Materiały źródłowe

• #1 Which hiatal hernia’s need to be fixed? Large, small or none? – Dunn – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5885/html

  Hiatal hernias are a common occurrence in the western population, with an estimated prevalence of 15% to 20%. […] If untreated, they may progress to gastric volvulus necessitating emergency surgery and partial or total resection of the stomach with resultant increased morbidity, length of stay, and mortality. […] Since there is wide variability in the symptomatology and severity of hiatal hernias, it is important to understand when repair of these hernias is indicated. […] Surgery is recommended for all acute symptomatic presentations of PEHs (obstruction or incarceration/strangulation). […] Type I hiatal hernias are not typically surgically repaired if they are asymptomatic, given their low overall morbidity. […] Influential studies published more than 40 years ago led to recommendations that surgeons prophylactically repair all PEHs in order to avoid the potential development of volvulus and/or gastric ischemia.

• #2

  https://umiamihealth.org/en/treatments-and-services/surgery/thoracic-surgery/hiatal-hernia

  A hiatal hernia occurs when part of your stomach pushes up into your esophagus through the opening that separates your chest from your stomach (esophageal hiatus in the diaphragm). This prevents the esophageal sphincter from closing completely, which can cause food and stomach acid to back up into your esophagus, called acid reflux. […] Hiatal hernias may be caused by increased pressure in your abdomen when you lift something heavy, push during a bowel movement, cough, or vomit. You can also get a hiatal hernia during pregnancy or from a buildup of fluid in your abdomen. […] Hiatal hernias affect men and women of all ages, but it mainly occurs in people 50 and older. People who are overweight or smokers have a greater risk of developing a hiatal hernia. […] Your doctor may recommend lifestyle changes to reduce symptoms. They may tell you to avoid acidic or fatty foods that cause heartburn, eat at least a few hours before bedtime, avoid lying down after eating, and eat several smaller meals instead of three large meals each day. If you’re overweight or a smoker, losing weight and quitting smoking can also help improve your symptoms. […] If lifestyle changes and medicine dont relieve symptoms, your doctor may suggest surgery. The procedure will depend on the repairs needed to restore normal function of your esophagus.

• #3 Hiatal hernia – UF Health Jacksonville

  https://ufhealthjax.org/conditions-and-treatments/hiatal-hernia

  Hiatal hernia can develop at any age, though it most often occurs in people over 50. […] It is associated with obesity, smoking and pregnancy. […] A common management for hiatal hernia includes lifestyle changes. This can include weight loss, avoiding large meals at night and eating smaller meals more frequently, avoiding caffeine and spicy foods that trigger acid reflux symptoms. […] One of the most common treatment options for hiatal hernia are medications that can help reduce the amount of acid produced in the stomach and therefore symptoms like heartburn and acid reflux. […] Surgery is usually recommended if you experience severe or persistent symptoms that do not respond to or only partially respond to medications.

• #4 Hiatal Hernia

  https://healthlibrary.inova.org/Search/85,P00379

  Health experts dont know what causes hiatal hernias. They dont know how to stop them from happening. […] Follow your healthcare providers advice for treating and managing your hiatal hernia. You may need to make some lifestyle changes, such as: […] Losing weight if you are overweight or obese […] Not eating for 3 to 4 hours before going to bed […] Not bending over right after eating […] Quitting smoking […] Elevating the head of your bed while you sleep.

• #5 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=85&contentid=p00379

  Health experts dont know what causes hiatal hernias. They dont know how to stop them from happening. […] You may need to make some lifestyle changes, such as: Losing weight if you are overweight or obese […] Not eating for 3 to 4 hours before going to bed […] Not bending over right after eating […] Quitting smoking […] Elevating the head of your bed while you sleep.

• #6 Hiatal Hernia: Symptoms, Surgery, Treatment, and More

  https://www.healthline.com/health/hiatal-hernia

  Doctors dont know exactly what causes hiatal hernias or how to prevent them from happening. […] However, certain factors like living with obesity and smoking may increase your risk of a hiatal hernia, so maintaining a moderate weight and quitting smoking may help decrease your risk of developing one.

• #7 Hiatal hernia – UF Health

  https://ufhealth.org/conditions-and-treatments/hiatal-hernia

  Controlling risk factors such as obesity may help prevent hiatal hernia.

