Omeprazole for Hiatal Hernia Reviews

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Brand names:
Prilosec,
Prilosec OTC,
Omesec

Omeprazole
has an average rating of 3.2 out of 10 from a total of 19 reviews
for the
off-label treatment of Hiatal Hernia.
16% of reviewers reported a positive experience, while 74% reported a negative experience.

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Omeprazole rating summary

3.2/10 average rating

19 ratings from 19 user reviews.

Compare all 5 medications used in the treatment of Hiatal Hernia.

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• What foods should I avoid when taking omeprazole?
• How soon after taking levothyroxine can I take omeprazole?
• Is famotidine safer than omeprazole for heartburn?
• Pantoprazole vs. omeprazole: What’s the difference between them?

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• Barrett’s Esophagus
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How to Fix a Hiatal Hernia Yourself, and When to Seek Medical Help

While there are lifestyle changes you can make to treat hiatal hernias, consider speaking with a doctor first. In some cases, you may need other treatment or surgery to remove it.

Your diaphragm — which is your primary muscle used for breathing — is a thin, dome-shaped muscle that separates your chest cavity from your abdomen.

An opening in your diaphragm (called a hiatus in medical terminology) allows your esophagus (the tube that carries food from your mouth to your stomach) to connect with your stomach. If the upper part of your stomach pushes through this opening, you have a hiatal hernia.

Keep reading to learn how to treat a hiatal hernia at home, hernia prevention tips, and when you should seek professional medical help.

According to a 2019 research review, one of the first steps in treating symptomatic hiatal hernia is addressing gastric acid secretion. Recommendations include:

• losing weight (if needed)
• decreasing food portion sizes
• eating several smaller meals throughout the day (as opposed to a few large meals)
• elevating the head of your bed by 8 inches
• avoiding meals 2 to 3 hours before bedtime or before lying down
• avoiding or limiting “trigger” foods and drink such as fried foods, fatty foods, acidic foods (citrus, tomato, vinegar), spicy foods, caffeine (coffee, chocolate), alcoholic beverages, carbonated drinks
• quitting smoking
• taking over-the-counter (OTC) medications such as antacids, such as Gaviscon (aluminum with magnesium hydroxide) or H-blockers (such as Pepcid AC or famotidine)
• avoiding tight clothing that can increase the pressure on your abdomen, such as a tight belt, control top hosiery, and body shapers

If you have a hiatal hernia, be aware of symptoms that may indicate blood flow to your stomach has been blocked by an obstruction or a strangulated hernia. Call your doctor immediately if you:

• can’t pass gas or empty your bowels
• feel nauseated
• experience vomiting
• have chest pain

Chest discomfort could also be a symptom of heart concerns, which also requires emergency medical treatment.

In addition to losing weight and avoiding “trigger” foods, there are a number of anecdotal treatments for hiatal hernias that are suggested by proponents of natural healing. Some of these suggestions include:

• yoga
• self-massage, massaging your abdominal muscles in a downward motion while lying on your back on a flat surface
• consuming apple cider vinegar, cinnamon, aloe vera, slippery elm, or chamomile

The warm water method

Another natural treatment, known as the warm water method, suggests following these steps to treat a hiatal hernia:

1. First thing after waking up, drink a glass of warm or room temperature water.
2. Stand up, bring your arms straight out from your sides, and then bend your elbows so your hands touch your chest
3. Stand as high as possible on your toes and then drop down abruptly. Repeat 10 times.
4. Raise your arms up in the air and, for about 15 seconds breathe short quick breaths with your mouth.

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Please note: The anecdotal treatments discussed in this section are not medically approved. Before trying them, consult with your doctor to see if they’re appropriate and safe for your current health situation.

If lifestyle changes and home treatments aren’t helping, your doctor may recommend prescription medication or surgery.

Prescription medication for hiatal hernias include:

• esomeprazole (Nexium)
• lansoprazole (Prevacid)
• omeprazole (Prilosec)
• pantoprazole (Protonix)
• rabeprazole (Aciphex)

Surgery for hiatal hernias typically involves three steps. The surgeon:

• moves the hiatal hernia from your chest cavity back into your abdomen
• repairs the valve in your esophagus where your esophagus joins your stomach
• tightens the hole (hiatus) in your diaphragm

According to the Esophageal Cancer Awareness Association (ECAA), hiatal hernias are quite common, occurring in up to 60 percent of people by the time they are 60 years old. They also note that it’s unusual for serious conditions to develop from this type of hernia. Hiatal hernias are most common in adults who are 50+ years old.

