{ "schema_version": 1, "kind": "condition", "id": "hiatus-hernia", "name": "Hiatus Hernia", "category": "chronic", "sources": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 · ACG Management of GERD 2022 · Hiatal Hernia - StatPearls, Puri & Sharma, updated 31 January 2026 - https://www.ncbi.nlm.nih.gov/books/NBK562200/", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 · ACG Management of GERD 2022 · Hiatal Hernia - StatPearls, Puri & Sharma, updated 31 January 2026 - https://www.ncbi.nlm.nih.gov/books/NBK562200/ · Hiatal Hernia - disease-level clinical article (hiatus-hernia-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 939, "generic": "Omeprazole", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 20.0, "adult_dose": "20 mg once daily in the morning before food", "adult_duration": "8 weeks, then reassess", "dose_source": "Egyptian National Drug Formulary - Gastrointestinal Tract 2025 (omeprazole monograph): \"Gastroesophageal reflux disease, including reflux esophagitis - Oral: 10-20 mg once daily. Up to 40 mg once daily in refractory cases. Duration: 4-8 weeks.\" The paediatric statement shown here is not from this formulary, whose only paediatric omeprazole line is 0.7-1.4 mg/kg in children over 2 years for severe ulcerating esophagitis. The ACG GERD guideline is not held in this corpus.", "rationale": "Most hiatus hernias are asymptomatic and need nothing. When they cause reflux symptoms the treatment is the reflux treatment: the article's recommendation is a proton pump inhibitor once a day, taken in the morning before food, over a course of 8 weeks. The dose is the sourced omeprazole dose for reflux.", "cautions": [ "MOST ARE ASYMPTOMATIC AND NEED NO TREATMENT. StatPearls: 55-60% of people over 50 have one, and symptoms appear in about 10% of them at most. Finding one on a scan is not a reason to start a drug.", "Dysphagia, vomiting, weight loss, anaemia or chest pain are not to be treated with a PPI and reviewed in two months - they need endoscopy.", "A large paraesophageal (type II-IV) hernia can strangulate. Sudden severe chest or epigastric pain with retching and inability to vomit is a surgical emergency.", "Surgery is for a mechanically defective sphincter, failure of PPI, severe erosive oesophagitis, or a symptomatic large paraesophageal hernia - not for the hernia's existence.", "Long-term PPI is not free of cost: review the need at every repeat rather than continuing it by default." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Licensed in children over 1 year at 10-20 mg daily under specialist care. A hiatus hernia found in a child is a paediatric surgical question, not a prescription.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "OMEGASTAZOLE 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "RIVA PHARMA S.A.E.", "price_egp": 18.0, "pack_count": 14, "unit_price": 1.29, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMEPRAL 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 32.0, "pack_count": 14, "unit_price": 2.29, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RISEK 20 MG 28 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 75.0, "pack_count": 28, "unit_price": 2.68, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMISEC 20MG 14CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "THE UNITED PHARMACEUTICALS CO LTD-JORDAN > MODERN PHARMA", "price_egp": 42.0, "pack_count": 14, "unit_price": 3.0, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EPIRAZOLE 20MG 14CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 44.0, "pack_count": 14, "unit_price": 3.14, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OMEPAK 20 MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SEDICO", "price_egp": 50.0, "pack_count": 14, "unit_price": 3.57, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "RISEK 20 MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "JULPHAR", "price_egp": 57.0, "pack_count": 14, "unit_price": 4.07, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NAPIZOLE 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 62.0, "pack_count": 14, "unit_price": 4.43, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "hiatus-hernia" }, { "id": 940, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "Hiatal Hernia - disease-level clinical article (hiatus-hernia-clinical.txt)", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - An incarcerated paraesophageal hernia or gastric volvulus presents with acute nausea, vomiting, and chest pain, and requires immediate decompression and urgent repair." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "hiatus-hernia" } ] }