Tag: Esophageal hiatus

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Health Problems & Solutions

Some Health Quaries & Answers

Stop the bottle, spare the teeth  :

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Q: My three and a half-year-old daughter has a poor appetite. She is only 10 kg while the expected weight is 15 kg (as per the pediatrician’s calculation). The doctor prescribed de-worming medication several times as well as tonics. I give her milk with Pediasure in a bottle at night. She has several decayed teeth and frequently complains of toothache.

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A: Your daughter probably has caries. The bottle will worsen her cavities because the milk will stick to the teeth which will allow bacteria to thrive in her mouth. These milk teeth will eventually fall off and you may feel they do not require any treatment. But food will get stuck there and cause discomfort. This will make her reluctant to eat, resulting in inadequate weight gain. Also, she is old enough to discard the bottle. You are probably giving it to her in the hope that she receives some calories. Stop the bottle and take her to a dentist. He might be able to fill the cavities.

Hiatus hernia
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Q: I have heart burn all the time. After some tests the doctor found that I have hiatus hernia. What should I do?
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A: The esophagus runs through the diaphragm to the stomach. It functions to carry food from the mouth to the stomach.The esophagus passes through the diaphragm just before it meets the stomach, through an opening called the esophageal hiatus.

 

A hiatal hernia occurs when part of the stomach protrudes up into the chest through the sheet of muscle called the diaphragm. This may result from a weakening of the surrounding tissues and may be aggravated by obesity and/or smoking.


Hiatus hernia is a condition where part of the stomach slides into the chest cavity. Many hiatus hernias are asymptomatic. Pain occurs because of acid reflux from the stomach into the esophagus.

You can get relief by losing weight, not lying down for an hour after food, and using medications like omeprazole and pantoprazole. If the hiatus hernia is long-standing with severe symptoms, surgery may be required.

Sugar free
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Q: I am diabetic and have been taking Sugar Free in my coffee, tea and curd. Is it safe?
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A: There are many natural and synthetic sugar substitutes available. In India, the ones commonly used are saccharin and aspartame. Both have been certified as safe although initially saccharin was found to cause bladder cancer in mice. Aspartame consumption should not be more than 40 mg a day. In these circumstances, perhaps it is better for you to get used to tea and coffee without sugar.

Vital fluid
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Q: I am a 37-year-old woman. I am pale and the doctor said I am anaemic. My haemoglobin is 7gm. He gave me a capsule containing iron and zinc to be taken twice a day. After three months there has been no improvement. What should I do?

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A: Your anaemia needs to be investigated. You may be losing blood because of heavy periods, piles or a stomach ulcer. Or you may have intestinal parasites that are depleting you of blood. Rarely, cancer may present itself as anaemia. If there is no cause for the anaemia other than iron and zinc deficiency, it should respond to supplements. The binding sites on the intestines for iron and zinc absorption are identical. If you consume a tablet containing both these elements they compete for the binding site and block it. To be effective, iron and zinc have to be taken as separate tablets or capsules 12 hours apart (one in the morning and the other in the evening). Or, you take iron one day and zinc the next.

Health hour
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Q: My son is unable to run or jog owing to a tight work schedule. Can he follow some other form of exercise?

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A: The requirements of exercise for the maintenance of health have increased from 30 minutes three times a week to an hour a day. If you son is unable to spare that kind of time, he can get more or less the same benefits by skipping or continuous stair climbing (up and down) for 20 minutes. Cross training and doing different activities probably deliver the best benefits as compared to repeating the same one. Different sets of muscles are used, producing all-round toning.

Source: The Telegraph ( Kolkata, India)

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Ailmemts & Remedies

Hiatal Hernia

Alternative Names:Hernia – hiatal,  Hiatus hernia.

Definition:
.Hiatal hernia is a condition in which a portion of the stomach protrudes upward into the chest, through an opening in the diaphragm. The diaphragm is the sheet of muscle that separates the chest from the abdomen. It is used in breathing.

click  see to picture

The  diaphragm normally has a small opening (hiatus) that allows your food tube (esophagus) to pass through on its way to connect to your stomach. The stomach can push up through this opening and cause a hiatal hernia.
click to see picture

The esophagus runs through the diaphragm to the stomach. It functions to carry food from the mouth to the stomach.The esophagus passes through the diaphragm just before it meets the stomach, through an opening called the esophageal hiatus.

click  to see picture

A hiatal hernia occurs when part of the stomach protrudes up into the chest through the sheet of muscle called the diaphragm. This may result from a weakening of the surrounding tissues and may be aggravated by obesity and/or smoking.

.CLICK & SEE THE PICTURES
In most cases, a small hiatal hernia doesn’t cause problems, and you may never know you have a hiatal hernia unless your doctor discovers it when checking for another condition. But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn and chest pain. Self-care measures or medications can usually relieve these symptoms, although a very large hiatal hernia sometimes requires surgery.

Classification:
There are two major kinds of hiatus hernia:
The most common (95%) is the sliding hiatus hernia, where the gastroesophageal junction moves above the diaphragm together with some of the stomach.

The second kind is rolling (or paraesophageal) hiatus hernia, when a part of the stomach herniates through the esophageal hiatus and lies beside the esophagus, without movement of the gastroesophageal junction. It accounts for the remaining 5% of hiatus hernias.

A third kind is also sometimes described, and is a combination of the first and second kinds.

Symptoms:
Small hiatal hernias
Most small hiatal hernias cause no signs or symptoms.

