Hiatal Hernia

To avoid sliding down when the bed is at a slant, you can tuck a small pillow or folded small blanket under your bottom. It helps.
In addition to drinking some water to reduce the acid, chewing is most helpful (even with nothing in your mouth) because the saliva is alkaline and neutralizes the acid.

If its small, my gi dr told me that they leave them alone , if there not causing problems and small ones usually don't and for me to continue my ppi

My chronic acid reflux/GERD was completely remedied when I eliminated gluten from my diet. After many invasive tests over a few years (during which a hiatal hernia was found) plus a variety of other symptoms that were hard to pin down, a blood test (cascade) showed that I had inherited celiac genes from both parents. The hiatal bugs me once in a while, but I’ve been advised to just hang in there with it since it’s not causing any physical damage. The medical advice … from my (female) nurse practitioner, not from the (male) gastroenterologist who seemed pretty clueless and hinted that I was exaggerating things… was to go gluten-free. That was eight years ago now.

@debra54 that’s what my gastroenterologist told me, too.

Plus with surgery sometimes it's just a trade off for another problem

PPIs for long term cause bone loss and Alzheimer.

Depends what you read. Here’s this from Touch Neurology:
“No association between PPI use and the risk of dementia was shown in eight studies and two studies showed a decreased risk of dementia with PPI use. There was no association between PPI use and AD in one study, but the same study showed that PPI use is associated with an increased risk of non-AD dementia”.

@wendymb what is AD?

March 21, 2016
By Matthew Solan, Executive Editor, Harvard Men's Health Watch
ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

A new study has shed light on one of the long-term effects of proton pump inhibitors (PPIs). These drugs are commonly used to treat gastroesophageal reflux disease (GERD), heartburn, and peptic ulcers. PPIs (omeprazole, lansoprazole, esomeprazole, pantoprazole, and others) help reduce the amount of stomach acid made by glands in the lining of the stomach.

Research published online on February 15 in JAMA Neurology showed that there may be an association between chronic use of PPIs and an increased risk of dementia. Experts compared prescription PPI intake and diagnosis of dementia among approximately 74,000 adults ages 75 and older. In the study, chronic PPI use was defined as at least one prescription every three months in an 18-month window. The most common PPIs in use were omeprazole (Prilosec), pantoprazole (Protonix), and esomeprazole (Nexium). All participants were free of dementia at the study’s beginning. Yet, after the eight-year follow-up, chronic PPI users had a 44% increased risk of dementia compared with those who did not take any medication. Men were at a slightly higher risk than women. Occasional users of PPIs had a much lower risk.

Putting the results in perspective
The researchers were quick to stress that this study only provided a statistical association between PPI use and risk of dementia, and that taking PPIs does not automatically mean you will get dementia. However, the study continues the ongoing discussion about the impact of long-term medication use, according to Dr. Houman Javedan, clinical director of inpatient geriatrics at Harvard-affiliated Brigham and Women’s Hospital. “Older adults take more medications as they age, and often continue them long after they are still necessary,” he says. “They either get used to taking it, and do not think to ask their doctor if they should stop, or they are afraid of what might happen if they do.”

Many older adults also take multiple drugs at one time, a situation known as polypharmacy. In fact, an estimated 44% of men and 57% of women older than age 65 take five or more medications; 12% of both men and women in this age group take 10 or more. “How different drugs interact with each other, and what the consequences of long-term use are, continues to be explored by scientists, as the researchers tried to do in this case with PPIs,” says Dr. Javedan.

It is not clear how PPIs might make a person more vulnerable to dementia. Evidence suggests parts of the drug may cross the blood–brain barrier, which becomes more porous as a person ages, and interact with brain enzymes. In initial animal studies, PPIs were shown to increase levels of beta amyloid in the brains of mice, and higher amounts of this protein have been linked to dementia and Alzheimer’s disease. Other research has shown a possible connection between chronic PPI use and vitamin B12 deficiencies, as well as an increased risk of osteoporosis. “There still may be other mechanisms at work that are unknown,” says Dr. Javedan. “But this study raises the question whether chronic PPI usage is safe, especially among the older population.”

Yeah but that was 2016. The ones I saw were 2023. So many studies during that time and they do tend to contradict one another. Even within the same article, there are contradictions. I think my point is to just stay aware of the current studies, ask the doctor, and know your own risk/benefit ratio.