If you have a sliding hiatal hernia, usually no treatment is necessary. If you have occasional or mild symptoms-a feeling of burning, warmth, heat, or pain behind the breastbone (commonly known as heartburn)-you can make the following lifestyle changes:

• If you smoke or chew tobacco, stop. Nicotine from tobacco relaxes the valve between the esophagus and stomach (lower esophageal sphincter, or LES). This can allow stomach acid and juices to back up (reflux) into the esophagus, which cause the symptoms of heartburn.
• Change your eating habits. For example, avoid coffee and alcohol, and eat smaller, more frequent meals. This may make heartburn less likely to occur. Take your spouse or partner along with you when you see your doctor to discuss diet habits. It will be easier to make changes in your diet if your family understands what you need to do and why.
• Lose weight if you are overweight. Being overweight puts additional pressure on your stomach and increases the likelihood that heartburn will occur. Even losing a few pounds can help.
• Avoid or reduce pressure on your stomach to make heartburn less likely to occur. Some ways you can do this are to avoid lying down within 2 or 3 hours after eating and avoid wearing tight clothing across your stomach.

Along with making lifestyle changes, taking nonprescription medicines may control mild or occasional heartburn. These medicines include acid reducers or blockers and antacids.

If you have symptoms that last longer and occur more often than ordinary heartburn, you probably have gastroesophageal reflux disease (GERD). Hiatal hernia and GERD often occur together. Your symptoms may vary from mild to severe. For more information, see the topic Gastroesophageal Reflux Disease (GERD).