It’s not currently known why the opening in your diaphragm becomes weak and enlarges. It may be hereditary or it may be caused by pressure buildup in your abdominal cavity from such things as:

• obesity
• straining during bowel movements
• heavy lifting
• exercises such as weightlifting
• coughing
• vomiting

You can’t prevent hereditary conditions, but you may be able to address other potential causes.

In a 2007 interview, John E. Pandolfino, MD stated that, “Obese people are certainly more prone to the development of hiatus hernia.” This leads to the conclusion that, if you are overweight, reducing your weight could lower your chances of experiencing a hiatal hernia. Other prevention methods to consider could include:

• avoiding strenuous activities such as lifting heavy objects
• quitting smoking
• eating a balanced, nutritious diet

Hiatal hernias are quite common, especially in adults who are 50+ years old. Fortunately, it’s unusual for serious conditions to develop from them.

Some lifestyle changes that can help include:

• losing weight (if needed)
• avoiding “trigger” foods
• wearing loose clothing
• quitting smoking

If home treatment is not effective, your doctor may recommend prescription medication or, in some cases, surgery.

Gastroesophageal reflux disease (GERD). Hernia of the esophageal opening of the diaphragm (HH). | Center for Endosurgical Technologies

Gastroesophageal reflux disease (GERD) is a disease characterized by the reflux of gastric contents into the esophagus.

Hiatal hernia is an enlargement of the hiatus that allows part of the stomach to enter the chest. In 90% hiatal hernia leads to GERD.

40% of people constantly (with varying frequency) experience heartburn, the main symptom of GERD. In general, the prevalence of GERD in Russia among the adult population is 40-60%, and esophagitis is found in 45-80% of people with GERD.

Causes of GERD.

The human stomach contains hydrochloric acid, the walls of the stomach are resistant to acid. The esophagus does not have such stability. The body has a number of mechanisms that prevent the entry of gastric contents into the esophagus. For various reasons, these mechanisms may not be able to cope, and gastric contents enter the esophagus, burning its walls.

D The main symptom of GERD is heartburn,

occurs in 83% of patients. In addition, symptoms of reflux (casting) can be pain in the upper abdomen and behind the sternum, belching, regurgitation of food, and swallowing disorders. GERD can also lead to disruption of the heart and lungs. Symptoms may be aggravated by violation, alcohol intake, physical activity, bending over and in a horizontal position.

Diagnosis of GERD is based on characteristic complaints. The main method of instrumental diagnosis of GERD is FGS. If necessary, X-ray examination with contrast is performed.

Treatment of GERD must be prescribed by a doctor.

This usually includes diet and proton pump inhibitors (omeprazole, pariet). The main treatment should be carried out within 4-8 weeks, maintenance therapy – 6-12 months. In this case, the probability of relapse (return of the disease) is up to 80% with erosive esophagitis and up to 98% with improperly prescribed treatment.

In addition, it is necessary: ​​

• Reduce body weight (if it is increased), stop smoking;
• Diet: Avoid tomatoes in any form, acidic fruit juices, gas-producing foods, fats, chocolate, coffee, garlic, onions, peppers, alcohol, very spicy, hot or cold foods, and carbonated drinks;
• Overeating should be avoided; they should stop eating two hours before bedtime. You should not increase the number of meals: it is necessary to observe 3-4 meals a day without snacks;
• Conditions that increase intra-abdominal pressure should be prevented (exclusion of loads that increase intra-abdominal pressure, wearing corsets, bandages and tight belts, lifting weights of more than 8-10 kg on both hands, work associated with forward bending of the torso, physical exercises associated with overstrain of the abdominal muscles)

In some cases, an operation is prescribed.

