Diaphragmatic Hernia (Hiatal Hernia): Drug Therapy

Therapy goals

  • Improvement of the symptomatology
  • Avoidance of complications of pyrosis (heartburn) as a sign of reflux esophagitis (esophagitis caused by frequent reflux of acidic gastric juice into the esophagus).

Therapy recommendations

  • Symptomatic therapy (for axial hiatal hernia): depending on the severity of symptoms:
    • Antacids/drugs to block gastric acid (for occasional heartburn).
    • Proton pump inhibitors (PPIs; acid blockers):
      • Long-term therapy often necessary due to high recurrence rates (recurrence).
      • Maintenance dosing (step down) according to symptoms in more severe courses of gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; peptic esophagitis); inflammatory disease of the esophagus (esophagitis) caused by the pathological reflux (reflux) of acid gastric juice and other gastric contents.
      • On demand therapy (when needed) for milder courses of GERD with a dose every 2-3 days.
      • In the absence of therapeutic success doubling or tripling the dose possible.
  • See also under “Further therapy“.