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Because it keeps the stomach acid from flowing up into the Hiatal hernia at night.

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Q: Why is an elevated head of bed recommended for hiatal hernia?
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What is a hernia and how can you get one?

A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it. They can occur in the abdomen, diaphragm, anus, vertebrae, and even inside the head.


What is a hiatal hernia?

A hiatus hernia or hiatal hernia is the protrusion (or herniation) of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm. The symptoms include acid reflux, and pain, similar to heartburn, in the chest and upper stomach. In most patients, hiatus hernias cause no symptoms. Sometimes patients experience heartburn and regurgitation, when stomach acid refluxes back into the esophagus. The following are possible causes or contributing factors for having a hiatus hernia: * Obesity * Frequent coughing * Straining with constipation * Frequent bending over or heavy lifting * Heredity * Smoking * Stress The diagnosis of a hiatus hernia is typically made through an upper GI series or endoscopy. There are two major kinds of hiatus hernia: * The most common (95%) is the sliding hiatus hernia, where the gastroesophageal junction moves above the diaphragm together with some of the stomach. * The second kind is rolling (or paraesophageal) hiatus hernia, when a part of the stomach herniates through the esophageal hiatus beside, and without movement of, the gastroesophageal junction. It is about 100 times less common than the first kind. A third kind is also sometimes described, and is a combination of the first and second kinds. In most cases, sufferers experience no discomfort and no treatment is required. However, when the hiatal hernia is large, or is of the paraesophageal type, it is likely to cause esophageal stricture and discomfort. Symptomatic patients should elevate the head of their beds and avoid lying down directly after meals until treatment is rendered. If the condition has been brought on by stress, stress reduction techniques may be prescribed, or if overweight, weight loss may be indicated. Medications that lower the lower esophageal sphincter (or LES) pressure should be avoided. Antisecretory drugs like proton pump inhibitors and H2 receptor blockers can be used to reduce acid secretion. Where hernia symptoms are severe and chronic acid reflux is involved, surgery is sometimes recommended, as chronic reflux can severely injure the esophagus and even lead to esophageal cancer. The surgical procedure used is called Nissen fundoplication. In fundoplication, the gastric fundus (upper part) of the stomach is wrapped, or plicated, around the inferior part of the esophagus, preventing herniation of the stomach through the hiatus in the diaphragm and the reflux of gastric acid. The procedure is now commonly performed laparoscopically. With proper patient selection, laparoscopic fundoplication has low complication rates and a quick recovery. Complications include gas bloat syndrome, dysphagia (trouble swallowing), dumping syndrome, excessive scarring, and rarely, achalasia. The procedure sometimes fails over time, requiring a second surgery to make repairs. [1] 1. http://en.wikipedia.org/wiki/Hiatal_herniaThere are different types of hiatal hernias. I had a sliding hernia, which is the most common. It's not as bad as it sounds, as only about 50% of the people who have one, feel any discomfort. The sphincter in your esophagus opens a little bit (causing acid reflux) and part of your stomach can slide up and down your diaphragm. It's usually just a little bit and the top part of your esophagus (above your diaphragm and connects to your stomach) gets irritated and creates a hernia. Most people don't notice it but for those who do, it's painful.


What is the cardiac position?

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