine
Proton Pump Inhibitors
Proton Pump Inhibitors also reduce stomach acid production and contribute to accelerating the healing of esophageal ulcers if present. Examples include:
Lansoprazole
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Esomeprazole
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Omeprazole
Surgical Treatment
Surgical intervention for hiatal hernia is typically resorted to in specific cases, such as unresponsiveness to medical treatment, presence of severe symptoms, or development of significant health complications. Professor Aayed Alqahtani outlines the types of surgeries used to treat hiatal hernias below:
Stitches and Mesh Repair
This type of procedure is used in simple cases or early stages of the hernia, and involves:
Using medical sutures to tighten and close the hernia in the diaphragm muscle.
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Placing a mesh to support the area and prevent the stomach from protruding through the diaphragm muscle into the esophageal region.
Nissen Fundoplication
Known as Nissen Fundoplication, this is a common procedure performed laparoscopically. Sutures are used to wrap the upper part of the stomach around the lower esophagus to help secure the stomach in place.
Endoluminal Fundoplication
Endoluminal fundoplication is a less common type of procedure for treating hiatal hernia. In this method, an endoscope is used to secure the stomach and narrow the hernia site through the esophagus, without the need for large surgical incisions or cuts in the abdomen.
Collis-Nissen Gastroplasty
Known as Collis-Nissen gastroplasty, this procedure is used in cases where the patient suffers from a shortened esophagus. A portion of the stomach tissue is utilized or modified to effectively lengthen the esophagus.
Open Surgery
In rare cases, open surgery may be required, involving a large abdominal incision to secure the stomach inside the abdominal cavity while narrowing the junction between the stomach and the esophagus. A medical feeding or drainage tube may occasionally be attached to the stomach to help it stabilize in position for several weeks before the physician removes it.
