Hiatus Hernia

Understanding this painful and common condition

Hiatus means opening
Hernia means “an abnormal protrusion of an organ through tissue into another space”

A Hiatus Hernia is when an opening occurs in the stomach wall and as a consequence, the lining of the stomach pushes through into the oesophagus.

The main function of the stomach is to produce gastric acid juices which break down food into small enough molecules so it can be processed by the small intestine, on its way through the digestive system.

The effect of gastric acid on the lining of the oesophagus is akin to bathing in car battery acid.  So no surprise that this “condition” is painful and debilitating!  There are many names for the symptoms associated with it.

Acid Reflux; Dyspepsia; Gastritis; Heartburn; Gastro-oesophageal reflux (GORD) and Peptic Ulcer.

The list of symptoms is long.  They range from burning pain in the stomach, chest or gullet, indigestion (which we put down to something we ate disagreeing with us or that we are possibly “allergic” to).  Others are belching, bloating, hoarseness, difficulty in breathing, dark circles under the eyes, tired all the time, alternating constipation and diarrhoea feeling nauseous after eating and also after taking medication, anaemia, split nails, skin problems, rectal itching, food sensitivities and heartburn.  

Warning Signs

All of these signs are signals that our digestive system isn’t functioning properly and it is trying to alert us to it.  The discomfort suffered can vary from mild and infrequent, intermittent to intense and constant.  But what do we do?  We take a variety of pills and potions to deaden the pain or discomfort because when we can’t feel it we can kid ourselves that it has been “cured”.  When, what happens in reality is the situation gets worse and the body will create even more signs and “shout louder” by making the pain more intense until we can’t ignore it.

It goes without saying that any digestive system compromised in this way will carry with it conditions like yeast overgrowths (candida), parasites and all the embarrassing symptoms of irritable bowel syndrome.

Some symptoms can also be a sign of other organ dysfunction like stomach ulcers, gall bladder problems, diabetes/pancreas dysfunction and even some forms of cancer.  The pain of angina is often mistaken for dyspepsia which is why it is called heart burn.  More often, the symptoms could be the result of a poor diet, and lifestyle, bad posture and constipation.  Obesity and a large intestine/colon which is clogged puts pressure on the abdomen and the stomach which will increase the likelihood of acid reflux as will dehydration.  Most people drink insufficient water to keep their bodies functioning properly,

Because there are so many possibilities for the onset of any of these symptoms it is vital get them checked out rather than ignore them and hope they will go away on their own or self medicate.

If the only advice offered is prescribed medication to suppress the symptoms that is the time to seek alternative advice to improve the function of the body in general, but specifically the digestive system.

If Hiatus Hernia or acid reflux is diagnosed, it is wise to investigate what is causing it.  Possible causes are the obvious ones like over eating, particularly very rich foods.  Overweight, smoking and unusual conditions like Bornholm Disease – symptoms can be mistaken for oesophagitis and sometimes heart attack.  It is actually a virus that causes sore throat, inflammation and neck, chest and upper abdomen pain/spasms.

Barrett’s Oesophagus, though rare, affects 5% of people diagnosed with hiatus hernia.  The two main symptoms are acid reflux and regurgitation of food.  In this condition the gullet is constantly being attacked by stomach acid and if left untreated can progress to dysphagia (difficulty in swallowing).  Additionally, there can be penetrating pain in the chest and between the shoulder blades which usually indicates ulceration of the oesophagus.  Treatment is imperative to prevent internal bleeding (which will ultimately create anaemia) and perforation of the ulcer into the chest cavity and lungs.

Sliding Hiatus Hernia is the most common.  It results in a weakness in the diaphragm muscles which allows the upper part of the stomach wall and the lowest part of the oesophageal tube to stick up into the chest cavity.  The pressure pushes acid up (and sometimes food along with it) through the opening and back up past the oesophageal sphincter resulting in feelings of heartburn and/or acid reflux.

In Rolling or para oesophageal hernia, instead of sliding up into the oesophagus, it rolls up into the chest and lies alongside (parallel to) the oesophagus.  If pockets of stomach sac fill up with gas, the pain and pressure can be horrific.  Belching and vomiting are symptoms of this form of hiatus hernia.  If the hernia gets bigger this will mean less space for the heart and lungs and can result in sufferers being short of breath and it can also affect heart beat causing it to be irregular.

Acid reflux is sometimes associated with an ulcer causing bacteria called Helicobacter pylori. Good liver function is vital as is stabilising the pH of the stomach and encouraging good bacteria.

Stress is also a major contributory factor.  Most people are aware that their symptoms are much worse when they are “wound up”.  Anxiety brings tension of the abdominal muscles which slows down digestion, causes constipation (anally retentive).

