Hiatal hernia

Hiatal hernia or hiatal hernia is a disease in which a portion of the stomach protrudes into the chest , through the hole that is located in the diaphragm (the muscular layer that separates the chest from the abdomen and is used to push the lungs in the process of respiration ). That hole exists to let the esophagus (the tube that carries food from the mouth to the stomach) through.

This hernia results in retention of acid and other contents above this opening. These acids and other substances can easily back up into the esophagus (called “reflux”).

Summary

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  • 1 Description
    • 1 Types of hiatal hernia
  • 2 Diagnosis
  • 3 Causes
  • 4 Symptoms
    • 1 Confusion with heart problems
  • 5 Treatments
  • 6 Recommendations
    • 1 Plants
  • 7 sources

Description

The diaphragmatic hiatus is an orifice that connects the esophagus with the stomach and separates the thorax from the abdomen , forming an acute angle that prevents gastric contents from escaping into the esophagus (an event known as regurgitation ). The normal dimension of the hiatus is 1.5 centimeters on average, but for various reasons it can be extended to 3  cm , causing the deformation of the stomach and various functional alterations.

Normal diaphragm with normal hiatus, without hiatal hernia.

When this happens, the stomach membrane can gradually rise, altering its original appearance and causing the gastric content to come out, driven by pressure, towards the esophagus. The consequences of these alterations are hiatus hernia and gastroesophageal reflux .

The hiatal hernia turns out to be a structural alteration, a disease that many people suffer from regardless of age.

Specifically, it occurs when the upper part of the stomach, that is, the portion attached to the last portion of the esophagus , presses on the diaphragm , upwards and to the sides, forming a bag that invades the chest space, entering it through a tiny opening located in the diaphragm. When that happens there is reflux of the contents of the stomach into the esophagus . But reflux can occur in some people without a hernia. Therefore, there is another group of patients who have reflux because, without having a hernia, the esophageal sphincter (the one that allows the passage between the esophagus and the stomach) does not work well.

Types of hiatal hernia

There are three types of hiatal hernias.

  • Those of sliding, which occur when part of the stomach and esophagus ascend and are located in the chest cavity. This type of hernia is the most common.
  • Paraesophageal hiatal hernia, which occurs when the junction of the esophagus with the stomach remains in place, but part of the stomach rises to lie in the chest, parallel to the esophagus.
  • The mixed ones, which combine both hernias.

Diagnosis

A hiatal hernia is usually discovered during a test or procedure to determine the cause of heartburn or pain in the chest or upper abdomen. These tests or procedures include the following: [1]

Weak diaphragm with too open hiatus, leading to hiatal hernia.

  • X-ray of the upper digestive system. X-rays are taken after you drink a whitish liquid that coats and fills the inner lining of the digestive tract. This coating allows the doctor to see the outline of the esophagus, stomach, and first part of the intestine.
  • Upper endoscopy. The doctor inserts a thin, flexible tube equipped with a light and camera (endoscope) down your throat to examine the inside of your esophagus and stomach for inflammation.
  • Esophageal manometry. This test measures rhythmic muscle contractions in the esophagus when you swallow. Esophageal manometry also measures the coordination and strength exerted by the muscles of the esophagus.

Causes

The cause of this type of hernia is unknown, but it may be the result of weakening of the supporting tissue. In adults, there may be a number of risk factors such as aging, obesity , and cigarette smoking.

Like so many other diseases, it has been thought that there may be genetic causes or malformation of stem cells, as could exist in any other part of the body, as well as the aging process, mistreatment of the stomach due to the intake of highly seasoned foods, liquor , cigarettes, medication side effects, stress , chronic cough, constipation and obesity .

Children with this condition are usually born with it (congenital) and it is often associated with gastroesophageal reflux in infants.

Hiatal hernias are very common, especially in people over the age of 50, and can cause reflux (regurgitation) of gastric acid from the stomach into the esophagus.

