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Hiatal hernia
What's new
The American Society for Gastrointestinal Endoscopy (ASGE) has published an updated guideline for the diagnosis and management of gastroesophageal reflux disease (GERD), including surgical indications in patients with hiatal hernia. Transoral incisionless fundoplication is suggested for small hiatal hernias (≤2 cm) with Hill grade I or II in patients with chronic or refractory GERD, regurgitation-predominant GERD, chronic PPI use, or a preference to avoid chronic PPI use. The Stretta procedure is suggested for small hiatal hernias with Hill grade I or II when other alternatives are unavailable. Combined hiatal hernia repair is suggested for large hiatal hernias (>2 cm) with Hill grade III or IV. .
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of hiatal hernia are prepared by our editorial team based on guidelines from the American Society for Gastrointestinal Endoscopy (ASGE 2025) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES 2024,2013).
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