Hiatus Hernia

One of the more common problems associated with the old age are the gastro-intestinal ones. Hiatus hernia is one of the more common diseases of gastro-intestinal old age. It is the problem of displacement of a portion of the stomach through the opening in the diaphragm through which the oesophagus passes from the chest to the abdominal cavity. When you suffer from this disease, a portion of the upper wall of the stomach protrudes through the diaphragm at the point where the gullet passes from the chest to the abdomen. 

Your diaphragm is a large dome-shaped muscle that divides the chest from the abdomen. It is responsible for breathing and is aided by the muscles between the ribs when exerted. There are special openings in it to allow for the passage of important blood vessels and for the food channel to pass into oesophagus. Hiatus hernia occurs at the oesophageal opening.

The two main types of hernia are sliding type or rolling or para-oesophageal type. The more common type of hernia is sliding, where the upper portion of the stomach and the cardio-oesophageal junction rises up through the diaphragm by direct herniation through the hiatus. In the second type of hiatus hernia which is relatively rare, the upper portion of the stomach herniates through the hiatus along the oesophagus so that cardio-oesophgeal junction remains relatively unchanged with respect to the diaphragm.

This is one of the more common problems after middle age. Half the people above 60 years of age suffer from it, though there are no symptoms. A lot of old people suffer from hiatus hernia or free oesophageal regurgitation, causing trouble, causing trouble. At times, hiatus hernia may resemble coronary artery disease, which is also common in old age. Both these problems can often occur in the same individual and you should keep this in mind before starting any treatment. Take a barium meal x-ray test to get correct diagnosis of this problem.

Symptoms of Hiatus Hernia :

• Pain in specific areas like the back of the breast bone, at nipple and the lower end of the breast bone or on the left side of the chest, which could be mistaken for angina.  At times, the base of the throat, right lower ribs and behind the right shoulder blade. The pain increases when you stoop.
• Heart-burn, especially after a meal
• Feeling of fullness and bloatedness
• Flatulence
• Discomfort on swallowing
• Inflammation that can cause occult bleeding, which if persists over the long time can cause anaemia. It is the primary cause of anaemia in the old people to due to loss of blood.

Causes of Hiatus Hernia :

• Wrong diet with excess consumption of white flour, refined sugar and products prepared from them like cakes, pastries, biscuits and white bread, preservatives and flavourings. These products devitalize the whole system and weaken the muscle tone. The muscles thus lose their resilience and the connective and fibrous tissue s are affected due to poor nutrition and thus lead to more decomposition and damage, finally causing hiatus hernia.
• Drinks such as tea, coffee and alcohol that affect the mucus lining of the stomach and irritate the digestive tract. If you take these drinks with meals will cause fermentation and produce gas. This causes the distension of stomach which presses against diaphragm and the oesophageal opening and thus increases the risk of herniation.
• Sedentary occupations
• Lack of exercise
• Obesity due to excess consumption of food
• Smoking
• Shallow breathing
• Mental and emotional tensions

Treatment for Hiatus Hernia :

You can start the treatment for this condition by raising the head end of the bed by keeping bricks below the legs of the bed. This prevents the regurgitation of food at night. You can also use pillows for this purpose.

Next go for relaxation. For this purpose, learn diaphragmatic breathing. The procedure is as follows: lie down with both the knees bent and feet close to buttocks, totally relaxed. Place both the hands on your stomach lightly and concentrate on this area. Breathe in gently; push the abdomen up with the hands simultaneously, until you cannot take in any more air. Now relax, exhaling through the mouth with an audible sighing sound and let the abdominal wall sink in. Your shoulders and chest should remain steady throughout. You should be able relax at your wish and thus prevent building up of any physical or mental symptoms. Learn the practice shavasana or ‘dead body’ pose as it is the best method for relaxation.

Precautions for Hiatus Hernia :

• Do not take water between meals but half an hour before or an hour after meal. This aids the digestion, besides reducing the incidences of heart-burn. When you drink water with meals, it increases the overall weight in the stomach, slows the digestive juices by diluting the digestive juices, thus increasing the risk of fermentation and gas formation. This distends the stomach and causes discomfort and pain.
• Take small frequent meals instead of few large ones.
• Masticate the food thoroughly to break down the food into small particles and slow the rate of food intake.

Your meals should consist of seeds, nuts and whole cereal grains, vegetables and fruits, with fresh fruits, raw or lightly-cooked vegetables and sprouted seeds forming the bulk of your meals. Avoid over-processed foods like white bread, sugar, cakes, biscuits, rice puddings and over cooked vegetables. 50% of your diet should consist of fruits and vegetables and the remaining 50% of food should be from protein, carbohydrates and fat.

Drink raw juices extracted from fresh fruits and vegetables since they are valuable in the treatment of hiatus hernia. Consume these juices half an hour before meal. Carrot juice is especially beneficial as it has a very restorative effect since it is rich in vitamin A and calcium.  It is alkaline in nature, thus soothing stomach. Tomato juice is also very useful. Add salt and pepper to the glass of fresh tomato juice, which you should consume early in the morning. It provides the relief from the continuous burning sensation in the chest caused by hiatus hernia.

Rice provides the relief in cases of hiatus hernia. Take the gruel of rice mixed with a glass of buttermilk and an over-ripe banana twice a day. It is very helpful diet in indigestion and burning caused by hiatus hernia.

Allow the hot drinks to cool a little before drinking. Avoid the extremes in temperature both in food and drink. Do not gulp down your drink. Avoid condiments, pickles, tea, coffee, alcoholic beverages and smoking.