Brief Answer:
Several advises given below, including foods to avoid. Coffee makes reflux worse.

Detailed Answer:

Hello,

Patients with hiatal hernia are at increased risk for acid reflux and heartburn. There are a few things to do to reduce the reflux and also some measures to reduce acidity of the stomach fluids so they do not cause much damage of the esophagus and throat while they go up.

Food and meals:
- try to eat frequent small amount of food (the same for liquids, take in frequent small amounts) during the day. Instead of eating 3 big meals you can have 5 smaller meals with the later meal at least 3-4 hours before bed time.
- coffee makes reflux worse due to relaxation of the muscles of the valve between the stomach and the esophagus. So try to avoid coffee, if you can not completely quit coffee try to have it only before noon time and not later.
- alcohol and smoking are also to be avoided as they increase reflux and increase acid production in the stomach making symptoms worse.
- try to avoid fast food, fried food and very fat food- the reason is because these food increase acid production of the stomach and increase the time food stays in your stomach so the reflux is worse.
- fruit and vegetable are generally good but you might notice some that you do not tolerate well and you might need to avoid those as well.
- some patients are better with milk and some are worse when they use milk so you will have to see how you react to it and decide if you should take it to help your symptoms or not.
- avoid acid and sour food- these increase the acidity in the stomach

Other measures:
- raising the head of the bed with bricks to elevate your head while you sleep might reduce reflux and help you feel better. This is better than adding pillows as pillows might cause problems with your neck.
- try to keep a BMI 20-25. This is the weight related to your height. People that have BMI more than 25 and especially those with BMI over 30 are more at risk of reflux. Being careful with the kind of food you eat and the amount of food you consume in a day combining it with an active lifestyle and exercises might help you keep a normal BMI.
- some medications like ibuprofen, naproxen, aspirin, can make your stomach produce more acids and worsen the symptoms so you might be better using paracetamol (does not hurt the stomach) instead if ibuprofen for pain or fever in case you need it. If you need to take ibuprofen or other medications in its class please take them in the smaller effective dose and after food.
- your doctor might have already prescribed you some medications that reduce stomach acidity. Lansoprazole is found to be one of the best for this purpose.

Hope I have answered your query.
Let me know if I can assist you further.


Kind regards,
Antoneta Zotaj, MD

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