DEAR DR. ROACH: I am a 72-year-old female with MGUS. I was just diagnosed with an ulcer, Barrett's esophagus, GERD and a hiatal hernia of 8 cm. My surgeon has put me on high-dose Prilosec and Carafate before bed. My oncologist has given the OK for surgery for the hernia, but friends have told me that the surgery is really dangerous. My surgeon is concerned about the hernia being so large. What do you think about this surgery, and is it a good idea at my age? I am having really bad issues with digestion. -- F.H.
ANSWER: A hiatal hernia is a larger-than-normal hiatus (hole) in the diaphragm where the esophagus goes through and connects with the stomach. If the hiatus is large enough, the stomach can move upward into the chest, which often causes symptoms of abdominal discomfort. This is then called a paraesophageal or hiatal hernia.