• #8 How to Fix a Hiatal Hernia Yourself, and When to Seek Medical Help

  https://www.healthline.com/health/how-to-fix-a-hiatal-hernia-yourself

  Keep reading to learn how to treat a hiatal hernia at home, hernia prevention tips, and when you should seek professional medical help. […] Tips for preventing hiatal hernias […] You cant prevent hereditary conditions, but you may be able to address other potential causes. […] In a 2007 interview, John E. Pandolfino, MD stated that, Obese people are certainly more prone to the development of hiatus hernia. This leads to the conclusion that, if you are overweight, reducing your weight could lower your chances of experiencing a hiatal hernia. Other prevention methods to consider could include: […] Some lifestyle changes that can help include: […] If home treatment is not effective, your doctor may recommend prescription medication or, in some cases, surgery.

• #9 Hiatal Hernia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22859

  Preventing a hiatal hernia involves measures that reduce intraabdominal pressure, such as maintaining a healthy weight, avoiding heavy lifting, and practicing good posture. Additionally, dividing meals into smaller portions taken more frequently and staying upright after eating can help minimize the risk. […] Patients receiving treatment for GERD and hiatal hernia-related symptoms should adhere to their medications and follow postoperative instructions closely. These instructions usually include modifying the diet in the postoperative period.

• #10 Hiatus hernia | healthdirect

  https://www.healthdirect.gov.au/hiatus-hernia

  You are less likely to develop a hiatus hernia if you maintain a healthy weight and if you avoid straining your abdomen. […] If you have symptoms of GORD caused by a hiatus hernia, you can reduce or relieve your symptoms by: Following medicine instructions use medicines as suggested by your doctor. Avoiding excessive abdominal pressure avoid straining while on the toilet, and weightlifting. Adjusting your position sitting upright or elevating the head of your bed may reduce your symptoms. […] Lifestyle changes that may also help include: avoiding certain foods and drinks such as fatty or spicy foods that can cause reflux, eating smaller meals, losing weight if needed, quitting smoking.

• #11 Exercises to Prevent a Hiatal Hernia: Surgical Consultants of Northern Virginia: General Surgeries

  https://www.scnv.com/blog/exercises-to-prevent-a-hiatal-hernia

  A hiatal hernia is when the stomach presses into the chest cavity. […] Larger hernias may require surgery, but typical hiatal hernias can heal with exercises and stretches that can strengthen the diaphragm. These exercises can reduce the risk and may even relieve some symptoms. […] Doing exercises to strengthen stomach muscles can help reduce your risk for a hiatal hernia. […] A strong diaphragm can also reduce your risk of a hiatal hernia. […] While there may be several exercises and yoga poses that can be done to prevent and reduce the symptoms of a hiatal hernia, it may be recommended to consult an expert to ensure it is a hiatal hernia.

• #12 Preventive Exercises for Hiatal Hernia | Maryland Bariatrics

  https://mdbariatrics.com/blog/which-exercises-prevent-hiatal-hernias/

  Hernia-proofing your core muscles by strengthening them is key to preventing this type of hernia, even if its genetic. A strong ab musculature will protect against small tears in the diaphragm, which lead to large problems down the line! […] Core stability exercises such as planks and side planks bridges strengthen not only your abs but also all four sides of your torso. Flexibility training for these muscle groups improves functionality, including daily activities like walking upstairs or getting out of bed. Aerobic activity strengthens heart function, which pumps oxygenated blood around our body. When our body is functioning better, we feel better!

• #13 What Is a Hiatal Hernia? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/hiatal-hernia/guide/

  It is difficult to prevent a hiatal hernia, but there are steps you can take to reduce your risk and minimize any symptoms. These include maintaining a healthy weight and not smoking. […] If you have a hiatal hernia that leads to GERD, the following lifestyle changes can help prevent episodes of GERD: Losing weight, Reducing meal and portion size, Avoiding acidic foods, like tomatoes and citrus fruit, Avoiding caffeine and alcohol, Limiting carbonated beverages, Limiting fried and fatty foods, Eating at least three to four hours before lying down, Keeping your head and torso elevated at least 6 inches when you rest or sleep, Quitting smoking.

