What is the primary treatment for sliding hernias?

The primary treatment for sliding hernias, particularly those associated with gastroesophageal reflux disease (GERD), focuses on controlling reflux symptoms. A sliding hernia, also known as a hiatal hernia, occurs when a portion of the stomach protrudes through the diaphragm into the thoracic cavity. This displacement can lead to reflux as the normal barrier between the stomach and esophagus is compromised.

Managing reflux may involve lifestyle changes such as weight loss, dietary modifications, and the use of medications such as proton pump inhibitors (PPIs) or H2 blockers to reduce acidity and improve symptoms. While surgical intervention may be indicated for complicated cases or when medical management fails, controlling reflux is often the primary concern for many patients with sliding hernias, especially when symptoms are mild to moderate.

Observation and monitoring may sometimes be applied for asymptomatic cases or very mild hernias, but this does not address the underlying issue of reflux. Dietary modifications can also play a role in managing symptoms but are typically part of a broader approach that includes reflux control.