Hiatal hernia and omeprazole

I have been taking 40mg of omeprozole twice a day for several weeks.  I was diagnosed with a hiatal hernia on March 30.  I am supposed to take this for three months and then drop down to once a day.
Previous to my diagnosis I had taken 20 mg Prilosec OTC first once a day, than twice after my diagnosis, since the prescription was nearly $200.00 for just 2 weeks worth.
I was still having heartburn at night so I finally filed the prescription.  It really isn't doing any better than the first OTC that I tried per the Physicians Assistant.
I have been unable to get a follow up appt. with the Gastroenterologist until June!  I have so many questions, I don't even want to take this scary medicine, and it isn't really working very well.  It is time to refill the precription and I am anxious for all the aforementioned reason.
I would have loved to discuss the alternatives with the Dr., but I can't get past the nurses.  
I have read that there are many possible natural alternatives that I can try.  Still, I have spent over $1,200 and never had a discussion with the Dr.  At least not one I was aware of.  He apparently spoke to me after the endoscope.  I remember nothing.
I need some encouragement, I am so frustrated that I feel like I can treat myself as well as my absentee Dr.

[Ratnakar Kini, MD]

Hi,
What you suffer from is GERD with nocturnal breakthrough pain.And hiatal hernia is a risk factor for GERD.
The treatment consist of PPI + nighttime zantac.
You can continue taking omeprazole twice a day ( before breakfast and before dinner) and a zantac at bedtime.
The treatemnt is not complete without lifestyle modifications -

Lifestyle modifications -
1. Head elevation while sleeping
2. Small frequent meals
3. Going to bed 2- 3 hours after food
4. Avoiding bed time snacks
5. Avoiding smoking and alcohol
6. Avoiding tight fitting clothes
7. Avoiding cola, citrus drinks, carbonated drinks, tea, coffee, spicy food
8. Weight reduction

[TBS123]

I forgot to add that I have some inflamation (inflammation) of the larynx.

[TBS123]

Thanks for the advice regarding Zantac.  I will try that.
Another question I have concerns exercise.
I do resistance training, walking, and some aerobics 5 times/week.
I wonder if I should continue to do crunches and other abdominal exercises.
I am 5'4 and weigh about 120.
Unfortunately for me, there are no lifestyle mods for me to try, because I don't do any of them anyway.
I did buy a wedge pillow, though.
Also, I have read that sometimes the problem is not too much acid, but too little.
How can I tell?

[Ratnakar Kini, MD]

If you can see the lifestyle modifications- avoid tight fitting clothes is one of them.
Anything that increases the abdominal pressure worsens GERD.
So you may have to avoid abdominal exercises which may increase the abdominal pressure.
Reflux can be either acid reflux or bile reflux.

[jullanache]

A related discussion, Exercise routines for GERD sufferers was started.