• #14 10 Lifestyle Changes: Effective Hiatal Hernia Treatments – Dr. Adam S. Harris, M.D.

  https://surgeonadamharris.com/lifestyle-changes-for-effective-hiatal-hernia-treatments/

  Maintaining good posture can significantly reduce the discomfort associated with hiatal hernia. […] Improper lifting techniques can put stress on the abdominal muscles and exacerbate hiatal hernia symptoms. […] Physical therapy can be beneficial for individuals with hiatal hernia by strengthening the diaphragm, a key muscle involved in breathing and maintaining proper alignment of the organs. […] Practicing relaxation techniques can be beneficial for individuals with hiatal hernia, as stress and anxiety can exacerbate symptoms. […] Smoking has detrimental effects on overall health, including the exacerbation of hiatal hernia symptoms. […] Excessive alcohol consumption can worsen hiatal hernia symptoms by increasing stomach acid production and relaxing the lower esophageal sphincter. […] Regular check-ups with a healthcare provider are an important part of managing hiatal hernia. […] In conclusion, managing hiatal hernia involves a combination of lifestyle changes, medication, and other treatment modalities to alleviate symptoms and improve quality of life.

• #15 Hiatal Hernia: Symptoms, Causes, Diagnosis, and Treatment

  https://www.webmd.com/digestive-disorders/hiatal-hernia

  Most people dont notice symptoms of a hiatal hernia and dont need treatment. […] Your doctor will decide the best long-term treatment for you, depending on things such as the nature of your hernia, your reflux, and your symptoms. Treatment options are: […] Some changes to your daily life can help with acid reflux symptoms. They include: […] Lose extra pounds. […] Dont smoke. Smoking can cause intense heartburn. […] Weight loss is common after hernia surgery, with an average loss of 10 to 15 pounds.

• #16 Hiatus hernia | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/hiatus-hernia/

  Treatment for a sliding hiatus hernia usually focuses on relieving the symptoms of GORD, such as heartburn. […] Lifestyle changes and medication are the preferred treatments. Surgery is usually only recommended as an alternative to long-term medication or if other treatments haven’t worked. […] Lifestyle advice may include: eating smaller, more frequent meals, rather than 3 large meals a day; avoiding lying down (including going to bed) for 3 hours after eating or drinking; removing any foods or drinks from your diet that make your symptoms worse. […] There are several things you can do yourself to help relieve symptoms of GORD caused by a hiatus hernia. These include: eating smaller, more frequent meals, rather than three large meals a day; avoiding lying down (including going to bed) for at least 3 hours after eating or drinking; avoiding drinking during the night; removing certain foods from your diet if you think they make your symptoms worse; avoiding alcohol, caffeine, chocolate, tomatoes, fatty foods, spicy foods and acidic food or drinks, such as citrus fruit juice, if they make your symptoms worse; avoiding bending over or stooping, particularly after eating or drinking; raising the head of your bed by around 20cm (8 inches) by placing a piece of wood or blocks under it; don’t use extra pillows, because this may increase pressure on your abdomen.

• #17 Hiatus Hernia Symptoms, Causes & Treatment | Spire Healthcare

  https://www.spirehealthcare.com/conditions/hiatus-hernia/

  In most cases, a hiatus hernia doesn’t need treatment if it isn’t causing you problems; simple lifestyle changes can relieve any symptoms. […] You can manage symptoms of a hiatus hernia, specifically heartburn and acid indigestion, by making changes to your diet. […] They may suggest simple changes that you can try at home, such as avoiding bending over, lying down or lifting heavy objects immediately after eating or drinking. […] Living a healthier life: stop smoking, don’t drink too much alcohol, lose any excess weight and take time to relax. […] Over-the-counter medications, such as antacids that neutralise stomach acid, can help relieve your hiatus hernia symptoms, especially heartburn and acid reflux. […] If lifestyle changes and medication are unsuccessful and your symptoms are very severe, your GP or consultant may suggest surgery. […] A hiatus hernia surgery is usually done as a keyhole (laparoscopic) surgery and has a good success rate. […] If your hiatus hernia continues for more than three weeks, is severe or getting worse, not getting treatment can lead to serious complications.

