For those with severe acid reflux and hiatal hernia, antireflux surgery is often recommended. The most widely used procedure is a Nissen fundoplication. To determine if you are a candidate for antireflux surgery, we recommend that you work with a GERD expert who can help you evaluate all of your treatment options. Over-the-counter heartburn medications can provide relief from the occasional burning sensation that might stem from a moderately-sized hiatal hernia. They can be taken as needed throughout the day in most cases. Calcium- and magnesium-based antacids are most commonly stocked in the digestive aids aisle of your local drugstore.
Nighttime symptoms are natural since you no longer have the benefit of gravity helping to keep the contents of the stomach where they belong – in the stomach. When lying down, the stomach contents can more easily flow up into the esophagus, causing the symptoms you’re all too familiar with. Swallowing, which typically clears these fluids from the esophagus, does not occur during sleep, so the sneak a peek at this site fluids can pool, potentially doing more harm. Endoscopic diagnostic tools are also used to diagnose hiatal hernias. An endoscope (a thin, flexible tube equipped with a small light) is threaded down your throat when you’re under sedation. This allows your doctor to look for inflammation or other factors that may be causing your acid reflux. These factors could include hernias or ulcers.
These procedures are done only as a last resort for treating acid reflux disease after medical treatment has proven to be inadequate. Prokinetics ( Reglan , Urecholine ) can help strengthen the LES, empty your stomach faster, and reduce acid reflux. All of these are signs of an incarcerated hiatal hernia, a condition which can lead to the strangulation of the blood supply and gastric perforation. An incarcerated hernia should always be considered a medical emergency in need of immediate treatment. The paraesophageal hernia is less common, but is more cause for concern. The esophagus and stomach stay in their normal locations, but part of the stomach squeezes through the hiatus, landing it next to the esophagus. Although you can have this type of hernia without any symptoms, the danger is that the stomach can become “strangled,” or have its blood supply shut off.
In many cases, lifestyle changes combined with over-the-counter medications are all you need to control the symptoms of acid reflux disease. Obesity is one of the factors responsible for both the aforementioned conditions, and hence controlling your weight can help manage the symptoms. However, if the condition is severe, you could go for hiatal hernia repair, which involves correcting the diaphragm by surgical procedures, that helps in alleviating the symptoms. Sliding hiatal hernias are a major risk factor for GERD and more often than not, the two conditions are seen together. Conversely, GERD can also cause a hiatal hernia. In sliding hiatal hernia, the lower esophageal sphincter (LES), which is normally at the same level as the diaphragm, squeezes above the diaphragm. This further weakens the LES as it does not get support from the diaphragm to remain closed. This can aggravate the symptoms of GERD.