Frequently Asked Questions About Heartburn and Reflux
3. I am a 55-year-old male who is about 30 pounds overweight. Lately, I've been experiencing frequent heartburn and have an acid taste in the back of my throat. Now, my doctor is telling me I have a hiatal hernia. Is this a serious problem? Will it require surgery? continued...
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.
4. 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.
- Eat slowly.
- 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.