Hiatal Hernia: Care Instructions

Overview

A hiatal hernia occurs when part of your stomach bulges up through the diaphragm and into your chest. The diaphragm is a sheet of muscle that separates your belly (abdomen) from your chest.

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.

Treatment for a hiatal hernia that causes heartburn may include home treatment with lifestyle changes and medicines.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and contact 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?

• 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.
• 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.
• If the doctor gave you a prescription medicine, take it as prescribed. Call your doctor if you think you are having a problem with your medicine.
• 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.
• Stay at a weight that’s healthy for you. Talk to your doctor if you need help losing weight.

When should you call for help?

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

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

Contact your doctor now or seek immediate medical care if:

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