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What You Should Do If You Have a Hiatal Hernia

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Updated October 05, 2009

A hiatal hernia occurs when the upper part of the stomach pushes through an opening in the diaphragm, and up into the chest. This opening is called the esophageal hiatus or diaphragmatic hiatus. If you've been diagnosed with a hiatal hernia, you'll need to know how to live with it.

Eat 6 small meals instead of 3 big meals.
This keeps your stomach from getting too full. This will also reduce gastric pressure. Another tip is to eat slowly.

Don't eat or drink anything 1 to 2 hours before going to bed.
If you take naps, try sleeping in a chair. Lying down with a full stomach can cause stomach contents to press harder against the hernia, increasing the chances of refluxed food.

Avoid foods that are known to increase heartburn.
Avoid the foods that can trigger your heartburn, either by increasing acid production and gastric pressure or by loosening the lower sphincter muscle. Also, avoid foods that can irritate the lining of the esophagus, such as spicy foods, coffee, citrus fruit and juices. Especially if you eat any of these foods at dinnertime will increase your chances of having nighttime heartburn. If you aren't sure what foods trigger your heartburn symptoms, try keeping a heartburn record for a week. You can also check out a chart for foods with little risk of causing heartburn.

Avoid bending over soon after eating.
Bending over shortly after eating a meal may result in regurgitating the food.

Avoid alcohol.
Alcohol increases the production of stomach acid. Alcohol also relaxes the lower esophageal sphincter (LES), allowing stomach contents to reflux back up into the esophagus. This is compounded if you have a hiatal hernia. If you still want to consume alcohol, find out how and when to consume alcohol when you suffer from heartburn.

Use an antacid.
Antacids will work very quickly on heartburn you may be experience because of the hiatal hernia. An H2 blocker will work for a longer period of time, usually up to 12 hours. Your doctor may suggest taking one of the H2 blockers. Since they take an hour or so to begin working, your doctor may suggest taking a H2 blocker in combination with an antacid. If you don't find relief from these, your doctor may prescribe a proton pump inhibitors.

Sleep with your head and shoulder on an incline.
With the head higher than the stomach, gravity helps reduce this pressure, and keeps stomach contents where they belong--in the stomach. You can elevate your head in a couple of ways. You can place bricks, blocks or anything that's sturdy securely under the legs at the head of your bed. You can also use a wedge-shaped pillow to elevate your head

Don't wear clothing that constricts the stomach.
Clothing that fits tightly around the abdomen will squeeze the stomach, forcing food up against the hiatal hernia, and cause food to reflux into the esophagus. Clothing that can cause problems include tight-fitting belts and slenderizing undergarments.

Don't smoke.
Smoking stimulates the production of stomach acid. Find out the other reasons it's good to stop smoking if you suffer from heartburn with your hiatal hernia.

Avoid activities that cause abdominal strain.
This includes heavy lifting and straining during bowel movements. If you must lift something that is heavy, bend your knees and lift with your legs and don't bend at the waist to lift a heavy object. If straining during your bowel movements, consider taking a stool softener.

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