Procedures - Hiatus
General advice for treating heartburn
and oesophagitis includes avoiding foods and substances that
can increase acid reflux into the oesophagus. These include
cigarettes, caffeine, chocolate, fatty foods, spicy foods
and alcohol. It is sensible to eat smaller meals in the evening
and moderate weight loss will usually improve symptoms of
reflux. It may be necessary to elevate the head of the bed
by using pillows or by placing a wedge under the mattress.
Prescription drugs are often recommended to decrease acid
production in the stomach.
If volume reflux is the main problem,
the refluxate will merely become alkaline and in these circumstances,
surgery is likely to be recommended.
Surgery for hiatal hernia is similar
to surgery for GORD. The main principle is to return the stomach
into the abdominal cavity and to suture it in such a way that
it is unlikely to slide back into the chest. When a large
hiatal defect is present it may be necessary to reinforce
this area using a mesh.