• #18 Hiatus hernia | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/hiatus-hernia/

  If you’re overweight, losing weight may help to reduce the severity and frequency of your symptoms. […] If you smoke, you should try to give up. Tobacco smoke can irritate your digestive system and may make your symptoms worse. […] Surgery is usually only recommended for a sliding hiatus hernia (hernias that move up and down, in and out of the chest area) if the problem fails to respond to lifestyle changes and medication. […] You may also want to consider surgery if you have persistent and troublesome symptoms, but don’t want to take medication on a long-term basis. […] If you have a para-oesophageal hiatus hernia, where the stomach pushes up through the hole in the diaphragm next to the oesophagus, surgery may be recommended to reduce the risk of the hernia becoming strangulated.

• #19 Hiatal hernia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/diagnosis-treatment/drc-20373385

  Making a few lifestyle changes may help control the symptoms caused by a hiatal hernia. Try to: […] Maintain a healthy weight. […] Stop smoking. […] Elevate the head of your bed 8 inches (20 centimeters). […] If you’ve been diagnosed with a hiatal hernia and your problems persist after you make lifestyle changes and start medicine, you might be referred to a doctor who specializes in digestive diseases, called a gastroenterologist.

• #20 Hiatus hernia

  https://www.nhs.uk/conditions/hiatus-hernia/

  There are things you can do yourself to manage hiatus hernia symptoms. […] eat smaller, more frequent meals […] raise the head end of your bed by 10 to 20cm so your chest and head are above the level of your waist, which can stop stomach acid travelling up towards your throat […] try to lose weight if you’re overweight […] try to find ways to relax […] do not have food or drink that triggers your symptoms […] do not eat within 3 or 4 hours of going to bed […] do not wear clothes that are tight around your waist […] do not smoke […] do not drink too much alcohol […] do not stop taking any prescribed medicine without speaking to a doctor first. […] Speak to a pharmacist for advice if you keep getting hiatus hernia symptoms. […] They may recommend medicines called antacids or alginates, which can help ease your symptoms. […] It’s best to take these with food or soon after eating, as this is when you’re most likely to get symptoms. […] Although antacids and alginates help symptoms in the short term, they will not cure the problem and should not be taken regularly for long periods.

• #21 Hiatal hernia diet: Food list and tips

  https://www.medicalnewstoday.com/articles/320468

  Eating and avoiding certain foods can be a part of the lifestyle and dietary changes to reduce or prevent symptoms of hiatal hernia. […] Non- or low-acidic foods may reduce the likelihood and severity of hiatal hernia and GERD symptoms. […] It is a good idea for people with a hiatal hernia to limit or avoid foods that are acidic, rich, oily, or contain preservatives. […] Aside from diet, a person could try making some lifestyle adjustments to help manage hiatal hernia and GERD symptoms. […] Other lifestyle changes, such as maintaining a moderate weight and quitting smoking can also help manage symptoms of a hiatal hernia.

• #22 Hiatal Hernia Treatment: 4 Options

  https://www.verywellhealth.com/treating-hiatal-hernias-1742603

  Some people don’t experience symptoms or need treatment and most people get relief from lifestyle changes and medication. […] Several key lifestyle changes can help minimize your symptoms: Weight loss relieves the abdominal pressure that can cause a hernia. […] Follow a low-fat, high-fiber diet to help reduce constipation and stomach acid production. […] Get enough fluids by drinking at least eight cups of water daily. This will help reduce the risk of constipation and dilute acid in your stomach. […] Avoid trigger foods that can cause heartburn, including high-fat and fried foods, spicy foods, tomato-based sauces, citrus, garlic, onion, carbonated drinks, caffeine, and alcohol. […] Quit smoking because smoking relaxes the LES, allowing food and acid to reflux more easily. […] Eat several smaller meals throughout the day instead of a few large meals and avoid eating late in the day.

• #23 Hiatal Hernia: Causes, Symptoms, Diagnosis & Treatment

  https://www.clevelandclinicabudhabi.ae/en/health-hub/health-resource/diseases-and-conditions/hiatal-hernia

  Quitting smoking. […] Not wearing a tight belt or tight clothing that can increase the pressure on the abdomen — such as control top hosiery and body shapers. […] Taking medications after eating to reduce acid in the stomach. These over-the-counter medications include antacids, Gaviscon, or H2 blockers (such as Pepcid AC or Zantac). […] If you take over-the-counter medications for longer than 2 weeks without any improvement, see your physician. He or she can prescribe stronger medications such as pantoprazole (Protonix), rabeprazole (Aciphex), esomeprazole (Nexium), omeprazole (Prilosec), lansoprazole (Prevacid), or others.

