10 Tips for Living with a Hiatal Hernia

Coping Tips and Lifestyle Changes for Hiatal Hernia Sufferers

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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.

Types of Hiatal Hernia

There are two categories of hiatal hernias, sliding or para-esophageal.

A sliding hiatal hernia is one in which the gastro-esophageal junction and part of the stomach slides into the chest.

This may occur because of weakening of the anchors of the esophagus to the diaphragm, from years of longitudinal esophageal muscle contractions, or from increased pressure in the abdomen. This junction and part of the stomach reside permanently in the chest, or just "slide" into the chest during swallowing. As an individual swallows, the esophagus contracts and shortens, and pulls on the stomach. After the swallow, the junction falls back into the abdomen. Approximately 90% of all hiatal hernias are the sliding type.

A para-esophageal hernia is one in which the gastro-esophageal junction remains where it belongs, but part of the stomach is squeezed up into the chest beside the esophagus. These hernias remain in the chest at all times. With this type of hernia complications can occur, such as incarceration and strangulation. Incarceration means the hernia is stuck and being squeezed. Strangulation results from the lack of blood supply, leading to death of the tissues involved, when incarceration persists too long.

Surgical intervention is required for these types of hernias.

No matter what type of hernia you have, the following tips can help limit the amount of discomfort you feel. 

1. 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.

2. 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.

3. 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.

4. Avoid Bending Over Soon After Eating

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

5. 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.

6. Use an Antacid

Antacids will work very quickly on heartburn you may be experiencing 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 an H2 blocker in combination with an antacid. If you don't find relief from these, your doctor may prescribe a proton pump inhibitors.

7. Sleep with Your Head and Shoulders 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

8. 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.

9. 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.

10. 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.


"Heartburn, Gastroesophageal Reflux (GER), and Gastroesophageal Reflux Disease (GERD)." NIH Publication No. 07–0882 May 2007. National Digestive Diseases Information Clearinghouse (NIDDK). 27 Jul 2007

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