All 4 of my family have had GERD and been on PPI's. In the end diet change has resolved it for all 4 of us, we all eat less junk food and carbs and increased meat intake - I'm fully carnivore now, but my other family members are closer to "keto".
Several doctors pointed out to me that reflux can actually be caused by low stomach acid, as there is a valve at the top of the stomach that closes when there is enough acid level, low acid prevents the valve closing and that causes the acid to bubble up through the unclosed valve which should be shutting. Taking antacids or ppis makes this worse rather than better.
As another benefit I've lost 50kg, arthritis in my right hand is gone, old knee and shoulder injury have stopped giving me problems so I'm back to lifting weights, prediabetes is gone (fasting glucose normal) and my blood pressure has gone from 148/110 to 122/78.
I hate the idea of long-term PPIs due to the controversy over side-effects. All these below have helped to manage reflux and pain caused by hiatal hernia and have made my symptoms manageable to the point where I forget about them sometimes (this works for me so NOT medical advice, check with a doctor):
- Raised the head of the bed (the actual bed, not using pillows) by 4-6 inches. I got furniture raising feet for this.
- Sleeping on left side as much as possible
- Losing weight (this is the big one)
- Changed diet to high fibre intake and excluding fizzy drinks, alcohol, problem foods like bread (this varies upon individual as you say although for low acid, apparently Apple Cider Vinegar can help)
- Plenty of low-impact exercise such as walking
- Diaphragmatic breathing exercises
- Simple Stretches (eg:
https://www.youtube.com/watch?v=2Wgylrijzlg - but I would NOT do the "bridge" for reflux)
- For HH - First thing in the morning glugging a pint of warm water quickly (warm to supposedly relax things), then jumping repeatedly from a step. Exhaling quickly as I fall and the idea is that the water is heavy and creates a sort of hammer effect to try to nudge the stomach down. Best not to do this on a very hard surface or it could cause plantar fasciitis. Alternatively, I suppose one of those mini indoor trampolines would work.
- Some Chiropractors specialise in HH and can use a manipulation technique that may provide relief.