• #24 Hiatal Hernia | Columbia Surgery

  https://columbiasurgery.org/conditions-and-treatments/hiatal-hernia

  Hiatal hernias require repair for two main reasons: […] If surgical treatment is required, our surgeons nearly always use minimally invasive anti-reflux techniques, including laparoscopy and endoscopy, with the type of procedure used depending upon the amount of stomach that has migrated through the diaphragm into the chest. […] An early-stage hiatal hernia may be repaired by decreasing the size of the enlarged hiatus (the opening in the diaphragm through which the esophagus travels on its way to the stomach). […] To repair and prevent a sliding hiatal hernia, Nissen fundoplication involves wrapping of the fundus (upper part) of the stomach around the bottom portion of the esophagus to create a bulge of tissue that holds the stomach in place below the diaphragmatic hiatus. […] In Collis-Nissen gastroplasty, the surgeon uses the upper portion of the stomach to extend the esophagus and ease this tension.

• #25 Hiatal Hernias | University of Michigan Health

  https://www.uofmhealth.org/conditions-treatments/surgery/hiatal-hernia

  Hiatal hernias dont always require treatment beyond regular monitoring and medications. […] Under certain conditions, however, treatment will be necessary. Those conditions include: chronic anemia; chronic pain; complications by gastroesophageal reflux disease; complications by esophagitis; danger of strangulation; inability to vomit; recurrent pneumonia or other infections. […] Minimally invasive surgery can effectively diminish the size of a hernia, as well as reduce the opening in the diaphragm, thereby preventing strangulation. […] Your surgeons may also perform a fundoplication, which will help to prevent acid from rising through the stomach.

• #26 Which hiatal hernia’s need to be fixed? Large, small or none? – Dunn – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5885/html

  In recent years, however, some studies have found that the risk of catastrophic complications is much lower than these initial estimates. […] Few studies have looked at the natural history of paraesophageal hernias without surgical intervention, making it difficult to assess the risks of watchful waiting. […] The question of whether a patient should receive surgery is further complicated by the patients age and medical comorbidities. […] The literature supports only repairing those hernias which are symptomatic. […] For type II-IV hiatal hernias, the literature also supports repair of those hernias which are symptomatic. […] For hernias which are asymptomatic, the literature is conflicting. […] As such, the best course of action is a carefully held discussion between patient and surgeon on the risks and benefits of elective repair versus watchful waiting. […] Age is not a contraindication to surgery.

• #27 Gastroesophageal Reflux Disease (GERD) and Hiatal Hernia | Duke Health

  https://www.dukehealth.org/treatments/digestive-disorders/esophagus-disorders

  A hiatal hernia, or type of hiatal hernia called a paraesophageal hernia, occurs when the stomach and other abdominal organs enter the chest area through the hiatus, a naturally occurring hole in the diaphragm. The presence of a hiatal or paraesophageal hernia allows acid to flow freely into the esophagus and may cause additional symptoms including nausea, vomiting, chest pain, heartburn, and difficulty swallowing. A surgical procedure can repair these hernias and offer symptom relief. […] As a comprehensive center, we offer several procedures to treat GERD, hiatal hernia, and paraesophageal hernia. […] In this standard surgical treatment of GERD, your surgeon wraps part or all of the stomach around the lower esophagus to strengthen the muscle and stop the acid reflux. This surgery is typically performed through small incisions.

• #28 Gastroesophageal Reflux Disease (GERD) and Hiatal Hernia | Duke Health

  https://www.dukehealth.org/treatments/digestive-disorders/esophagus-disorders

  During this minimally invasive procedure, your surgeon wraps a ring of magnetic titanium beads around the lower esophageal muscle to prevent the contents of your stomach from refluxing into your esophagus. […] Small instruments are passed through an endoscope, which is inserted in your mouth to reach your stomach. No incisions are required. The surgeon wraps the upper part of your stomach around your lower esophagus and uses a special device to help the esophageal valve prevent stomach acid from refluxing into your esophagus. […] If you experience GERD caused by obesity, gastric bypass surgery can bring relief by moving much of the acid-producing portion of the stomach away from the esophagus.