Surgery is necessary if:

• Therapy fails for 3 months or more (reflux persists or pain or heartburn persists)
• Presence of heart attacks (angina pectoris, arrhythmias) caused by GERD
• Organic damage to the esophagus (scarring, stenosis)
• Barrett’s esophagus according to FGS

CAUTION. Barrett’s esophagus is one possible complication of GERD. Barrett’s esophagus is 125 times more likely to develop esophageal cancer than the general population!!! Esophageal cancer is very aggressive and responsive to therapy.

Laparoscopic fundoplication is the gold standard for GERD surgery worldwide.

In this operation, the fundus of the stomach is wrapped around the esophagus and sutured. The created cuff prevents the reflux of gastric contents into the esophagus.

We have been performing fundoplication since 2001. During this time, more than 300 operations have been performed. In 15 years, we have never needed to switch to open surgery. The presence of previous operations is not a contraindication to surgery.

The operation is very well tolerated by the patient. After our operations, the patient stays in the hospital for 1 day (on average). Most patients are discharged the next day. Pain is minimal.

We perform the operation with a laparoscopic (endovideosurgical) approach. With this technique, there is no large incision. 5 punctures of the anterior abdominal wall are performed (5 and 10 mm each). An inert gas is pumped inside, a video camera and instruments are introduced. The operation is carried out from the inside.

After the operation, you must follow a diet and limit physical activity for a month. A month later, the restrictions are lifted.

To make an appointment for a consultation: e-mail: [email protected], tel.: +7 (391) 297-52-52

5

In the 1980s and 1990s, the number of patients requiring surgical treatment significantly decreased. This was due to the emergence of new antisecretory, antacid and prokinetic drugs. Over the past decade, the developed drug treatment regimens have significantly reduced the risk of complications and improved the quality of life of patients with mild to moderate reflux esophagitis. However, the main problem of conservative treatment was and remains an almost complete relapse of the disease after the termination of the next course of drug therapy. The untimely performance of the operation for reflux esophagitis and HH is largely due to the fact that surgeons and gastroenterologists still do not have a unified point of view on the tactics of treating patients with these pathological conditions. Disputes continue about the indications for its surgical treatment and the timeliness of the transition from conservative to surgical treatment. Particularly controversial are the issues of choosing treatment tactics for mild and moderate reflux esophagitis.

It is undesirable to take drugs that reduce the tone of the LES (theophylline, progesterone, antidepressants, nitrates, prostaglandins, calcium antagonists, β-blockers, anticholinergic drugs), as well as having an adverse effect on the mucosa of the esophagus (non-steroidal anti-inflammatory drugs, doxycycline, quinidine).

Drug treatment should be aimed at reducing the acidity of gastric juice, neutralizing the produced hydrochloric acid and accelerating the evacuation of food from the stomach. To this end, therapy may include the use of various groups of drugs.

Antacids (almagel, maalox, phosphalugel, gastal, etc.) and alginates (gaviscon, topalkan, etc.) are superior to other drugs in terms of the speed of achieving a therapeutic effect (pain and heartburn relief). Antacids are prescribed for symptomatic purposes, their action is aimed at neutralizing the acid and, unfortunately, for a short time. Their main active ingredients are aluminum hydroxide, magnesium trisilicate, bismuth nitrate. Some of the above complex antacids are available in tablets, others – in the form of a gel. The frequency of their intake is determined by the severity of clinical symptoms, usually 4-5 times a day between meals and at bedtime. The advantage of these drugs is good tolerability by most patients and the rapid onset of the clinical effect.

There are, however, adverse effects of taking antacid preparations. In particular, aluminum-containing drugs with prolonged use can cause hypophosphatemia and constipation. After a series of chemical transformations, these preparations form poorly soluble compounds excreted with feces in the human intestine, which include phosphorus. This can be avoided by the appointment of phosphorus-containing agents (for example, phosphalugel, but its alkalizing ability is less than that of almagel).

Massive therapy with calcium carbonate leads to alkalosis and is contraindicated in hypercalcemia, osteochondrosis, the presence of calcium-containing stones in the kidneys and gallbladder.

Taking into account the important role of esophageal and gastric motility disorders in the pathogenesis of EC, prokinetics – drugs that normalize the motility of the gastrointestinal tract, improve the function of the lower esophageal sphincter, occupy a significant place in the treatment of such patients. Prokinetics increase LES pressure, improve esophageal clearance and gastric emptying.

