GERD & Heartburn Support Group
Gastroesophageal Reflux Disease (GERD) is defined as chronic symptoms or mucosal damage produced by the abnormal reflux of gastric contents into the esophagus. This is commonly due to transient or permanent changes in the barrier between the esophagus and the stomach. If you are afflicted with GERD or heartburn, join the group and find support.

Reading the posts on the gastritis board could really help you. Good luck..
I have a hernia also and have had GERD in the past. My GERD has mostly ended, but I do have a problem with it once in awhile. My main problem was at night while in bed.
I did many things to greatly reduce my GERD problem, so in my case it was a combination of things that got it under control. The first thing I did was to raise my head while in bed with a wedge pillow. This helped more than any other single item. Now we have a power lift bed so I can easily raise my upper body. If you have not tried a wedge pillow that would be the first place I would start.
Diet is also important, but I do not know if a low carb diet would have much to do with GERD. It is good for other things regardless. It is more important to find your trigger foods. There are many and well known. You will probably have to stop or reduce these foods especially at night. After about a year of watching what I ate, things have improved to the point where I now eat what ever I want, but I do make a point to eat dinner early. The less in your stomach at bedtime the better.
When first diagnosed, I was put on a PPI, but got off of it in about 4 months if I remember correctly. The sooner you can get off of any PPI or other antacid the better. All will make things worse in the long run.
To help with meals, I took DGL Ultra before each meal. This can really help you quickly. You cannot find DGL in conventional drug stores, but it is easily available online or in health food stores.
Another thing that I took was digestive enzymes before each meal. They help with the break down of food. The brand that I took also included a small dose of acid. Remember that most stomach acid problems are due to the lack of acid not access acid.
After several months I was able to stop all medications Rx and OTC. I still have a problem now and then and when I do I just eat a stick of celery. Celery works as fast as any antacid and does no harm in any case. A slice or more of an apple will do the same thing, but it is easier to keep celery on hand.
Those are my thoughts for now. Good luck and welcome again to the group.
I never had a problem with my wedge pillow like you described. One thing to remember is that you still use your standard pillow on top of the wedge. That may help. We have had a power bed for several years now that has the lift capability so I no longer use a wedge. However, the results are the same; lift the bed up (wedge pillow, blocks under the frame, or a power lift) and then use your standard pillow like you always have. Now, for us, it seems very weird to lay flat (on a hotel bed for example).
Steve
I do think even a small sliding HH causes the reflux problem for most of us. It does cause the valve to dysfunction and allows acid to come up especially while lying down at night. I also dont have an issue too often unless I treat myself too much and or go on holiday.
I managed this totally with diet alone. It took me a year and a half to get to a really good place but it works. Diet is the key. It takes a lot of discipline. That is the hard part for most people.
Low carb didnt work at all for me. In fact I often had a good piece of whole wheat bread to stop my heartburn. I think wheat is a good acid absorber. It is my go to food all the time now. I am not a believer in a no wheat diet at all.
The not drinking water is also an important point. it makes a big difference to not drink fluids with your food. Drink in between. Apples often made me worse. It is different for everyone I find. Do a food journal. That will help. The PPI should eliminate the symptoms pretty quickly. Then you can slowly get off and try to manage it with a careful diet.
I stop eating way earlier than 7 pm. I stop by 5 pm. I eat a lot in the morning and am pretty full most of the day and am fine after 5 pm.
Keep your meals small until you get way better as well.
So it is possible to do this without PPIs if you have the discipline to do it! The size of the HH can make this more challenging. If yours is small you can do it. Bigger than that is harder.