Hiatus Hernia
Hitaus Hernia can be defined as 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. 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
patient 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 resilient,
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
pillows 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 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 especially 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.
Source: www.healthlibrary.com through www.scribd.com
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