• #29 Hiatus Hernia | Treatment For Hiatus Hernia

  https://drrehanhaidry.com/hiatus-hernia/

  Prior to having an endoscopy (a camera down the throat investigation), a person is unlikely to know they have a hiatus hernia and their GORD type symptoms may be managed with conservative measures such as stopping smoking, cutting down alcohol, eating smaller meals and avoiding trigger foods. […] TIF is a minimally invasive advanced endoscopy procedure which creates a new anti reflux valve to prevent stomach contents leaking up. […] The join between the bottom of the food pipe and stomach created during the TIF procedure is associated with less side-effects, so for instance the patient can still belch (cTIF patients experience less gas/bloating) and vomit. There is a much lower risk of swallowing issues after cTIF compared with traditional hiatus hernia surgery.

• #30 SciELO Brazil – Hiatal hernia repair: prevention of mesh erosion and migration into the esophagogastric junction Hiatal hernia repair: prevention of mesh erosion and migration into the esophagogastric junction

  https://www.scielo.br/j/abcd/a/7gKfkxc9kJFhnKYgCTLw65q/

  The proposed technique should be useful for preventing erosion and migration into the esophagus. […] In order to cover the mesh, prevent or minimize the risk of esophageal or gastric wall erosion and migration of mesh: a) during dissection, the preserved remnant sac was placed behind the esophagogastric junction. […] In this manner, the mesh was covered in order to prevent late migration or erosion of the mesh into the esophagus. […] We believe that the proposed procedure accomplishes the purpose of preventing mesh erosion and migration into the esophagogastric junction. Up to now, after late follow-up, we have not observed them in our patients.

• #31 Hiatal hernia – Symptoms & treatment of hiatus hernia

  https://www.iqoro.com/hiatal-hernia/

  A hiatal hernia occurs when the muscles in the diaphragm weaken, making it unable to hold the stomach in place. This causes the lower esophageal sphincter to not close tightly, and the esophagus to be pushed upwards. Stomach acid can then leak up into the esophagus, causing heartburn and other uncomfortable symptoms. […] Since the underlying cause of these problems is weak muscles, the only long-term effective treatment is to strengthen the diaphragm through exercise. […] To avoid the symptoms getting worse, it is important to start strengthening the muscles as soon as possible. In addition, it takes longer and longer to build up the muscles the longer you wait to start training. […] Research shows that training with IQoro is a simple, risk-free and cost-effective treatment that can prevent the need for hiatal hernia surgery.

• #32 Hiatus Hernia

  https://www.svph.org.au/hospitals/toowoomba/patient-information/hiatus-hernia

  If you have symptoms such as reflux, your doctor may prescribe PPIs (Proton Pump Inhibitors) or antacid medications. […] Changing lifestyle factors such as: […] weight loss […] avoiding foods- such as fatty or spicy foods that aggravate the reflux […] avoiding pressure on your abdomen even avoiding straining while on the toilet. […] It is important to discuss any concerns with your GP as early treatment is best for long term health.

• #33 Hernia Types: Hiatal Hernias

  https://www.herniainfo.com/us/en/blog/hiatal-hernias

  Although there is no way to prevent a hiatal hernia, here are some things that may lower the chances of getting one: […] Maintaining a healthy weight […] Avoiding acid foods (citrus, juice, tomatoes, etc.) […] Limiting fatty, fried, and caffeinated items (carbonated drinks, alcohol, condiments, etc.) […] Creating a better bedtime routine […] Eliminate snacks at least three hours before bedtime […] Elevate your head 6 inches higher than your body when lying down […] Quitting smoking […] Reducing the amount of pressure you put on the abdomen by not: […] Lifting heavy objects […] Wearing restrictive clothing that is too tight in the abdomen.

• #34 Hiatus Hernias | Sliding, Rolling | Treatment – RefluxUK

  https://refluxuk.com/diagnosis/hiatus-hernia

  When a hiatus hernia evolves most people will develop reflux although they can be asymptomatic. Hiatus hernias are probably the main cause of GORD as they cause failure of the LOS. […] A hiatus hernia is a degenerative bio-mechanical failure. Once this is understood it is clear that life-style changes and medications can only control symptoms and cannot solve the fundamental anatomical problem. […] In the presence of a hiatus hernia we would advise that LINX or fundoplication is more likely to achieve a good result in terms of reduced reflux symptoms than other interventions.

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