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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
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 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.
Education
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