A hernia is the pressing of an organ through an opening in the muscle wall of the cavity that protects it. With a hiatal hernia , a portion of the stomach pushes through the hole where the esophagus and the stomach join. The most common cause of a hiatal hernia is an increase in pressure on the abdominal cavity. Pressure can come from coughing, vomiting, straining during a bowel movement , heavy lifting, or physical strain.
Pregnancy, obesity, or excess fluid in the abdomen also can cause hiatal hernias. Continued A hiatal hernia can develop in people of all ages and both sexes, although it frequently affects middle-aged people. In fact, the majority of otherwise healthy people over age 50 have small hiatal hernias. Many people with a hiatal hernia never have any symptoms.
In some people, acid and digestive juices escape from the stomach into the esophagus gastroesophageal reflux. Heartburn A bitter or sour taste in the back of the throat Bloating and belching Discomfort or pain in the stomach or esophagus Vomiting Most hiatal hernias do not cause problems and rarely need treatment.
Successful treatment of hiatal hernias usually involves treating the symptoms of gastroesophageal reflux disease GERD that are triggered by the additional pressure in the abdomen. Losing weight , if you are overweight , and maintaining a healthy weight Having a common-sense approach to eating, such as eating moderate to small portions of foods, and limiting fatty foods, acidic foods such as tomatoes and citrus fruits or juices , foods containing caffeine, and alcoholic beverages Eating meals at least three to four hours before lying down and avoiding bedtime snacks Elevating the head of your bed by 6 inches this helps allow gravity to keep the stomach contents in the stomach Not smoking Wearing looser clothing, especially around the waistline Taking medications, such as over-the-counter antacids or H2 blockers or PPIs.
If you take over-the-counter drugs and see no improvement or take them for longer than two weeks, see your doctor. He or she may prescribe a stronger medication. If medications and lifestyle changes are not effective in treating your symptoms, diagnostic tests may be performed to determine if surgery is necessary. People with a hiatal hernia who also have severe, chronic esophageal reflux may need surgery to correct the problem if their symptoms are not relieved through these management techniques.
Surgery may also be needed to reduce the size of the hernia if it is in danger of becoming constricted or strangulated so that the blood supply is cut off. During surgery, gastroesophageal reflux is corrected by pulling the hiatal hernia back into the abdomen and creating an improved valve mechanism at the bottom of the esophagus. The surgeon wraps the upper part of the stomach called the fundus around the lower portion of the esophagus.
This creates a tighter sphincter so that food will not reflux back into the esophagus. Hiatal hernia surgery can be performed either by opening the abdominal cavity or laparoscopically. During laparoscopic surgery, five or six small 5 to 10 millimeter incisions are made in the abdomen. The laparoscope and surgical instruments are inserted through these incisions. The surgeon is guided by the laparoscope, which transmits a picture of the internal organs on a monitor.
The advantages of laparoscopic surgery include smaller incisions, less risk of infection, less pain and scarring, and a more rapid recovery. I am pregnant and have terrible heartburn. Is there anything I can do to get relief? More than half of all pregnant women report heartburn, particularly during their third trimester. Heartburn occurs during pregnancy, in part, because your digestive system works more slowly due to changing hormone levels.
Also, your enlarged uterus can crowd your stomach, pushing stomach acids upward. Here are some ways you can reduce your heartburn during pregnancy: Eat several small meals each day instead of three large ones. Avoid fried, spicy, or rich foods, or any foods that seem to increase your heartburn. Don't lie down directly after eating. Keep the head of your bed higher than the foot of your bed. Ask your doctor about trying over-the-counter heartburn relievers such as Tums or Maalox.
If your heartburn persists, see your doctor. He or she may prescribe drugs that are safe to take during pregnancy. Eating certain foods, including onions, peppermint, and high-fat foods, as well as drinking alcohol, can cause the lower esophageal sphincter muscle, which controls the opening between the esophagus and the stomach, to relax. Usually, this muscle remains tightly closed except when food is swallowed. However, when this muscle fails to close, the acid-containing contents of the stomach can travel back up into the esophagus, producing a burning sensation commonly referred to as heartburn.
Caffeinated beverages and foods such as coffee, tea, colas, and chocolate can also aggravate heartburn and gastroesophageal reflux disease GERD. Tomatoes, citrus fruits, or juices also contribute additional acid that can irritate the esophagus.
In addition, smoking relaxes the lower esophageal sphincter, contributing to heartburn and GERD. Improving your eating habits can also reduce reflux. After eating, keep an upright posture. Eat moderate portions of food and smaller meals. Lastly, eat meals at least three to four hours before lying down, and avoid bedtime snacks. What is Barrett's esophagus and how is it treated? Barrett's esophagus is a change in the lining of the lower esophagus that develops in some people who have chronic GERD or inflammation of the esophagus.
These symptoms include a burning sensation under the chest and acid regurgitation. These symptoms generally decrease with drugs that reduce acid in the stomach. Some people with Barrett's esophagus may not have any symptoms at all. The only way to confirm the diagnosis of Barrett's esophagus is with a test called an upper endoscopy. This involves inserting a small, lighted tube endoscope through the throat and into the esophagus to look for a change in the lining of the esophagus.
While the appearance of the esophagus may suggest Barrett's esophagus, the diagnosis can only be confirmed with small samples of tissue biopsy obtained through the endoscope. Pepcid AC may be only part of a complete program of treatment that also includes changes in diet or lifestyle habits. Follow your doctor's instructions very closely. Store at room temperature away from moisture, heat, and light. Do not allow the liquid medicine to freeze. Throw away any unused Pepcid AC liquid that is older than 30 days.
What happens if I miss a dose? Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose. What happens if I overdose? Seek emergency medical attention or call the Poison Help line at What should I avoid while taking Pepcid AC? It can increase the risk of damage to your stomach. Avoid taking cimetidine Tagamet , ranitidine Zantac , or nizatidine Axid while you are taking Pepcid AC, unless your doctor has told you to.
This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
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