Regurgitation may occur in the absence of a demonstrable hernia and conversely, no regurgitation may occur, even when a large hernia is present.
Indigestion is the classic symptom. Regurgitation of bitter fluids into the mouth may occur, especially with belching or when bending.
Indigestion when the person lies down at night is due to the weight of the abdominal contents pushing up against the diaphragm and causing regurgitation.
An hiatus hernia may be diagnosed on the symptoms, but can be confirmed by a barium meal X-ray. For those who have had this X-ray, the reason they are strapped to the table and tilted head down is to demonstrate reflux.
Medical control is usually possible. Avoiding foods which upset, eating small meals frequently rather than large meals infrequently and antacids are usually effective. Avoiding bending, losing weight and avoiding tight clothes around the waist are useful adjuncts to treatment.
Considerable relief may be obtained by raising the head of the bed. Using several pillows is not good as the person is then bent at the waist. Raising the head of the bed and using only one low pillow offers better results. It may be necessary to raise it 10 to 20 cms.
Operative repair of the hernia is reserved for severe cases with failure of medical treatment.
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