I'm 32 and have a hiatal hernia. Is it safe to treat reflux without taking PPIs lifelong?
The question, asked by a man aged 30 to 44
I've been dealing with acid reflux for a while and was told I also have a hiatal hernia. PPIs help, but I don't really want to depend on them indefinitely if there are other safe options. I've been reading about lifestyle changes and other treatments, but I'm not sure what actually works when a hiatal hernia is involved. What options should I discuss with a doctor?
The hiatal hernia is a situation where the upper portion of the stomach moves through the diaphragm and enters the chest. This will weaken the valve that prevents acid from entering the stomach. This leads to acid reflux to the food pipe. Here are the things that can make the condition worse:
Any form of pressure on the stomach, due to belly fat, tight clothing, straining, constipation, or lifting something too heavy.
Improper times of meals can cause acid reflux, particularly when lying down.
Foods like fried, spicy foods, and caffeine can be a trigger.
Smoking can weaken the valve.
In the case of having a small hiatal hernia, there is no need for using PPIs for life. Some lifestyle and weight changes can eliminate the symptoms to avoid PPIs. In the case of a large hernia and reflux, it is suggested to have surgery.
Suggested Tests
- Upper GI endoscopy
- Barium swallow, to show the type and position of the hernia
- 24-hour pH-impedance monitoring, done off PPIs under medical supervision
- Oesophageal manometry, to assess the valve at the base of the food pipe
- H. pylori stool antigen
- Vitamin B12 and serum magnesium, given ongoing PPI use
- Waist measurement, as pressure around the abdomen can worsen reflux with a hiatal hernia
How Clinic Living Plus Can Help
At CLP, we help you manage reflux in a way that reduces your reliance on PPIs. This process is safe, and your gastroenterologist is in the loop.
We help in carrying out the right diagnosis, and we work with your gastroenterologist to assess the size of the hernia and the severity of the situation.
The management of the PPI is done by our doctors by slowly reducing the dosage rather than suddenly stopping the PPI.
Weight management, constipation, and good posture to relieve the pressure on the valve.
Exercising without straining the abdominal muscles, assisted by our physiotherapist and trainer.
Identifying the triggers and developing a meal plan with the right portion sizes.
Improving gut health by healing the food pipe and stomach linings.
Right habits and assistance helps patients with hiatal hernia to live comfortably.
Lifestyle & Nutrition Tips
- Avoid doing any work which involves lifting and bending.
- Do not exercise after eating because it will increase the abdominal pressure and make the situation worse.
- Eat food at home in smaller portions.
- Avoid food which contains fats and oils as it causes reflux.
- It is necessary to have enough water and fiber in the body.
What to Do Next
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