Hiatus hernia medical therapy: Difference between revisions

Jump to navigation Jump to search
Line 6: Line 6:
In most cases, Most of the time patients experience no discomfort and no treatment is required. However, when a hiatal hernia is large, it is likely to cause [[esophageal stricture]] which results in discomfort. Symptomatic patients benefit from not lying down immediately after meals and also benefit by elevating the head of their beds.  If stress has been idetified as the major riskfactor,  [[stress management|stress reduction techniques]] may be practiced, or if overweight, [[weight loss]] may be indicated. Certain medications causes  [[lower esophageal sphincter]] (or [[Lower esophageal sphincter|LES]] to relax those medications should be avoided.  Anti-acid drugs like [[proton pump inhibitors]] and [[Histamine H2 receptor|H2 receptor]] blockers can be used to decrease the acid secretion.   
In most cases, Most of the time patients experience no discomfort and no treatment is required. However, when a hiatal hernia is large, it is likely to cause [[esophageal stricture]] which results in discomfort. Symptomatic patients benefit from not lying down immediately after meals and also benefit by elevating the head of their beds.  If stress has been idetified as the major riskfactor,  [[stress management|stress reduction techniques]] may be practiced, or if overweight, [[weight loss]] may be indicated. Certain medications causes  [[lower esophageal sphincter]] (or [[Lower esophageal sphincter|LES]] to relax those medications should be avoided.  Anti-acid drugs like [[proton pump inhibitors]] and [[Histamine H2 receptor|H2 receptor]] blockers can be used to decrease the acid secretion.   
==Medical Therapy==
==Medical Therapy==
'''Sliding hiatus hernia'''
Pharmacologic medical therapy is recommended among the patients with '''Sliding hiatus hernia''' when experince symptoms of gastroesophageal reflux disease (GERD) symptoms like
* [[Nausea]]
* [[Vomiting]]
* [[Regurgitation]]
* [[Heart burn]]
* [[Regurgitation]]
* [[Dysphagia]]
===Lifestyle Modifications===
===Lifestyle Modifications===
*The following measures are recommended as the first line to treat GERD:<ref name="pmid17573791">{{cite journal |author=Piesman M, Hwang I, Maydonovitch C, Wong RK |title=Nocturnal reflux episodes following the administration of a standardized meal. Does timing matter? |journal=Am. J. Gastroenterol. |volume=102 |issue=10 |pages=2128–34 |year=2007 |pmid=17573791 |doi=10.1111/j.1572-0241.2007.01348.x}}</ref><ref name="pmid16682569">{{cite journal |author=Kaltenbach T, Crockett S, Gerson LB |title=Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach |journal=Arch. Intern. Med. |volume=166 |issue=9 |pages=965–71 |year=2006 |pmid=16682569 |doi=10.1001/archinte.166.9.965}}</ref><ref name="pmid259568342">{{cite journal| author=Ness-Jensen E, Hveem K, El-Serag H, Lagergren J| title=Lifestyle Intervention in Gastroesophageal Reflux Disease. | journal=Clin Gastroenterol Hepatol | year= 2016 | volume= 14 | issue= 2 | pages= 175-82.e1-3 | pmid=25956834 | doi=10.1016/j.cgh.2015.04.176 | pmc=4636482 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25956834  }}</ref><ref>Khoury RM, Camacho-Lobato L, Katz PO, Mohiuddin MA, Castell DO. Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease. ''Am J Gastroenterol'' 1999;94:2069-73. PMID 10445529.</ref>
*The following measures are recommended as the first line to treat GERD:<ref name="pmid17573791">{{cite journal |author=Piesman M, Hwang I, Maydonovitch C, Wong RK |title=Nocturnal reflux episodes following the administration of a standardized meal. Does timing matter? |journal=Am. J. Gastroenterol. |volume=102 |issue=10 |pages=2128–34 |year=2007 |pmid=17573791 |doi=10.1111/j.1572-0241.2007.01348.x}}</ref><ref name="pmid16682569">{{cite journal |author=Kaltenbach T, Crockett S, Gerson LB |title=Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach |journal=Arch. Intern. Med. |volume=166 |issue=9 |pages=965–71 |year=2006 |pmid=16682569 |doi=10.1001/archinte.166.9.965}}</ref><ref name="pmid259568342">{{cite journal| author=Ness-Jensen E, Hveem K, El-Serag H, Lagergren J| title=Lifestyle Intervention in Gastroesophageal Reflux Disease. | journal=Clin Gastroenterol Hepatol | year= 2016 | volume= 14 | issue= 2 | pages= 175-82.e1-3 | pmid=25956834 | doi=10.1016/j.cgh.2015.04.176 | pmc=4636482 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25956834  }}</ref><ref>Khoury RM, Camacho-Lobato L, Katz PO, Mohiuddin MA, Castell DO. Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease. ''Am J Gastroenterol'' 1999;94:2069-73. PMID 10445529.</ref>

