How we can manage a case of hiatus hernia?

Managing a hiatus hernia typically involves a combination of lifestyle changes, medications, and in some cases, surgery. Here are some common approaches:

Lifestyle Changes:-
1. Dietary Adjustments: Eat smaller, more frequent meals instead of large ones. Avoid foods and drinks that can trigger reflux, such as spicy foods, caffeine, and alcohol.
2. Weight Management: Maintaining a healthy weight can reduce pressure on the abdomen and lessen symptoms.
3. Elevate the Head of Your Bed: Raising the head of your bed by about 10 to 20 cm can help prevent stomach acid from traveling up towards your throat while you sleep.
4. Quit Smoking: Smoking can exacerbate symptoms, so quitting is highly recommended.

Medications:-
1. Antacids: Over-the-counter antacids can provide quick relief by neutralizing stomach acid.
2. H2 Receptor Blockers: These medications reduce acid production and provide longer relief than antacids.
3. Proton Pump Inhibitors (PPIs): PPIs are more effective at reducing acid production and healing the esophagus.
4. Homoeopathy: Symptomatic Homoeopathic medicine.

Surgical Options:-
Surgery is usually considered if lifestyle changes and medications do not alleviate symptoms, or if there are complications such as severe reflux, bleeding, or obstruction. The most common surgical procedure is Nissen fundoplication, where the top of the stomach is wrapped around the lower esophagus to strengthen the valve between the esophagus and stomach⁵.