Non-surgical treatment : A guide to Hernias

If you have a hiatus hernia which is not presenting with any symptoms then there are a couple of non-surgical options which include an anti-indigestion medicine or a motility stimulant.

In practically all other hernia cases, surgery is the only option.

Anti-indigestion medicines

These are designed to treat the effects of heartburn and indigestion which are caused by a variety of factors, one of these being a hiatus hernia.

There are three groups of anti-indigestion medicines which include:

• Alginates/antacids: these work by either neutralising the acid in your stomach or giving a protective coating to the walls of your stomach and oesophagus.
• Acid-suppressants: also known as H2 blockers. This type of medicine prevents a chemical called histamine (made by the body) from acting on cells within the stomach to produce acid. It suppresses histamine which reduces the production of stomach acid.
• Proton pump inhibitor: a type of medicine which completely blocks the production of stomach acid. It does this by shutting down a system within the stomach called the ‘proton pump.

These are available as tablets, liquids or capsules.

You may be familiar with the brand names of these medicines which include ‘Zantac’,‘Losec’ and ‘Protium’. These are purchased over the counter at your local pharmacy. There are also combination anti-indigestion medicines which contain both antacids and alginates. These are better known by their brand names ‘Rennies’, ‘Gaviscon’ and ‘Andrews Antacid’.

Motility stimulant

This is a drug which affects the oesophageal sphincter: this is a ring shaped muscle at the end of the oesophagus at the point where it joins the stomach. This muscle usually acts as a valve and closes off the oesophagus to prevent the contents of the stomach from flowing back up it.

But if a hernia has developed then this prevents it from doing so. The vale is left open enough so that stomach acid and other contents will enter the oesophagus.

A motility stimulant speeds up the rate at which the stomach empties of food and also tightens the oesophageal sphincter. This ensures that stomach contents are prevented from flowing back up the oesophagus.

There are two types of motility stimulant:

• Metoclopramide
• Domperidone

There are side effects with these stimulants although these tend to be rare. They are available on prescription or over the counter.

If none of these medicines work then surgery is the only answer. If a hernia does present with symptoms then your GP will advise you to undergo surgery.

This may sound daunting but it is a very simple operation which can be done as a day case which means that you are able to go home afterwards. It can be performed under a local anaesthetic which speeds up your recovery time as well.

More than 70,000 hernia operations are carried out in the UK each year.

Find out more about hernia surgery in our treatment for hernias section.