Will a Hiatal Hernia Go Away on Its Own?

A hiatal hernia generally does not go away on its own, but that does not mean every hiatal hernia requires surgery. Small sliding hiatal hernias that cause few or no symptoms may only need monitoring. When symptoms such as acid reflux develop, they can often be managed with lifestyle changes and medication. Surgery may be considered when symptoms remain significant despite conservative treatment or when the hernia creates a greater risk of complications. 

If you’ve recently been diagnosed with a hernia, you may be wondering if it will go away. You may also feel inclined to try and manage the condition on your own instead of surgery. Before you make any decisions that can impact your health and overall well-being, consider the following information about hiatal hernias.

What Are Hiatal Hernias?

Hiatal hernias develop when a portion of the stomach forces its way up into the diaphragm. Normally, the muscles in the diaphragm are strong enough to keep the stomach and internal organs in place. But when the diaphragm or chest muscles become too weak to support the abdomen and organs properly, they shift and cause swelling and pain.

Hiatal hernias are extremely common, especially among babies and older adults. Though pregnancy, trauma, obesity, physical strain, and old age are the most common causes, anyone can develop them. Though the condition is no cause for alarm, those who experience symptoms may ponder solutions to help alleviate the discomfort. Hiatal hernias can also be asymptomatic.

Hernias that don’t cause pain or discomfort generally do not require surgery. Without proper care, hernias can become worse. Treatment is highly dependent on the type of hernia present.

Hiatal hernias are also known as sliding or type I due to a portion of the stomach or organs sliding in and out of an opening or weakness in the diaphragm. Type II, III, and IV are known as paraesophageal hernias. Instead of the stomach or organs sliding into the diaphragm, they slide up into the chest cavity, near the esophagus.

Regardless of the type of hiatal hernia present, the condition increases the risk of GERD or gastroesophageal reflux disease, strangulation, and other serious complications. The danger of hiatal hernias is that the stomach is not the only organ that can roll or slide out of place into the diaphragm or chest. Other organs, such as the pancreas, liver, or colon, can also become trapped there.

Non-Surgical Treatments to Consider

If your hiatal hernia is not causing any serious symptoms, you may consider putting off surgery for a while. However, you’ll need to make some lifestyle changes and take medications to manage the condition. You should also follow your doctor’s treatment recommendations and the following considerations.

• Avoid eating a few hours before lying down
• Consume smaller portion sizes
• Lose excess weight
• Avoid caffeinated, alcoholic, and carbonated beverages
• Avoid fatty or spicy foods
• Exercise
• Refrain from smoking
• Avoid sleeping flat
• Use antacids, proton pump inhibitors, or antihistamines

Hernia symptoms often come and go. Surgery is usually recommended as a last resort if medication and lifestyle adjustments fail. In rare cases, emergency surgery is necessary for serious hernias that become life-threatening.

Do You Need Treatment for a Hiatal Hernia?

Your situation	What it usually means	Typical next step
No symptoms; a small sliding (Type I) hernia	Often needs no procedure	Monitor over time and use general lifestyle measures. Hernias that don’t cause pain or discomfort generally do not require surgery.
Mild to moderate symptoms — heartburn, acid reflux / GERD	Symptoms are often controllable	Lifestyle changes (smaller meals, don’t lie down after eating, weight management, limit caffeine, alcohol, carbonated drinks and fatty or spicy foods, stay active, don’t smoke) plus medication — antacids, H2 blockers, or proton pump inhibitors (PPIs).
Symptoms persist despite lifestyle changes and medication	Conservative care isn’t enough	Surgical evaluation for hiatal hernia repair. Surgery is usually recommended as a last resort when medication and lifestyle adjustments fail.
Large or paraesophageal hernia (Types II–IV), or warning signs — trouble swallowing, severe pain, bleeding, risk of trapped organs	Higher risk of complications	Surgical evaluation may be appropriate, particularly when a paraesophageal hernia is causing significant symptoms or there is concern for complications. The decision depends on the type and size of the hernia, symptoms, overall health, and specific risks identified by the surgeon.

