I will try to answer all your questions and then give you up to date recommendations for the treatment of esophagitis. A hiatal hernia will never go away unless it is operated on or if it it caused by increased pressure in abdomen, ie pregnancy, fluid. The esophagitis or inflammation can affect you by giving you pain in the chest and it can radiate to the back. Hopefully with the following recommendations you will feel normal. Your hiatal hernia did not come from poor posture or bending over.
You have GERD. GERD= gastro esophageal reflux disease
If your heartburn symptoms are severe or persist you should see your doctor. For now you might want to try the following measures.
Eat bland foods. Although many doctors tell their patients to avoid spicey foods, fatty foods, citrus fruits, tomato juice or sauce, chocolates, alcohol and carbonated drinks, coffee (also decaf), there is no scientific evidence that is is helpful. You should avoid PROVOCATIVE foods which are any foods that specifically causes you discomfort. You should also stop smoking. You should not eat anything 2 hours before bedtime. The head of the bed should be raised 6-8 inches (can use large cans with sand) and try sleeping with left side down IF you have nighttime reflux. Don't lie down for 2-3 hours after a meal. Some medications may make the reflux worse, including anti-cholinergics, NSAIDS, antibiotics, anti-depressants, nitrates, progesterone, beta blockers and calcium channel blockers, iron, potassium, sedatives and bronchodilators. Several non-prescription agents may help; Gaviscon, Mylanta or Maalox as directed on bottle, acid suppressing agents such as OTC Tagamet, Zantac, Pepcid, or Axid or the stronger agents ( PPI's) such as Prilosec or Nexium, Prevacid, Aciphex and Protonix. Again follow instruction on the labels. Your Doctor may want to double your dose if you fail to improve.
It is important to LOSE WEIGHT if you or overweight. This has been clearly associated with worsening of reflux disease.
If you do not improve on the above regimen or if you have trouble swallowing or pain upon swallowing your doctor may want to proceed with other tests such as endoscopy or pH monitoring.
If your symptoms persist or worsen, surgery ( laparoscopic Nissen Fundoplication
) may be considered.
Here are useful websites:
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