Many people are familiar with GERD or gastroesophageal reflux disease. In fact, millions of Americans today have GERD. Of those who suffer from GERD, approximately 50% to 90% also have hiatal hernia. Hiatal hernia is the condition wherein there is a protrusion of the stomach located in the diaphragm, that body part that joins the esophagus and stomach. Those who have a small hiatal hernia are unaware that they have it since they rarely experience problems. But the larger hiatal hernias can cause the food and stomach acid to go up the esophagus, causing heartburn and pain in the chest.

If you have hiatal hernia, some of the symptoms you experience become even worse whenever you lean forward, strain yourself, lie down or try to carry heavy objects. Symptoms of hiatal hernia is also made worse by pregnancy. There are also cases (although very rarely) when the protruding part of the stomach in the cavity chest becomes twisted, or its blood supply is cut off. Either of these can cause severe pain in the chest. It can also make swallowing difficult, and the esophagus can be blocked.

There are a number of medications and self-care measures you can use to relieve the symptoms of hiatal hernia, but these only work on minor hiatal hernias. If you have a large hiatal hernia or experiennce the more serious symptoms of the condition (e.g., twisted stomach protrusion and/or cut off of blood supply), the only way you can ever feel relief is your hiatal hernia is surgically repaired.

The sliding hiatal hernia is another type of hiatal hernia wherein the stomach slides up and down the hiatus. This type of hernia rarely causes problems, but it does make acid reflux or GERD worse. The treatment for this type of hernia is similar to the treatment for the associated GERD. Surgery is typically performed for severe cases of GERD, as well as those cases wherein the GERD is complicated or fails to respond to adequate doses of medications. The surgical procedure involves pulling the stomach into the abdomen. It also involves shrinking the esophageal hiatus and attaching the diaphragm and esophagus.

If you experience symptoms of hiatal hernia, make sure to see a doctor so you can be diagnosed properly. If you also have GERD, below are a few tips you can keep in mind to make sure it doesn't get worse as a result of your hiatal hernia.

• Stay away from foods and drinks that can cause your esophagus to become irritated. These include fried foods, fatty foods, chocolate, peppermint, coffee, citrus fruits and juices, alcohol, and tomato-based products.

• Quit smoking.

• Try to lose weight if you are overweight.

• When you lie down, make sure your head is at least 6 inches higher.

• Wait at least 3 hours after eating to lie down.

• Take special medication or over-the-counter antacid.

Many people with GERD and hiatal hernia experience symptoms of reflux as a result of food sensitivities. When they consume such foods, stomach acid production increases or their stomach may become aggravated. If you have food sensitivities, it's crucial that you identify these foods so you can actively avoid them. To be certain, go to your doctor or nutritionist and seek help in identifying those problematic foods.