I have hiatal hernia.Acid reflux due to the hiatal hernia can cause coughing and even pneumonia, because stomach acid winds up in the lungs.My symptoms eased considerably when I stopped playing trombone. It appears that all the squeezing of the abdomen and diaphragm required for playing was aggravating the problem.In my experience, Gaviscon antacid with protective foam (sodium alginate) was very effective, and didn't produce the horrible side effects that the various acid blockers gave me. Your results may vary.Surgical fixes to this problem can be done, and are typically very successful. What I don't know is whether this can be done by laparascope or whether it requires open surgery.