Many people have hiatal hernias and it is very rare that the hernia needs to be treated (only if it becomes strangulated, and again, that is very rare). Some doctors believe that hiatal hernias can make heartburn/reflux symptoms worse, and if someone is symptomatic they will be given meds like Reglan, Prilosec, Prevacid, etc. The good news is that hiatal hernias are pretty common, they are not dangerous (most are discovered "by accident" when a person has a workup for heartburn or a related problem), and treatment is not aimed at the hernia itself, but any other GI symptoms that may be going on. I have reflux and I don't take Reglan (I take Prilosec, Pepto, and Gaviscon) but many people I have talked with do. I'm sure your boyfriend will be fine--it is always weird when you have to come to terms with something new going on in your body. P.S. If he has heartburn, the cough could be coming from the acid going up in his throat and irritating it, it could be due to a medication, or it could be one of those nonspecific little things that go away. Best wishes to both of you.