The Great Mimic-
Hiatal Hernia has been called the “great mimic” because it mimics many disorders. A person with this problem can get such severe pains in their chest that they think they are having a heart attack. They may think they have an over acid stomach because they will regurgitate stomach acid after they eat, or their stomach may hurt so badly they will think they have an ulcer. This is just a sampling of the symptoms that may occur from this disorder.
A hiatus hernia or hiatal hernia is the protrusion (or herniation) of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm.
It is important to understand the anatomy of the chest area before grasping how a hiatus hernia comes about. The stomach lies immediately under the diaphragm, a muscular sheet which separates the chest from the abdomen. The gullet (oesophagus) passes through a small opening in the diaphragm in order to reach the stomach. Normally, the stomach end of the oesophagus and its muscular control ring (sphincter) lie just beneath the diaphragm. When the stomach is distended, pressure pushes upwards against the diaphragm and this closes the sphincter, preventing the stomach contents from passing back up into the gullet.
Hiatus hernias are often found in conjunction with conditions such as acid reflux and obesity. The hiatus hernia is simply the movement of a portion of the stomach into the chest via an opening in the diaphragm. Many people do not realize they have a hiatal hernia
The following varieties of Eesophageal Hiatal Hernias have been recognized:
1) Sliding Variety: This is the type most commonly seen. The esophago-gastric junction is drawn into the thorax above the opening of the diaphragm and can slide back into the abdomen. There is free gastro-esophageal reflux, which causes symptoms of inflammation of the esophagus .
2) Rolling Variety: The esophago-gastric junction is not drawn up in such cases. Only the stomach herniates into the thorax. This kind of hernia does not produce any symptoms.
3) Mixed type: Here, the features of both sliding and rolling varieties are seen together.
4) Hiatus Hernia with a short esophagus : This is very rare. Some cases are due to a congenital short esophagus , while others are secondary to inflammation of the esophagus , where it contracts and is pulled up into the thorax.
Signs and symptoms:-
Hiatal hernia has often been called the “great mimic” because its symptoms can resemble many disorders. For example, a person with this problem can experience dull pains in the chest, shortness of breat (caused by the hernia’s effect on the diaphragm), and heart palpitations(due to irritation of the vagus nerve).
Naturally, when part of the stomach is forced into this opening, the sphincter cannot close properly. Thus, stomach acid may travel back up into the esophagus causing burning sensations (heartburn), esophageal spasms, inflammations and ulcers.
The cramped position of the stomach can also stress the vagus nerve, which stimulates the release of hydrochloric acid. This can cause both over and under secretion of hydrochloric acid and stomach enzymes. It may also affect the sphincter or valve at the bottom of the stomach so that digestive secretions “leak” out of the stomach and are lost before they have completed their job.
The hiatal hernia will also interfere with the movement of the diaphragm muscle. This muscle normally pulls downward to expand the chest capacity and inflate the lungs. Since the hiatal hernia interferes with this movement, the person may be restricted to shallow breathing, or will resort to using the chest and shoulders to expand the lung capacity and take a deep breath.
The esophagus may also “kink” in the throat, which will irritate the thyroid gland and may cause some difficulty in swallowing. Often persons with hiatal hernias will have difficulty in swallowing capsules or tablets as they get the sensation that they are “sticking” in their throat.
The irritation on the vagus nerve can cause reflex irritations throughout the body. The vagus nerve comes from the medulla and goes to the heart, esophagus, lungs, stomach, small intestines, liver, gall bladder, pancreas and colon. It also has links to the kidney, bladder, and external genitalia. Thus, a hiatal hernia may start imbalances in the system such as decreased stomach acid and ph imbalance in the intestines and elsewhere.
If a person develops poor stomach digestion due to a lack of hydrochloric acid, they will have difficulty digesting and assimilating protein and most minerals. It will also contribute to food putrefaction in the intestines, causing greater toxicity in the body. This lack of nutrition and toxic condition may contribute towards food allergies, constipation, anemia and immune and glandular system weaknesses
Two other problems that a hiatal hernia may contribute to are asthma and heart disease. Since the hernia reduces the lung capacity by interfering with natural breathing, it could be a factor in asthma. The hernia may also put pressure on the heart. Gas in the intestines may put pressure on the hernia and push it against the bottom of the heart, which may be one way in which a heart attack can be triggered. None of this spells immediate fatality, but it does point to a major contributing factor in degenerative illness.
The causes of a hiatal hernia are speculative and unique to each individual. However, there are a number causes. First of all there may be a mechanical cause. Improper lifting, hard coughing bouts heavy lifting, sharp blows to the abdomen (the kind that “knock the wind out of you”), tight clothing and poor posture may contribute to the development of this problem. Improper lifting may be the biggest mechanical cause of this disorder. If the air is not expelled out of a person’s lungs while lifting, it will force the stomach into the esophagus.
