Wear a truss. Such a supportive garment will push an inguinal hernia back into its proper position. This is a viable option if the hernia is reducible, and should remain in place whatever your size and physical activity (BMJ, 2004; 328: 59-60). You should make sure that the doctor provides adequate instruction on using the truss, and have it fitted while standing. Also ensure that the truss is specifically designed for your particular hernia, such as those made by Ohio-based Truform Orthotics and Prosthetics (US tel: +800 888 0458; www.truform-otc.com; e-mail: truform-otc@surgicalappliance.com) rather than a purchasing a generic ‘drugstore truss’, which may hinder circulation in the abdomen and legs.
* Strengthen the abdominal muscles to avoid an abdominal hernia. Lie on your back with the knees bent and feet flat on the floor. Keeping your shoulders on the floor, lift your buttocks and back. Repeat this exercise 10 times per session.
* Tone the diaphragm to ease a hiatus hernia. A diaphragm that is too tight because of stress needs relaxing, and a diaphragm with a weakened opening will require tightening. Yoga breathing and relaxation techniques can help with both.
* Stop smoking. Nicotine weakens the muscles of the abdomen, and chronic coughing due to smoking can worsen a hernia or even cause one.
* Eat plenty of roughage, and avoid fatty and fried foods. This will help to avoid constipation and straining during a bowel movement. Avoid foods that produce flatulence, as this can contribute to a strangulated hernia (where the blood supply is restricted or lost).
* Eat numerous small meals every day, rather than a few large ones, if you have a hiatus hernia. Don’t lie down or bend over within two hours of a meal as doing so will contribute to the possibility of acid reflux. Avoid spicy foods, fried foods and those that are hard to digest as these will delay the stomach’s emptying time. Avoid hard-fibre foods such as oats, and keep away from alcohol, caffeine and fizzy drinks.
* Raise your bed at the head end. You can do this easily by placing two bricks under the two front legs. This may help a hiatus hernia by allowing gravity to pull the stomach and its contents downwards while you sleep.
* Avoid lifting heavy weights. If you do need to lift something, bend at the knees and not at the waist.
* Lose weight if you are overweight. Extra fat within the abdomen can displace the stomach, pushing it upwards through the aperture in the diaphragm in the case of hiatus hernia. It can also contribute to displacement of an abdominal hernia.
* Take the herbal remedy horsetail (Equisetum arvense), which is rich in salicylic acid and silicates. The elemental silicon contained in this herb is thought to help in the strengthening of connective tissues in the body (Weiss RF, Herbal Medicine, Beaconsfield, UK: Beaconsfield Publishers, 1988; 238-9). For similar reasons, the herb Galeopsis, or hemp nettle, is also useful.
* Massage the affected area with comfrey gel. Comfrey contains allantoin, which aids cell proliferation and healing, and may also help to strengthen the abdominal wall tissues.