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Hiatal hernia

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When one part of the body protrudes through an opening into another part of the body, a hernia occurs. Hiatal hernias - also known as diaphragmatic hernias - form at the opening (hiatus) in diaphragm where the food pipe (esophagus) joins the stomach. When the muscle tissue around the hiatus becomes weak, the upper part of your stomach may bulge through the diaphragm into your chest cavity.



A variety of lifestyle changes can help ease the gastroesophageal reflux that may accompany a hiatal hernia. Some or all of the following measures may help:

  • Eat small meals. Large meals can distend your stomach, pushing it into your chest.

  • Avoid problem foods and alcohol. Try to avoid alcohol, caffeinated drinks, chocolate, onions, spicy foods, spearmint and peppermint — all of which increase production of stomach acid and relax the lower esophageal sphincter. Even decaffeinated coffee can be irritating to an inflamed esophageal lining. Also try to limit citrus fruits and tomato-based foods. They're acidic and can irritate an inflamed esophagus.

  • Limit fatty foods. Fatty foods relax the lower esophageal sphincter and slow stomach emptying, which increases the amount of time that acid can back up into your esophagus.

  • Sit up after you eat. Wait at least 3 hours before going to bed or taking a nap. By then, most of the food in your stomach will have emptied into your small intestine, so it can't flow back into your esophagus. Eating a bedtime snack stimulates acid formation and further aggravates acid reflux.

  • Don't exercise immediately after eating. Try to wait at least 2 to 3 hours before you engage in any strenuous activity. Low-key exercise, such as walking, is fine.

  • Lose weight. If you're overweight, slimming down helps reduce the pressure on your stomach. This may well be the most important thing you can do to relieve your symptoms.

  • Stop smoking. Smoking increases acid reflux and dries your saliva. Saliva helps protect your esophagus from stomach acid.

  • Avoid certain medications, if possible. Medications to avoid include calcium channel blockers such as diltiazem (Cardizem, Cartia); the antibiotic tetracycline; nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve); quinidine (Quinidex); theophylline; sedatives and tranquilizers; and alendronate (Fosamax). If you take any of these medications and suffer from heartburn, talk to your doctor. You may be able to take other drugs instead. But don't stop taking medications on your own.

  • Elevate the head of your bed. If you elevate the head of your bed 6 to 9 inches, gravity will help prevent stomach acid from moving up into your esophagus as you sleep. Using a foam wedge to raise your mattress also may help. Don't try to use pillows, which tend to increase pressure on your abdomen.

  • Avoid tight-fitting clothes. They put pressure on your stomach.

  • Take time to relax. When you're under stress, digestion slows, which makes GERD symptoms worse. Relaxation techniques such as deep breathing, meditation or yoga may help reduce acid reflux.

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