Six Meals a Day?

Q: I was diagnosed as having a hiatus hernia and reflux esophagitis. My doctor suggests six small meals each day, two 20 mg. tablets of losec each day, and that I stay away from acid foods. Are there other dietary recommendations?

A: We have abbreviated your question, although we did notice that you say you enjoy your food. We wonder if that is a euphemistic way of saying you are overweight.

Reflux esophagitis is when the stomach contents wash back up the esophagus because the sphincter and—in your case—the hiatus hernia are permitting backflow. Because gastric juices are usually acid, they damage the esophageal lining, making it raw and subject to cancerous change more than others.

Studies have confirmed that overweight people have more “acid reflux” than thin people. Additionally, eating just before bedtime is not a good thing. You should not eat food within four hours of going to bed. It may also help if you were to place a brick beneath each of the feet of the headboard on your bed, so as to encourage the esophageal contents to drain into the stomach.

Avoid a tight belt, which increases intraabdominal pressure.

Small meals tend to cause less reflux, but you may not require six of them. Spicy foods, with strong pepper or vinegar contents, are definitely not good. Bland food is more likely to neutralize the acid.

Losec is a very interesting medication. Losec is a “proton pump inhibitor,” which means it slows the pumping of hydrogen ions (H+) into the gastric contents. Because acidity is caused by a high hydrogen ion concentration, losec can cut acid production so significantly that your esophagus will heal. Of course, surgery can be performed for the hiatus hernia. But if losec does the trick along with the other advice, you don’t need it.

We hope you feel better soon.

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