A hiatal hernia is when the top part of your stomach bulges up into your chest cavity, preventing the LES from closing properly.
Many people with hiatal hernias have no symptoms at all. In other cases, the hernia can be caused by GERD, and in still others, GERD is a symptom of the hernia.
Hiatal hernias are more common after the age of 50 and in people who are obese. They sometimes also happen after coughing, vomiting, or a physical injury.
Losing weight along with a healthy diet can help control reflux symptoms due to a hiatal hernia. Some people with reflux due to hiatal hernias may benefit from over-the-counter or prescription heartburn medicines. In extreme cases, surgery may be needed to push the stomach back down and reinforce the barrier between the stomach and the esophagus.
Eating a large meal and then lying down
Eating a large meal at any time can trigger acid reflux, but it’s especially troublesome if you do it right before you go to bed or decide to lounge on the couch.
Blame it on gravity. “Eating right before lying down leads to reflux since the stomach is full while one is lying down and it is easier for the acid to back up into the esophagus,” explains Dr. Ivanina. “Large meals also may overcome the esophageal barrier and lead to increased acid exposure.”
Try eating several small meals staggered throughout the day instead of fewer large meals. Don’t lie down until two or three hours after you eat and, if you still have problems, try raising the head of your bed a few inches to offset the effect of gravity.
“A lot of people get some relief from sleeping on an incline or with a wedge under their body,” says Dr. Schiller.
Smoking can damage your digestive system just as it damages so many other parts of your body. Even secondhand smoke and chewing tobacco can contribute to reflux by relaxing the lower esophageal sphincter.
“Smoking and alcohol both contribute to reflux as they lower LES pressure, reduce acid clearance, and weaken protective esophageal functions,” says Dr. Ivanina.
Research has shown that quitting smoking can improve reflux (as if you needed another reason to quit, or to not start in the first place).
Smoking may also contribute to reflux by making you cough. “A lot of people who smoke cough, and every time you cough, you’re increasing pressure in your belly and promoting reflux,” says Dr. Schiller.