Large hiatal hernias
Larger hiatal hernias can cause signs and symptoms such as:

*Heartburn, worse when bending over or lying down
*Belching
*Chest pain
*Nausea
*Swallowing difficulty

A hiatal hernia by itself rarely causes symptoms — 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.

Causes:
A hiatal hernia occurs when weakened muscle tissue allows your stomach to bulge up through your diaphragm. It’s not always clear why this happens, but pressure on your stomach may contribute to the formation of hiatal hernia.

How a hiatal hernia forms
Your diaphragm is a large dome-shaped muscle that separates your chest cavity from your abdomen. Normally, your esophagus passes into your stomach through an opening in the diaphragm called the hiatus. Hiatal hernias occur when the muscle tissue surrounding this opening becomes weak, and the upper part of your stomach bulges up through the diaphragm into your chest cavity.

Possible causes of hiatal hernia  are:
*Injury to the area
*An inherited weakness in the surrounding muscles
*Being born with an unusually large hiatus
*Persistent and intense pressure on the surrounding muscles, such as when coughing, vomiting, or straining during a bowel movement or while lifting heavy objects.

The following are risk factors that can result in a hiatus hernia.

*Increased pressure within the abdomen caused by:
*Heavy lifting or bending over
*Frequent or hard coughing
*Hard sneezing
*Pregnancy and delivery
*Violent vomiting
*Straining with constipation
*Obesity (extra weight pushes down on the abdomen increasing the pressure)
*Use of the sitting position for defecation
*Heredity
*Smoking
*Drug use, such as cocaine.[citation needed]
*Stress
*Diaphragm weakness

Diagnosis:
The diagnosis of a hiatus hernia is typically made through an upper GI series, endoscopy or High resolution manometry.

Treatment:
In most cases, sufferers experience no discomfort and no treatment is required. However, when the hiatal hernia is large, or is of the paraesophageal type, it is likely to cause esophageal stricture and discomfort. Symptomatic patients should elevate the head of their beds and avoid lying down directly after meals until treatment is rendered. If the condition has been brought on by stress, stress reduction techniques may be prescribed, or if overweight, weight loss may be indicated. Medications that reduce the lower esophageal sphincter (or LES) pressure should be avoided. Antisecretory drugs like proton pump inhibitors and H2 receptor blockers can be used to reduce acid secretion.

Where hernia symptoms are severe and chronic acid reflux is involved, surgery is sometimes recommended, as chronic reflux can severely injure the esophagus and even lead to esophageal cancer.

The surgical procedure used is called Nissen fundoplication. In fundoplication, the gastric fundus (upper part) of the stomach is wrapped, or plicated, around the inferior part of the esophagus, preventing herniation of the stomach through the hiatus in the diaphragm and the reflux of gastric acid. The procedure is now commonly performed laparoscopically. With proper patient selection, laparoscopic fundoplication has low complication rates and a quick recovery.

Complications include gas bloat syndrome, dysphagia (trouble swallowing), dumping syndrome, excessive scarring, and rarely, achalasia. The procedure sometimes fails over time, requiring a second surgery to make repairs.

Lifestyle & Home Remedy:
Lifestyle changes may help control the signs and symptoms of acid reflux caused by a hiatal hernia. Consider trying to:

*Eat several smaller meals throughout the day rather than a few large meals.
*Avoid foods that trigger heartburn, such as chocolate, onions, spicy foods, citrus fruits and tomato-based foods.
*Avoid alcohol.
*Limit the amount of fatty foods you eat.
*Sit up after you eat, rather than taking a nap or lying down.
*Eat at least three hours before bedtime.
*Lose weight if you’re overweight or obese.
*Stop smoking.
*Elevate the head of your bed 6 inches (about 15 centimeters).
*Work to reduce the stress in your daily life.

Alternative Medication:
Some alternative medicine practitioners claim to have discovered a way to cure a hiatal hernia by pushing the stomach back to its normal position below the diaphragm. Practitioners may use their hands to apply pressure to the abdomen and manipulate the stomach.

There’s no evidence that such manipulation works to cure hiatal hernia. No clinical trials of the technique have been conducted.

But Practicing Regular Yoga Exercise & meditation has definitely got some better effect.

Prognosis:
A hiatus hernia  normally  does not cause any symptoms. The condition promotes reflux of gastric contents (via its direct and indirect actions on the anti-reflux mechanism) and thus is associated with gastroesophageal reflux disease (GERD). In this way a hiatus hernia is associated with all the potential consequences of GERD – heartburn, esophagitis, Barrett’s esophagus, esophageal cancer and dental erosion. However the risk attributable to the hiatus hernia is difficult to quantify, and at most is low.

Besides discomfort from GERD and dysphagia, hiatal hernias can have severe consequences if not treated. While sliding hernias are primarily associated with gastroesophageal acid reflux, rolling hernias can strangulate a portion of the stomach above the diaphragm. This strangulation can result in esophageal or GI tract obstruction and the tissue can even become ischemic and necrose.

Another severe complication, although very rare, is a large herniation that can restrict the inflation of a lung, causing pain and breathing problems.

Most cases are asymptomatic.

Prevention:
Controlling risk factors such as obesity may help prevent hiatal hernia.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://en.wikipedia.org/wiki/Hiatus_hernia
http://www.nlm.nih.gov/medlineplus/ency/article/001137.htm
http://www.mayoclinic.com/health/hiatal-hernia/DS00099

http://www.nlm.nih.gov/medlineplus/ency/presentations/100028_1.htm

http://www.nlm.nih.gov/medlineplus/ency/imagepages/17070.htm

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