Dear Dr. Cutler,

Could you provide me with information on hiatal hernia? My elderly father has requested any information you can give us. We would greatly appreciate it.

—Todd F.

Dear Todd,

Hiatal hernia is an abnormal condition in which the upper part of the stomach protrudes through the esophageal opening of the diaphragm, sometimes causing stomach acid to backflow into the esophagus. I can tell you that hiatal hernia occurs in about 30 percent of people who have no symptoms. The number may even be higher. The only way it can be detected is through an x-ray. The problem is not the hiatal hernia itself but the acid reflux that causes damage up in the esophagus.

Surgery should only be considered if medical intervention fails. And some of the most effective methods I know—better than acid-reducing drugs—are the following:

• Encourage your father to get on a plant-based, nutrient-rich diet. He should cook most of his vegetables at first because too many raw vegetables can promote gas.

• Talk to him about removing the stresses from his emotions and his mind. This can be achieved through meditation.

• Work with your father to create sensible meal plans and eliminate refined sugars from his diet, as well as greasy and spicy foods.

• Encourage him to take quality supplements with each meal that provide betaine hydrochloride (HCl), the good stomach acid needed for digestion, as well as digestive enzymes such as amylase, protease and lipase.

All the best!

Michael Cutler, M.D.