The best treatment for a hiatal hernia depends on the severity and whether you have symptoms.

A hiatal hernia is when part of your stomach or another organ slips through a hole in your diaphragm, the parachute-like organ above your stomach. Mild hiatal hernias often don’t cause symptoms, while severe hernias can cause life threatening gastrointestinal (GI) obstruction.

Your chances of developing a hiatal hernia increase with age. Symptomatic hiatal hernias are estimated to occur in about 9% of adults over age 50.

Hiatal hernia symptoms can often be managed conservatively with lifestyle changes and medications. Surgery may be required if you develop complications like gastroesophageal reflux disease (GERD) that persists or if you have a large hernia at risk of causing serious complications.

Read on to learn more about the treatment options for hiatal hernias.

Watchful waiting is when a doctor monitors your hernia, but no particular treatment is administered.


Watchful waiting can be combined with dietary or lifestyle changes. It avoids the need to undergo surgery or to take medications that can cause side effects.


Some untreated hernias may get worse over time or cause persistent symptoms such as chronic heartburn.

The most common symptom of hiatal hernia is GERD. Making dietary changes can potentially help improve or alleviate symptoms of GERD.

Avoiding the following may help relieve your symptoms:

  • onions and garlic
  • high sodium foods
  • peppermint or mint
  • chocolate
  • fried or spicy foods
  • tomatoes
  • citrus fruit
  • alcohol
  • coffee and caffeine
  • whole milk
  • carbonated drinks

Learn more about what to eat if you have a hiatal hernia.


Making dietary changes may help you reduce chronic heartburn associated with a hiatal hernia. Research supports the idea that reducing simple sugars, increasing fiber intake, and making changes to your overall eating pattern may improve GERD symptoms.


Making dietary changes to prevent GERD has little risk. You may have caffeine withdrawal if you suddenly give up caffeine.

GERD caused by mild hernias can often be managed with lifestyle modifications. These lifestyle changes can include:

  • losing weight if you’re overweight
  • elevating your head while sleeping
  • avoiding meals 2–3 hours before bed
  • eliminating trigger foods
  • eating smaller meals


You may find that lifestyle changes alone allow you to manage your symptoms without the need to take medications or undergo surgery.


Making lifestyle habits alone may not be enough to resolve your symptoms and may delay medical treatment.

The American College of Gastroenterology recommends an 8-week course of proton pump inhibitors (PPIs) as the initial treatment for GERD. They recommend the lowest dose that provides symptom relief.


PPIs can often relieve GERD symptoms associated with hiatal hernias. Many different types of PPIs have been used to successfully treat GERD, including:

  • omeprazole
  • esomeprazole
  • rabeprazole
  • zegerid
  • pantoprazole


PPIs are often well tolerated and rarely cause serious side effects. Side effects can include:

Hiatal hernias can be subdivided into sliding and paraesophageal hernias.

  • Sliding hernias develop when part of the top of your stomach slips through your diaphragm.
  • Paraesophageal hernias occur when your stomach is pushed next to your esophagus, or another organ protrudes through your diaphragm.

Surgery is generally recommended for:

  • people with sliding hernias and GERD that does not respond to conservative treatment
  • people with paraesophageal hernias causing symptoms
  • severe hernias obstructing your GI tract
  • all large hernias or paraesophageal hernias in people under age 60

Learn more about surgery for hiatal hernias here.


Surgery may relieve symptoms in people with moderate to severe hernias. It can also be a life-saving treatment for people with serious complications like GI tract obstruction.

Research suggests that surgery may reduce symptoms by as much as 90% over 10 years.


Most complications from hiatal hernia surgery are minor and not directly related to surgery. Complications can include:

  • collapsed lung, in less than 2% of people
  • stomach or esophageal injuries, in about 1% of surgeries
  • spleen or liver injury in about 2.3% of people, which is rarely serious
  • trouble swallowing

Here are some frequently asked questions people have about hiatal hernia treatment.

Can a hiatal hernia go away on its own?

Mild hiatal hernias may go away on their own without treatment. In a 2020 study, researchers found that 5 of 81 research participants with hiatal hernias had their hernias resolve without treatment before a 10-year follow-up.

Can you fix a hiatal hernia yourself?

It’s important to consult a doctor on how to best treat your hernia. They may tell you that it’s safe to treat your hernia with lifestyle changes alone.

What is the most common treatment for hiatal hernia?

About 95% of hiatal hernias are classified as sliding hernias. These hernias usually don’t require treatment if you don’t have symptoms. PPIs are commonly prescribed to reduce GERD symptoms.

What size hiatal hernia needs surgery?

Large hiatal hernias may need surgery. There’s no exact definition of a large hernia. In a 2022 study, researchers proposed that sliding hernias should be considered large if they’re bigger than 7 centimeters (2.8 inches) or if more than half your stomach is involved.

Hiatal hernias occur when part of your stomach or another organ protrudes through a hole in your diaphragm. They can often be treated with conservative options such as dietary changes, medications, or changing lifestyle habits.

You may need surgery if your symptoms do not respond to more conservative therapies. Surgery is also used to relieve emergency symptoms like GI tract obstruction.