Recent research found that 2/3rds more women than men suffer constipation and the reason?  Men sit on the toilet and don’t get up until they’ve finished.  Whereas women are usually in too much of a hurry and so if things don’t “move” immediately, they tend to put it off until later and so on and so on.  When we eat in a rush, standing up or on the run, when we’re anxious or angry our digestion is severely disturbed because our system sees any stressful situation as an emergency as switches to crisis mode, otherwise known as “flight or fright”.  The gut is the first place to lose its blood supply when we’re under stress.  The nervous system kicks into action and all energy is directed away from the digestive function and redirected towards the heart, brain and muscles in order to focus all our attention on “running away” or facing the perceived enemy.  The lining of the gut is being replaced and repaired on a constant basis.  When we’re under permanent and unrelenting stress, the blood supply to that area is literally starved of blood.  So the normal “repair service” is suspended.

Whist we no longer have to face the enemy in quite the same way as our ancestors; the modern day equivalent to triggering stress is being late for an appointment, held up in traffic, arguing, too much to do and not enough time, a bullying, demanding, controlling boss or partner, a near miss accident, noisy neighbours, visiting the dentist, concerns about your health, problematic children, balancing a social life with a family and work or financial concerns.

The “alarm” phase continues long after the event which means that the body is churning out adrenaline for some time.  If our lives are made up of all these stressful events, it is more or less permanently pumping out adrenaline and in these circumstances the immune system remains fully charged.  Eventually, it can not do it any more – it has no more to give and buckles under the strain.  No wonder we feel tired all the time, keep picking up one “bug” after another and then start to suffer the miserable symptoms of acid reflux, food sensitivities and constipation or explosive diarrhoea, high blood pressure, too much bad cholesterol and the myriad of other mysterious and often embarrassing illnesses?  The eventual outcome is complete exhaustion.  The body screams “give me a break”!  

Here is a list of some of the symptoms that can be associated to unrelenting pressure and stress.

Acid reflux; body odour; chronic fatigue; attacks of diarrhoea; constipation; food cravings; food sensitivities; headaches/migraines; high blood pressure’ high levels of bad cholesterol’ indigestion; heartburn; insomnia; lack of or increases appetite’ loss of libido; persistent colds or “viruses”; muscle spasms, nail biting; beck tension; overactive mind; believing you’re a “born worrier”; palpitations; poor co-ordination; inability to concentrate; reduced resistance to infection; restless limbs; sour breath; stomach cramps; sweating’ tearfulness; teeth grinding; tight shoulders; things “eating” away at you; hard to forgive and forget; known or unknown fears; new experiences hard to assimilate; feelings of being overwhelmed with responsibility, feelings of being spaced out; wanting to step off the wheel of life and so on ….

We rely too much on stimulants to help us deal with stress – coffee, cigarettes, alcohol, prescribed and self prescribed drugs, sugar, chocolate and shopping.  They do tend to give us an immediate boost but they bring us down just as quick.  A lot of depression is the coming down after the going up.  This barrage of insulin has a dramatic effect on our pancreas over time – hence so many people, once they reach their 50’s are diagnosed with diabetes.  The sad thing is now that the age is dropping and we are suffering these conditions at a much earlier time.  It might be possible to disguise distress for a while but all that happens is that the pressure builds and the stress piles up with the result that eventually, it completely disables our body from doing the job it was intended to do.  Heal and repair itself on a daily basis.

My busy practice is full of people with what they think are mysterious and sometimes embarrassing illness.  Hopefully, after you’ve read this you’ll understand that when I say we can help most people of any age with any condition, known or unknown; to resolve a lot of their discomfort and give them back control and responsibility for their lives; not because the work we do can “cure” any medical condition.  That is never the intention with complementary and alternative medicine.  We are here to give advice and guidance.  To investigate the obvious.  It is always advisable to seek the help of a medically qualified practitioner before seeking the help of a natural health practitioner.  In cases where potential clients have not done so, they may be advised to do so prior to any treatment programme beginning.  

For those who have been down the medical route and all tests and or procedures have been deemed “normal”, this may be a good time to seek complementary and alternative advice.  There is ALWAYS something you can do to improve the qualify of your emotional and physical health whether you are suffering a life threatening condition or a plethora of minor, irritating symptoms, meaning you are one of the “vertically ill” ie able to get up every morning and carry on, day after day, dragging yourself into life.  On their own, those minor irritating symptoms are manageable.  As the list of symptoms grows along with the pressure and stress they bring with them, you end up feeling totally pole axed.   

Sunday, 30 March 2008

© 2008 Bromley Health Management