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Half of Americans over age 50 suffer from hiatal hernias related to obesity.

Q.I was diagnosed with a hiatal hernia. Should I be concerned about this, and how would you treat it? --J.B., Montgomery, Ala.

A.A hiatal hernia is caused by the stomach pushing up, or herniating, through the diaphragm into the thorax. Approximately 50 percent of people over the age of 50 have hiatal hernias. I believe the reason there is such a high incidence of them is because obesity is so rampant--approximately one-third of Americans are overweight.

When I was in residency, I was in obstetrics rotation for two months, during which I delivered about 200 babies. I noticed that after about eight months of pregnancy most women developed belching and heartburn--symptoms commonly associated with a hiatal hernia--due to the uterus pushing against the stomach.

Because obesity is so rampant in the United States many Americans over the age of 50--many of them men--have a protuberant abdomen and, in fact, look like a woman who is eight or nine months pregnant.

Therefore, the most important thing I advise for a patient with a hiatal hernia is to lose weight, especially around the midsection. It also is extremely important to not overeat, since overeating is commonly associated with the symptoms of this condition.

I strongly recommend that you drink 8 ounces of water 30 minutes before eating and two hours after eating. Limit the consumption of fluids to 4 ounces to 8 ounces with meals.

I also recommend that you avoid chocolate, fried foods, caffeine, carbonated beverages, alcohol and cigarettes. These foods, beverages and habits may increase intra-abdominal pressure, or they may actually decrease the tone of the esophageal sphincter--the muscular band of the lower esophagus that separates the esophagus from the stomach.

By following these simple measures, you usually will be able to control the symptoms of a hiatal hernia.

Q. I am 52 years old and suffer from reflux esophagitis. What natural remedies will help me overcome this condition?

--B.R., Sebring, Fla.

A.Gastroesophageal reflux is due to hydrochloric acid refluxing up into the esophagus. This strong acid can burn the esophagus and lead to scarring, which eventually may lead to a stricture, ulcerations and bleeding of the esophagus, or to a precancerous condition.

You should first achieve ideal body weight, especially by decreasing weight in the midsection. Overeating is one of the main causes of reflux. I recommend that you eat frequent small meals and include extra fiber in your diet.

Decrease significantly or eliminate from your diet chocolate, coffee and other caffeinated beverages, carbonated beverages, fried foods, and alcohol. This holds true for smoking as well.

Drink 8 ounces of water 30 minutes before each meal and two hours after each meal. Limit fluid consumption to only 4 ounces to 8 ounces with meals. Avoid drinking any beverages four hours before bedtime.

Certain herbal supplements are beneficial in treating reflux esophagitis. The DGL form of licorice has been shown to heal both gastric and peptic ulcers and will help prevent ulcerations and inflammation in the esophagus. Take 380 mg (milligrams) of chewable DGL--approximately two chewable tablets taken 20 minutes before meals and at bedtime.

Drink approximately one liter of aloe vera juice a day, in small doses throughout the day. Freshly juiced cabbage juice is very healing for the gastrointestinal tract.

The herb slippery elm contains a mucilage that soothes the lining of the esophagus and stomach. I recommend 1 tsp (teaspoon) of powder mixed with water and taken four times a day.

If you continue to have symptoms and are following all the measures just stated, please be checked for food allergies or food sensitivities.

In addition, it is absolutely necessary that your condition and progress be monitored by a physician. Donald Colbert, M.D., is a family physician and nutrition expert. He is the author of The Bible Cure for Cancer and other booklets by Siloam Press. Send your questions about health and nutrition to Doctor's Orders, 600 Rinehart Road, Lake Mary, FL 32746.

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