H ₂ histamine receptor blockers. The emergence of this group of drugs has opened an era of effective drug therapy to reduce the secretion of hydrochloric acid. Appeared in the 1970s, they played a big role in the treatment of gastric and duodenal ulcers. However, these drugs were less effective in treating reflux esophagitis. Currently, there are 5 generations of H ₂ -blockers: I generation – cimetidine; II – generation – ranitidine; III generation – famotidine; IV generation – nizatidine; V generation – roxatidine. Currently, drugs from the group of ranitidine (zantac, ranitin) and famotidine (quamatel, famosan, gastromsidine) are most widely used, which are prescribed mainly for catarrhal forms of EC. These drugs effectively reduce the basal secretion of hydrochloric acid in the stomach and inhibit the secretion of pepsins. In the treatment of patients with erosive forms of the disease, they often turn out to be insufficiently effective even when taking double doses (600 mg of ranitidine and 80 mg of famotidine per day) and therefore gave way to their place inhibitors H ⁺ , K ⁺ py) , which is currently the most powerful antisecretory drugs.

Proton pump inhibitors (omeprazole, lansoprazole and pantoprazole) were introduced into clinical practice in the late 1980s [7]; rabeprazole and esomeprazole appeared not so long ago. Usually also given in double doses (omeprazole 40 mg, lansoprazole 60 mg, pantoprazole 80 mg), they achieve healing of esophageal erosions in 85-90% of patients, including those resistant to H ₂ -blockers. The drugs of this group are practically devoid of side effects since they exist in the active form only in the parietal cell.

At the same time, recent studies have shown that when using the usually recommended therapeutic dose of omeprazole (20 mg 2 times a day), approximately 20% of patients with EC retain pronounced changes in intraesophageal pH, and in almost 1/3 of patients, doses of omeprazole significantly exceeding standard therapeutic doses (up to 140 mg per day) are required to obtain a therapeutic effect.

The main course of treatment of EC exacerbations (especially erosive and ulcerative forms of EC) requires at least 8-12 weeks. At the same time, discontinuation of medication after achieving healing of esophageal erosions in many patients leads to a rapid recurrence of the disease. Therefore, many patients require maintenance treatment with proton pump blockers or prokinetics (in half daily doses) for at least 1 year, which allows maintaining disease remission in most patients.

Complications of taking antisecretory drugs .

According to recent publications, the number of patients with partial or complete non-response to the standard dose of PPI (once a day for 8 weeks) is 40-50%.

The “ rebound syndrome ” described in the literature leads to a sharp increase in gastric secretion after the withdrawal of antisecretory therapy due to hypergastrinemia. The development of the “rebound” syndrome was noted already after 2-4 weeks of taking h3-blockers and 6-8 weeks of taking PPIs . Of course, a sharp increase in acid secretion can provoke an acute ulcer, but this probability is higher with the use of H ₂ -blockers.

The existing “ fatigue syndrome” of receptors is clinically significant and characteristic of all drugs of the h3-histamine receptor blocker group. It is known that after 5-7 days of continuous use of H2-blockers, the effectiveness of therapeutic doses is reduced by more than 50%, and with longer use, the antisecretory effect is completely lost.

The literature describes the phenomenon of “nocturnal acid breakthrough” – a decrease in pH in the stomach below 4.0 for several hours in the period from 22 to 6 hours while taking PPIs. The development of this phenomenon was found in almost 70% of patients with reflux esophagitis and 80% of patients with Barrett’s esophagus, and is probably associated with an increase in the activity of the vagus nerves at this time and a decrease in the production of mucus by additional cells. licobacter pylori, which is described in more detail in the corresponding chapter.

Many authors confirm a 2-3-fold increase in the risk of developing diarrhea caused by Clostridium difficile against the background of long-term PPI therapy.

The relationship between long-term PPI use and fractures is still debatable. The review by L. Laine compared the data of 13,556 patients with hip fractures older than 50 years and 135,386 persons who made up the control group matched by sex and age for PPIs. An increased risk of hip fracture has been shown with PPI use for more than a year, with the highest risk seen with long-term high (>1.75) daily PPI use.