For patients with hiatal hernia for twenty years, different treatments can be adopted according to the severity of the patient’s symptoms or condition, including conservative medical treatment as well as surgical treatment. 1. Conservative medical treatment: In order to alleviate the symptoms of reflux, measures can be taken, including elevating the head of the bed, avoiding increasing the abdominal pressure, reducing weight appropriately, eating a low-fat diet, avoiding smoking and alcohol, etc. Drugs to promote the emptying of the esophagus and stomach, such as domperidone or cisapride, can be used. If the patient is combined with reflux esophagitis, acid-suppressing drugs can be added, such as cimetidine, ranitidine, omeprazole, lansoprazole and so on. 2. Surgical treatment: Surgical treatment should be considered in a timely manner for patients whose conservative medical treatment is ineffective, whose symptoms are severe and persistent, and who develop serious complications. Commonly used methods include repair of esophageal hiatus plus esophageal cardia fixation, gastric fixation plus gastric fundoplication, and highly selective vagotomy. When patients develop symptoms, they should go to the hospital in time and have standardized treatment under the doctor’s guidance to avoid serious adverse consequences.