Secondly, there are dietary causes. Hiatal hernia just about always accompanies a swollen ileocecal valve. The ileocecal valve is the valve between the small and large intestines which permits material to enter the colon from the large intestine, but prevents material in the colon from moving back into the small intestine. When this valve becomes swollen and irritated it cannot close properly. This allows material from the colon to leak back into the small intestine. This is analogous your sewer backing up into your kitchen. This creates gas and indigestion, which puts pressure on the stomach and presses it tighter against the diaphragm
The relationship between the ileocecal valve and the hiatal hernia is a chicken/egg situation … it is hard to know which comes first. However, it is clear that the ileocecal problem aggravates the hernia. Hence, the things which irritate that valve may be causal factors. These are the basic causes of digestive problems: poor food combining, overeating, drinking with meals, overeating and eating when upset.
Lastly, there are emotional causes. According to one applied kinesiologist text a hiatal hernia comes from repressed anger. A person “swallows their anger” and “can’t stomach it.” When you get angry, you suck your breadth upward. If you fail to release this anger, your stomach stays up. I have observed that most of the people with severe hiatal hernias have a great deal of emotional stress and hold a lot of it inside.
Loose weight, loosen your belt during meals, stop smoking and learn about which foods aggravate you and eliminate them from your diet.
Modify your diet-
Fried foods, spicy foods, and very hot or very cold foods can all make symptoms worse. Avoid dietary extremes.
An overly full stomach worsens symptoms. Do not eat large meals. Instead, eat only small amounts of food at any one time. Eat slowly and chew each bite well.
Drink 1 to 2 ounces of cabbage juice two to three times daily for two weeks. This common cruciferous vegetable contains phytochemicals that help smoothe the gastric lining. Cabbage juice has been used for centuries for ulcers. It can provide exceptional relief for acid reflux.
Avoid citrus fruit juices and coffee. These common beverages contribute to additional acid in the stomach.
Do not eat anything for at least two hours before going to bed. You may be able to avoid problems simply by giving your stomach time to empty out before you lay down.
Homeopathic remedies work by triggering the body to respond to an irritation or external stimulus that allows the individual to heal himself.
Lycopodium- is indicated for people whose pain and discomfort may start on the right side of the abdomen and then move to the left, writes Boericke. There may be loud belching, burning sensations in the chest after eating, and a large amount of flatulence that passes with force. The person will generally prefer very hot food and hot drinks. He may have a huge appetite and then be easily satisfied after eating only a few bites. Other indications are liver and gallbladder problems that accompany digestive difficulties, aggravating the hernia. Choose Lycopodium if the patient have a lot of stomach gas and a swollen abdomen. The patient himself finds easily and openly irritated at home, but forces himself to stay pleasant at work. Give one dose of Lycopodium 30 three times daily for up to three days.
Nux vomica- is indicated for people who over-indulge in food, drink, alcohol and other stimulants that may trigger acid reflux and the hernia, says Boericke. Nux vomica is an excellent remedy for people who have forceful, dominating personalities, are bossy and tend toward workaholics. The person may suffer from problems with the liver as well as other types of hernias. People needing this remedy may have a great deal of sensitivity in the area of the stomach, sour belching, acid indigestion and painful hernia symptoms. This remedy is most appropriate for people who also feel irritable and sensitive to noise and light.
Argentum Nitricum- is the remedy for frequent burping. You may have a history of peptic ulcer and you probably crave sweet foods, although you have difficulty digesting them. Take one dose of Argentum nitricum 30 three times daily for up three days.
Arsenicum Album- if patient awakens between 1:00 and 4:00 AM with gnawing pain and indigestion. He feel very thirsty, bust usually drink only a little bit. He may also have feeling of anxiety that register in the pit of your stomach, and crave acidic foods, including coffee, citrus juices, and vinegar dressing-all of which contribute to acid reflux heartburn pain. This remedy is also for a burning sensation in the throat or stomach that is alleviated by drinking milk and sitting up. People who need this remedy are usually anxious and restless. Give one dose of Arsenicum album 200c daily for up to two days. Stop for one week, if his symptoms have improved.
Carbo vegetabillis- is for a too-full feeling with an upper abdomen that is swollen and painful to the touch. He may feel sleepy and have a burning feeling in your stomach about thirty minutes after taking meal, and he probably burp a lot. Digestion is so sluggish that foods can putrefy before digestion is accomplished. They are often pale and feel chilly, but feel better with cool air and drinks. Give one dose of Carbo vegetabillis 30 three times daily for up to three days.
Pulsatilla- This remedy is for heartburn, queasiness, and a bad taste in the mouth brought on by eating rich and fatty foods (especially ice cream). Symptoms may include vomiting partly digested food. People who need this remedy feel tearful when ill, and greatly desire comfort.
National President : “Youth Homoeopathic Association”
(“Doctor Kunwar Homeopathy Clinic”) Haryana.
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