Table II.

Current therapeutic approaches of hiatal hernia.

Type of hiatal hernia	First line	Second line
Type I (sliding) hernia	PPI – once daily, 8 week course treatment Inadequate symptom control: PPI – twice daily, 8 week course treatment	Laparoscopic fundoplication (Nissen or Toupet) – especially in case of symptom persistence
Types II, III, IV (paraesophageal) hernias	Laparoscopic fundoplication (Nissen or Toupet) – definitive treatment	PPI, histamine receptor antagonists, antacids – for symptom relief