Depends. The only options are surgical repair or observation. Base you decision on how bad the symptom are and somewhat on the size of the hernia. Your fitness for an operation also comes in to play, but many large hernias repaired are for patients in their 70's and 80's. See a general surgeon with experience in hiatal and paraesophageal hernia repair for a consultation to get details about your case.
Depends. Most hiatal hernia require no surgical intervention. Eating right (right time, right amount, and right food selection), keeping your weight in check and an active lifestyle generally address most of the hiatal hernia symptoms.