Why Hernia Surgery Is Recommended

Surgery is the best and fastest way to eliminate a hernia. Depending on the cause, the procedure either reinforces the weak muscular wall or seals the opening so the organs no longer push through.

Orange County Robotic General Surgery offers hiatal hernia surgery and alternative treatments for hernias of types. Dr. Abitin Khosravi, MD, is a leading hernia repair expert. He uses the most advanced practices, including laparoscopic techniques and instruments, to minimize the risks associated with surgical hiatal hernia repairs for patients.

Hiatal Hernia Repair at Orange County Robotic General Surgery

To perform the procedure, Dr. Khosravi makes a few small incisions in the abdomen (in rare situations, the chest) to access the stomach or organs that are out of place and reposition them where they belong. Depending on the severity of the hernia, he may also revise the diaphragm and esophagus to seal the opening, keep the stomach and organs in place, and help prevent the hernia from returning. He does this by wrapping a small section of the upper stomach around the esophagus to shorten it.

Surgery doesn’t just eliminate the hernia; it also stops the symptoms. When considering treatment options, look at how your symptoms affect your daily life. You might not mind having to take antacids or modifying your activities and sleeping positions to keep acid reflux and GERD at bay. However, the longer the condition persists, the more damage it can cause to your body and health.

Untreated hiatal hernias eventually become larger. The pain can become excruciating, and the possibility of internal bleeding is high. Repeated episodes of acid reflux or GERD can lead to inflammation of the esophagus and lungs. Difficulty swallowing foods and fluids without pain and discomfort may occur.
It’s best to consider all treatment options for your situation if you experience hernia symptoms. But if your discomfort becomes persistent or unbearable, you should opt for surgery sooner than later.

Get Freedom and Relief From Hiatal Hernia Pain and Symptoms

Hernias don’t always go away on their own without medical intervention. There’s no sense in putting off surgery to heal your hernia pain and symptoms so you can resume enjoying your life hernia free.

Hiatal Hernia FAQs

Will a hiatal hernia go away on its own?

A hiatal hernia generally does not go away on its own because the anatomical opening or displacement does not typically correct itself without treatment. However, not every hiatal hernia requires surgery. Small sliding hiatal hernias that cause few or no symptoms may only need monitoring, while reflux-related symptoms can often be managed with lifestyle changes and medication. Surgery may be considered when symptoms remain significant despite conservative treatment or when the hernia creates a greater risk of complications.

Do all hiatal hernias need surgery?

No. Hernias that do not cause pain or discomfort generally do not require surgery. Surgery is usually considered when symptoms continue despite medication and lifestyle changes, or when the hernia is large or causing complications.

What are the non-surgical treatment options for a hiatal hernia?

Non-surgical care focuses on lifestyle changes and medication. Helpful steps include eating smaller meals, not lying down right after eating, maintaining a healthy weight, avoiding caffeine, alcohol, carbonated drinks, and fatty or spicy foods, staying active, and not smoking. Medications such as antacids, H2 blockers, or proton pump inhibitors (PPIs) may also be used.

When is hiatal hernia surgery recommended?

Surgery may be considered when symptoms remain significant despite medication and lifestyle changes or when the hernia creates a greater risk of complications. During hiatal hernia repair, the surgeon returns the herniated stomach or other tissue to the abdominal cavity and repairs the enlarged opening in the diaphragm. Depending on the patient’s condition, the operation may also include additional steps to address reflux.

What happens if a hiatal hernia is left untreated?

Some hiatal hernias can enlarge or become more symptomatic over time, although the course varies from person to person. Depending on the type of hernia, symptoms may include worsening reflux, pain, inflammation of the esophagus, or difficulty swallowing. Paraesophageal hernias can also carry a risk of more serious complications. Severe or sudden pain, persistent vomiting, gastrointestinal bleeding, or other concerning symptoms warrant prompt medical evaluation.

What are the different types of hiatal hernia?

Type I, or sliding hiatal hernia, occurs when stomach tissue slides in and out of the opening in the diaphragm. Types II through IV, known as paraesophageal hernias, occur when part of the stomach or other organs move up into the chest cavity near the esophagus and carry a higher risk of complications.

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