Revision as of 19:34, 7 February 2018

Hiatus Hernia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hiatus Hernia from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Electrocardiogram

Chest X Ray

Echocardiography or Ultrasound

MRI

CT

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hiatus hernia medical therapy On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hiatus hernia medical therapy

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hiatus hernia medical therapy

CDC on Hiatus hernia medical therapy

Hiatus hernia medical therapy in the news

Blogs on Hiatus hernia medical therapy

Directions to Hospitals Treating Hiatus hernia

Risk calculators and risk factors for Hiatus hernia medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

Overview

In most cases, Most of the time patients experience no discomfort and no treatment is required. However, when a hiatal hernia is large, it is likely to cause esophageal stricture which results in discomfort. Symptomatic patients benefit from not lying down immediately after meals and also benefit by elevating the head of their beds. If stress has been idetified as the major riskfactor, stress reduction techniques may be practiced, or if overweight, weight loss may be indicated. Certain medications causes lower esophageal sphincter (or LES to relax those medications should be avoided. Anti-acid drugs like proton pump inhibitors and H2 receptor blockers can be used to decrease the acid secretion.

Medical Therapy

Sliding hiatus hernia

Pharmacologic medical therapy is recommended among the patients with Sliding hiatus hernia when experince symptoms of gastroesophageal reflux disease (GERD) symptoms like

Lifestyle Modifications

References

  1. Piesman M, Hwang I, Maydonovitch C, Wong RK (2007). "Nocturnal reflux episodes following the administration of a standardized meal. Does timing matter?". Am. J. Gastroenterol. 102 (10): 2128–34. doi:10.1111/j.1572-0241.2007.01348.x. PMID 17573791.
  2. Kaltenbach T, Crockett S, Gerson LB (2006). "Are lifestyle measures effective in patients with gastroesophageal reflux disease? An evidence-based approach". Arch. Intern. Med. 166 (9): 965–71. doi:10.1001/archinte.166.9.965. PMID 16682569.
  3. Ness-Jensen E, Hveem K, El-Serag H, Lagergren J (2016). "Lifestyle Intervention in Gastroesophageal Reflux Disease". Clin Gastroenterol Hepatol. 14 (2): 175-82.e1-3. doi:10.1016/j.cgh.2015.04.176. PMC 4636482. PMID 25956834.
  4. Khoury RM, Camacho-Lobato L, Katz PO, Mohiuddin MA, Castell DO. Influence of spontaneous sleep positions on nighttime recumbent reflux in patients with gastroesophageal reflux disease. Am J Gastroenterol 1999;94:2069-73. PMID 10445529.
  5. Sontag SJ (1990). "The medical management of reflux esophagitis. Role of antacids and acid inhibition". Gastroenterol. Clin. North Am. 19 (3): 683–712. PMID 1977703.
  6. Komazawa Y, Adachi K, Mihara T, Ono M, Kawamura A, Fujishiro H, Kinoshita Y (2003). "Tolerance to famotidine and ranitidine treatment after 14 days of administration in healthy subjects without Helicobacter pylori infection". J. Gastroenterol. Hepatol. 18 (6): 678–82. PMID 12753150.
  7. Inadomi JM, Jamal R, Murata GH, Hoffman RM, Lavezo LA, Vigil JM, Swanson KM, Sonnenberg A (2001). "Step-down management of gastroesophageal reflux disease". Gastroenterology. 121 (5): 1095–100. PMID 11677201.
  8. Inadomi JM, McIntyre L, Bernard L, Fendrick AM (2003). "Step-down from multiple- to single-dose proton pump inhibitors (PPIs): a prospective study of patients with heartburn or acid regurgitation completely relieved with PPIs". Am. J. Gastroenterol. 98 (9): 1940–4. doi:10.1111/j.1572-0241.2003.07665.x. PMID 14499769.