What over-the-counter (OTC) antacids are suitable for treating symptoms of a hiatal hernia?

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Last updated: April 18, 2025View editorial policy

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From the Guidelines

Over-the-counter antacids, specifically alginate-antacids, can be beneficial in managing symptoms of a hiatal hernia by neutralizing stomach acid and displacing the postprandial acid pocket below the diaphragm, as demonstrated in a study published in Gut 1. The use of antacids like Tums, Rolaids, or Maalox can provide quick but temporary relief, while H2 blockers such as famotidine (Pepcid AC) or cimetidine (Tagamet HB) can reduce acid production for up to 12 hours. However, according to a more recent study published in Clinical Gastroenterology and Hepatology 1, alginate antacids are particularly useful for patients with post-prandial and/or nighttime symptoms, and in those with a known hiatal hernia, making them a preferred choice for adjunctive pharmacotherapy. Some key points to consider when using OTC antacids for hernia symptoms include:

  • Eating smaller meals to reduce symptoms
  • Avoiding lying down after eating to prevent acid reflux
  • Eliminating trigger foods that can exacerbate symptoms
  • Maintaining a healthy weight to reduce pressure on the stomach
  • Elevating the head of the bed to prevent nighttime reflux If symptoms persist beyond two weeks of OTC treatment or include difficulty swallowing, persistent pain, or vomiting, it is essential to consult a healthcare provider as prescription-strength medications or other interventions may be necessary.

From the FDA Drug Label

Purpose Antacid The FDA drug label does not answer the question.

From the Research

OTC Antacids for Hernia

  • There is no direct evidence to support the use of OTC antacids for hernia treatment in the provided studies.
  • However, a study on proton pump inhibitor (PPI) use after hiatal hernia repair 2 suggests that PPIs may mask symptoms of hiatal hernia recurrence, potentially delaying proper diagnosis and treatment.
  • The study found that 70% of patients remained or were restarted on PPI after their initial surgery, and that the use of PPIs may delay proper workup to identify recurrent hiatal hernia amenable to surgical repair.
  • Another study 3 is unrelated to the treatment of hernia with OTC antacids, as it focuses on muscular synergy during voluntary movement.
  • Therefore, there is limited relevant evidence to assist in answering this question, and the use of OTC antacids for hernia treatment is not supported by the provided studies.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The stability of synergy in agonists during the execution of a simple voluntary movement.

Electroencephalography and clinical neurophysiology, 1977

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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