I have a deep cough for at least 10 months, related it to allergies, now found out I have a hiatal hernia that the Dr said could be related. No gallbladder for about 11 years, have acid reflux

Hello Anon

Thank you for writing.

The diaphragm is dome shaped and has an opening called the hiatus. The esophagus passes through the hiatus into the stomach. A hiatal hernia occurs when the muscle surrounding the hiatus becomes weak. The upper part of the stomach projects through the diaphragm into the chest cavity.

Experts concur that pressure on the stomach leads to the development of a hiatal hernia. Possible causes are an inherited weakness in the muscles surrounding the hiatus or having a very large hiatus. Injury to the area of the diaphragm can be a cause. Increased pressure on this area can result from coughing, vomiting, straining with a bowel movement, or lifting heavy objects. People over the age of 50 years, or who are obese, or have a history of smoking have an increased risk of developing a hiatal hernia.

A person with a small hiatal hernia will not experience symptoms. However, signs of a large hiatal hernia are recurrent heartburn and acid reflux, belching, chest pain, and nausea.

Your hiatal hernia (and subsequent heartburn) may be the actual cause of your cough not getting any better, even if you are treating your allergies and have them under control.

Three types of medication are prescribed to treat the associated acid reflux. Antacids provide quick relief. The H-2 receptor blockers work to reduce the production of stomach acid. Proton pump inhibitors actually block acid production and allow the esophagus to heal. Lifestyle changes such as eating several small meals throughout the day, limiting the intake of fatty foods, and avoiding foods that trigger heartburn can be beneficial.

Other helpful tips are sitting up after eating, avoid eating three hours before bedtime, avoid alcohol, quit smoking, and loss weight. Elevating the head of the bed by six inches can provide relief. When treatment with lifestyle changes and medications is unsuccessful, surgical repair of the hiatal hernia is necessary. During the surgery, the stomach is pushed further into the abdominal cavity which reduces the size of the hiatus. The hernia may be removed or the esophageal sphincter may be reconstructed.

Please talk to your doctor about your options.

Best,
Susan