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Hiatal Hernia: Care Instructions

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Your Care Instructions

A hiatal hernia occurs when part of the stomach bulges into the chest cavity.

A hiatal hernia may allow stomach acid and juices to back up into the esophagus (acid reflux). This can cause a feeling of burning, warmth, heat, or pain behind the breastbone. This feeling may often occur after you eat, soon after you lie down, or when you bend forward, and it may come and go. You also may have a sour taste in your mouth. These symptoms are commonly known as heartburn or reflux. But not all hiatal hernias cause symptoms.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

  • Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
  • Do not take aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), unless your doctor says it is okay. Ask your doctor what you can take for pain.
  • Your doctor may recommend over-the-counter medicine. For mild or occasional indigestion, antacids such as Tums, Maalox, or Mylanta may help. Your doctor also may recommend over-the-counter acid reducers, such as famotidine (Pepcid AC), cimetidine (Tagamet HB), or omeprazole (Prilosec). Read and follow all instructions on the label. If you use these medicines often, talk with your doctor.
  • Change your eating habits.
    • It's best to eat several small meals instead of two or three large meals.
    • After you eat, wait 2 to 3 hours before you lie down. Snacking close to bedtime isn't a good idea.
    • Avoid foods that make your symptoms worse. These may include chocolate, mint, alcohol, pepper, spicy foods, high-fat foods, or drinks with caffeine in them, such as tea, coffee, colas, or energy drinks. If your symptoms are worse after you eat a certain food, you may want to stop eating it to see if your symptoms get better.
  • Try to quit smoking or chewing tobacco, or cut back as much as you can. If you need help quitting, talk to your doctor about quit-tobacco programs and medicines. These can increase your chances of quitting for good.
  • If you get heartburn at night, raise the head of your bed 6 to 8 inches by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows does not work.)
  • Do not wear tight clothing around your middle.
  • Lose weight if you need to. Losing just 5 to 10 pounds can help.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lose consciousness).
  • You vomit blood or what looks like coffee grounds.
  • You pass maroon or very bloody stools.
  • You have severe belly pain.

Call your doctor now or seek immediate medical care if:

  • You have new or worse belly pain.
  • Your stools are black and look like tar or have streaks of blood.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You are vomiting.
  • You have new or worse symptoms of indigestion.
  • You have trouble or pain swallowing.
  • You are losing weight.
  • You do not get better as expected.

Where can you learn more?

Go to http://www.healthwise.net/patientEd

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.