What is the recommended treatment for paraesophageal hernias?

The recommended treatment for paraesophageal hernias is surgery. This is due to the potential complications associated with this type of hernia, such as incarceration, strangulation, and obstruction of the stomach. Surgical intervention helps to reposition the stomach and restore the anatomy, thereby reducing the risk of these serious complications.

In cases of paraesophageal hernias, the herniated portion of the stomach moves above the diaphragm and can become trapped, which can lead to ischemia and necrosis of the stomach tissue if left untreated. Surgery not only addresses the hernia itself but may also involve reinforcing the hiatus to prevent recurrence.

Other treatment modalities, like medication therapy, endoscopic treatment, and physical therapy, may manage symptoms or address comorbid conditions but do not correct the underlying anatomical issue or prevent the associated risks. Therefore, surgery remains the definitive treatment for paraesophageal hernias, particularly when symptoms are significant or complications are present.