What Causes A Person To Choke While Sleeping?

Hello, You said you have a hernia, is it from hiatus hernia? because you did upper endoscopy right? A hiatus hernia is a herniation of elements of the abdominal cavity through the esophageal hiatus of the diaphragm. It is frequent finding by both radiologists and gastroenterologists. It occurs when weakened muscle tissue allows your stomach to bulge up through your diaphragm. It s not always clear why this happens. But a hiatal hernia might be caused by age-related change in your diaphragm, injury to the area, for example, after trauma or certain types of surgery, being born with an unusually large hiatus, persistent and intense pressure on the surrounding muscles, such as while coughing, vomiting, straining during a bowel movement, exercising or lifting heavy objects. Risk factor age 50 or older, and obese. The smallest type of hiatal hernia is asymptomatic. Patients with large type hernia may have symptoms of gastroesophageal reflux disease (GERD), the most common of which are heartburn, regurgitation, dysphagia and coughing. We can make a diagnosis of hiatal hernia by x-ray of your upper digestive system, Upper endoscopy, and Esophageal manometry. Most people with a hiatal hernia don t experience any signs or symptoms and won t need treatment. You are having the symptom of GERD such as coughing when you lay, heartburn and reflux you need management the same as you have GERD. In patients with mild and intermittent symptoms( fewer than two episodes per week) and no evidence of erosive esophagitis, we suggest step-up therapy. In patients who are naive to treatment, we initially recommend lifestyle and dietary modification and, as needed, low dose histamine 2 receptor antagonist(H2RAs) such as Ranitidine/ Famotidine. Antacid we give if the patient has symptom occur less than once a week. For a patient with continued symptom despite these measures, we increase the dose of H2RAs to standard dose, twice daily for a maximum of two weeks. Therefore, if symptoms of GERD persist, we discontinue H2RAs and initiate once-daily proton pump inhibitor(PPI) at a low dose and then increase to standard doses if required. Once symptoms are controlled, treatment should be continued for at least eight weeks. In patients with erosive esophagitis, frequent symptoms(two or more episode per week), and/or severe symptoms that impair quality of life, we use step down therapy in order to optimize symptom relief. The step-down therapy starts with standard-dose PPI once daily for eight weeks in addition to lifestyle and dietary modification. Lifestyle changes weight loss for who are overweight or have had recent weight gain, the elevation of the head of the bed in individuals with nocturnal or laryngeal symptoms (eg, cough, hoarseness, throat clearing). Avoid meals two to three hours before bedtime, Avoid fatty food, caffeine, chocolate, spicy foods, food with high-fat content, and peppermint), avoid tight-fitting garments, avoid tobacco and alcohol, abdominal breathing exercises to strengthen the antireflux barrier of the lower esophageal sphincter. Try your best with seeing your doctor and be calm to follow the instruction. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr Heang Chan Raksmey, General and Family Physician