Hiatus Hernia

Hiatus Hernia can be defined as displacement of a portion of the stomach through the opening in

the diaphragm through which the esophagus passes from the chest to the abdominal cavity. IN

this disease, a part of the upper wall of the stomach protrudes through the diaphragm at the

point where the gullet passes from the chest area to the abdominal area.

The diaphragm is a large dome-shaped muscle dividing the chest from the abdominal cavity. It is

the muscle concerned with breathing, and it is assisted by the muscles between the ribs during

exertion. It has special openings in it to allow for the passage of important blood vessels and for

the food channel, the oesophagus. Hiatus hernia occurs at the oesophageal opening.

The disease is common after middle age. It is estimated that about half the people above 60

years of age suffer from it, although most of them may not have any symptoms. The correct

diagnosis of haitus hernia can be arrived at by means of berium meal x-ray test.

Symptoms

Hiatus hernia is characterised by pain in certain areas. The most common areas are behind the

breast bone at the nipple level and lower, at the end of the breast one. Pain may also occur on

the left chest and this is often mistaken for angina.

Other areas of pain are the base of the throat, right lower ribs and behind the right shoulder

blade. The pain increases when the patients stoops with efforts and lies down. Other symptoms

of this disease are heart-burn, especially after a meal, a feeling of fullness and bloatedness,

flatulence and discomfort on swallowing.

Causes

The chief cause of the mechanical defect associated with hiatus hernia is faulty diet. The

consumption of white flour, refined sugar and products made from them, such as cakes,

pastries, biscuits and white bread as well as preservatives, and flavourings devitalise the system

and weaken the muscle tone. As a consequence, the muscles become less resilent, and

connective and fibrous tissue suffers through poor nourishment, and thus become more prone to

decomposition and damage. This ultimately leads to disease like hiatus hernia.

Drinks like tea, coffee, alcohol, also affect the mucous lining of the stomach and irritate the

digestive tract. These drinks, when taken with meals, encourage fermentation and produce gas.

This increases the distension of the stomach, causing pressure against the diaphragm and the

oesophageal opening and greatly increasing the risk of hemiation. Other causes of hiatus hernia

include sedentary occupations, without sensible exercise, overweight resulting from overeating,

smoking, shallow breathing and mental and emotional tensions.

Treatment

IN the beginning of the treatment, it would be advisable to raise the head end of the bed by

placing bricks below the legs of the bed. This will prevent the regurgitation of food during the

night. More pillow can also be used for the same purpose.

The next important step towards treating hiatus hernia is relaxation. An important measure in

this direction is diaphragmatic breathing. The procedure is as follows : lie down with both knees

bent and feet close to buttocks. Feel relaxed. Put both the hands lightly on the abdomen and

concentrate the attention of this area. Now breathe in, gently pushing the abdominal up under

the hands at the same time, until no more air can be inhaled. Then relax, breathing out through

the mouth with an audible sighing sound and allow the abdominal wall to sink back. The

shoulders and chest should, remain at rest throughout.

It is important to be able to relax at any time and thereby prevent building up of physical and

mental tensions which may cause actual physical symptoms. The best method for this is practice

shavasana, or ‘dead body ‘ pose. The procedure for this Asian has been explained in chapter 7

on yoga therapy.

The patient of hiatus hernia should observe certain precautions in their eating habits. The

foremost amongst these is not to take water with meals, but half an hour before or one hour after

a meal. This helps the digestive process considerably and reduces the incidence of heart burn.

Drinking water with meals increases the overall weight in the stomach, slows down the digestive

process by diluting the digestive process and this increases the risk of fermentation and gas

formation, which distends the stomach and causes discomfort and pain. Another important factor

in the treatment of this disease is to take frequent small meals instead of three large ones.

Thorough mastication of foods is also essential, both to break up the food into small particles

and to slow down the rate of intake.

The diet of the patient should consist of seeds, nuts and whole cereal grains, vegetables and

fruits, with emphasis on fresh fruits, raw or lightly cooked vegetables and sprouted seeds. The

foods which should be avoided are over-processed foods like white bread and sugar, cakes and

biscuits, rice puddings and over cooked vegetables. At least 50 per cent of the diet should

consist of fruits and vegetables, and the remaining 50 per cent of protein, carbohydrates and fat.

Raw juices extracted from fresh fruits and vegetables are valuable in haitus hernia, and the

patient should take these juices half an hour before each meal. Carrot juice is specially

beneficial as it has a very restorative effect, and is rich in vitamin A and calcium. It is an alkaline

food which soothes the stomach. All juices should be diluted with water on a 50: 50 basis as

they are concentrated.

The hot drinks should always be allowed to cool a little before taking. Extremes in temperature,

in both food and drink should be avoided, drinks should not be taken hurriedly, but sipped

slowly. The patient should avoid condiments, pickles, strong tea, coffee, alcoholic beverages

And smoking.

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