Monday, February 13, 2012
Ask the Doctor: Dealing with the Effects of a Hiatal Hernia
DEAR DR. DONOHUE: After an endoscopy, the doctor told me I have a hiatal hernia.
He said nothing could be done for it and that I will have to live with it the rest of my life.
He gave me no medicines or advice.
I am anxious about this and would appreciate any info you can give me. - Anon.
ANSWER: The swallowing tube - the esophagus - begins at the throat, travels down the chest and finally ends by attaching to the stomach.
To reach the stomach, it must go through an opening in the diaphragm, the muscle that separates the chest from the abdominal cavity.
That opening is the hiatus.
A hiatal hernia is a bulging of part of the stomach through the hiatus and into the chest cavity.
Many times, a hiatal hernia causes no symptoms and needs no treatment.
At other times, a hiatal hernia produces GERD - gastroesophageal reflux - an upward spurting of acid and digestive juices from the stomach into the esophagus.
That brings on heartburn, a common problem with many treatments.
People without such a hernia also develop GERD.
Here are some tips to handle heartburn.
Lose weight, if need be.
Don’t eat within three hours of going to bed.
Elevate the head of your bed using blocks that are 6 to 8 inches tall and placed under the bedposts.
This keeps stomach juices in the stomach while you sleep.
Sleep on your left side for the same reason.
Don’t wear constricting garments around the abdomen or too tight a belt.
Take antacids as needed - Tums, Rolaids, Mylanta and Maalox.
Eliminate any food that gives you heartburn.
Usual offenders are citrus fruits, tomatoes, onions, spicy foods, fatty and fried foods, chocolate, carbonated beverages, mints and caffeinated drinks.
If these steps don’t solve the heartburn problem, try medicines called acid blockers: Tagamet (cimetidine), Zantac (ranitidine), Pepcid (famotidine) and Axid (nizatidine).
In low doses, all of these can be purchased without a prescription.
The next step is medicines that turn off acid production.
Prilosec (omeprazole) doesn’t require a prescription.
The prescription drugs are Prevacid, Nexium, Aciphex, Protonix and Dexilant.
If necessary, surgical procedures can correct hiatal hernias.
The booklet on hiatal hernias explains this common condition in detail. To obtain a copy, write: Dr. Donohue - No. 501, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
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To Not Me,