Symptoms

A hiatal hernia rarely has symptoms, but when you eat or jerk down, fluids that are usually in the digestive process invade the hernia and weaken the hiatus, or sphincter, of the esophagus, causing discomfort with a feeling of warmth or fire.

The pain and discomfort are usually due to the reflux of gastric acid, air, or bile. Reflux happens more easily when there is a hiatal hernia, although a hiatal hernia is not the only cause of reflux.

  • chest pain
  • Heartburn that worsens when bending over or lying down
  • Difficulty swallowing.
  • palpitations

There are cases in which none of these symptoms are present . Serious complications can sometimes occur, which aggravate the case, such as:

  • Anemia due to inadvertent loss of blood through the stomach.
  • Aspiration of gastric contents passing into the lungs.
  • Strangulation of the hernia with partial necrosis of the digestive tube.

Confusion with heart problems

Sometimes hiatal hernia problems -and even heartburn- are confused with heart disease, so it is essential to make a thorough review of the case.

Treatments

Most people with a hiatal hernia do not experience any signs or symptoms and do not need treatment. If you have signs and symptoms — such as recurring heartburn and acid reflux — you may need medication or surgery.

Because the hernia is located in a very sensitive place, the appropriate treatment is generally applied through medicine and in a few cases through surgery; It is also appropriate to resort to a change in lifestyle and diet.

Antacids (for example aluminum magnesium gel or ranitidine) are often recommended to relieve heartburn. However, when the patient does not improve after 6 months of treatment, the specialist may consider him a candidate for surgery.

Perhaps most people who have hiatal hernia or any of the conditions that accompany it feel that it is impossible to follow the dietary regimen prescribed by a specialist, but the patient should think that changing habits will significantly improve their health and avoid the need for a surgical intervention.

Who should dictate the patient’s diet is a specialist in gastroenterology and not a nutritionist, because it is not about losing weight for the patient, but about preventing his problem from advancing and there is the need for surgery.

We must know that there are “buffers” of gastric acid. Among them are milk and its derivatives, all fruits, including citrus fruits – if the fruit is very acidic, it should be dissolved with water -, as well as all kinds of vegetables. Meat , chicken , or fish should be grilled or boiled, and cream soups, raw tomato, white rice and macaroni, bread, tortillas, and low- sugar fruit water are fine .

Dr. Cervantes Juárez, professor at the
National Autonomous University of Mexico (UNAM) [2]

recommendations

  • Eat several small meals throughout the day instead of a few large meals
  • Avoid foods that cause heartburn , such as fatty and fried foods, tomato sauce (while raw tomato can be consumed), spicy foods, alcoholic beverages , chocolate , mint , garlic , onion and caffeine .
  • Drastically reduce the consumption of bread and foods based on wheat flour.
  • Citrus fruits are low in acidity – compared to stomach acids – and do not generate more acidity in the stomach than normal.
  • Avoid lying down after eating.
  • Avoid eating late in the day: Eat at least two to three hours before bedtime.
  • Maintain a healthy weight – If you are overweight or obese , you will need to lose weight.
  • stop smoking
  • Put wooden blocks or bricks to raise the head of the bed about 15 cm, and use a higher pillow (or two lower pillows).
  • Avoid constipation .
  • A normal adult should urinate at least 1.5 liters of water daily (a good part of the water consumed is lost as perspiration ).
  • Practice phytotherapy (consumption of medicinal plants); Aloe vera and aloe vera are recommended .

Floors

If you already have symptoms of hiatal hernia, you can use various plants (in capsules or infusions):

  • aloe ,
  • rosemary ,
  • sage ,
  • basil ,
  • activated carbon ,
  • boldo ,
  • laurel ,
  • camomile ,
  • plantain ,
  • mint .
  • Drink liquorice ( liquorice ) and lemon balm teas daily.
  • Drink raw potato juice diluted in water daily. [3

 

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