Hiatus Hernia and acid reflux

Firstly, discover what your trigger foods are by keeping a diary. These are the foods that make you notice the acidity of any reflux and you will need to reduce them. There are various banned foods lists suggested but everyone is different so what affects one may not affect you. A common culprit, however, is fatty food which doesn't break down in acid.

I'm assuming you're on 30mg lansoprazole (the normal maintenance dose). Taken half an hour before breakfast every day is the best time for these. They become more effective over a few days continuous use. If they are insufficient, discuss with your doctor about doubling them.

Gaviscon is a useful adjunct to be used if you have a flare up. Unlike lansoprazole, it is immediate acting.

Drugs, however, may not help the reflux (being meachanical rather than chemical in nature). Lifestyle is the key here.

Lose weight, if necessary; do not overfill your stomach, eat little and often; avoid tight clothing; avoid exercise after food that will compress your stomach; leave at least 3 hours between your last meal and going to bed; raise the head of the bed by 6 to 8 inches on blocks.

Once your acid levels are in control, any reflux will be less damaging; once the reflux is under control as well, you should be feeling better.

Very sorry to hear of your troubles, which, with three years of similar through gastritis and a nightmare of stress last year, I fully empathise with.

Firstly, stress is one of the worst things for causing or worsening these kinds of illnesses, so every thing you can do to lessen or eradicate that the better.

Secondly, what, how and when you eat and drink can also have a major bearing on stomach troubles and reflux, and I have found certain measures that help me to at least be better than I was, if not cured.

Hopefully you might find some help from my own case and those of others who are in difficulty like you. Best wishes.

Several small/medium meals per day (I have seven medium, one every two hours or so), rather than fewer bigger ones, so you don't overfill your stomach. Eat relaxed, chew well. Be sat upright for and after meals, not bent or reclining, so you don't squash your stomach and press its contents upwards.

Fried foods, high-fat foods/meats, dairy, high-salt foods, spicy-hot foods, tomatoes, carbonated drinks, caffeine, alcohol and chocolate can all impact on stomach and reflux troubles for some people, so personal experimentation is key. Minty foods relax the lower oesophageal muscle, as do some of the above foods and drinks, which can let acid up easier, so they are bad. I use a fruity toothpaste, and strawberry gaviscon tablets for the now only occasional acid burn.

Wholewheat bread, cereals, bananas, hardboiled eggs are a few of the foods that suit me, but there are pulses, rice, various beans (not kidney beans apparently) and many other things to try. Chicken is one of the best meats due to its lower fat content, though even that can hit me and is not eaten lately.

Stress, excercise and bending activity that pressure and squeeze the stomach are also to be avoided. Be as calm and stress-free as you can.

Having your last meal a few hours before bed can prevent or lessen reflux at night, but I found that waiting to be too empty caused hunger discomfort, assorted spasms and kept me awake. Because of this I lie down about an hour and a half to two hours after last meal, and this is much better. I lie raised a bit on three pillows, on my right side, which is best for me, though the left side is usually recommended. Other people raise the bed-head itself about 6 to 8 inches or use a wedge affair..

Another thing that helps me greatly is to not burp after ten minutes after eating, as this can bring acid up and cause heartburn. I get the swallowed air out gently just after the meal, sittiing a little forward, then don't burp till after the next meal.

Water triggering heartburn is common. It can happen even with non-ill people. I learned that the best way to get my daily requirement is to drink around 130 ml or so with each meal, which, in my case, is added to by some sips of a nutrition drink. So generally I don't have to drink between meals, a thing which would slow my digestion a bit anyway and interfere with my set meal times.

In tests there was an indication that some people with reflux suffer heartburn through drinking water in several gulps because their lower eosophageal muscle doesn't open and close correctly when doing this with fluid, and so acid can escape upwards. But just adding water to your stomach between meals, when there is still food and fluids in there, will increase its volume and raise it nearer to the top where the muscle is, the pressure of which, if too much water is drunk, can then cause the muscle to open and let stomach fluid up. Cold water can also cause spasms, so sips of usual water is best.

Some say to drink water only between meals at points when the stomach is empty, but that cannot always be done easily - certainly not in my case, where I need to eat every couple of hours or will lose more weight. I can't have between-meal water slowing things down. So I find that a little drink of water with each bite of food that gets well chewed, then a few more af the end of the meal does the trick. I also have water with two cereal meals, which may sound utterly bland but is fine to me, as I avoid dairy milk and have yet to try my cereals with the likes of oat, rice, almond or soya milk. But they are good milk substitutes for people who don't/can't have dairy, unless a person has issues with them.