Categories
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.

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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.
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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.

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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.

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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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Categories
Yoga

Pranayama – A Yoga Breathing Exercise

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Breath and Prana
Breathing is a vital process which starts at the time of birth and stops at the death. The important Oxygen is provided to all the parts, organs and cells of the body. The maximum time a person can survive without oxygen is about 4 minutes. All the metabolic processes require oxygen. Oxygen is life, a vital force. This vital energy is called Prana(the sprit of life)

Definition of Pranayama:
The process of controlling the Prana(life) is called Pranayama. So pranayama is the science related to vital force supplying energy and controlling the body mind complex.Two Sanskrit words are combined in the word ‘Pranayama’ – Prana and Ayama. ‘Prana’ means life or life force. ‘Ayama’ means development or control. Therefore Pranayama is the development and control of life force. It is a form of breathing exercise, very important in yoga. It goes along with the asanas or exercise.

Breath is the life force that sustains life. Nobody can survive more than a few minutes without air. When the breath stops, life ends. The Forefathers of Yoga developed a special system- ‘Pranayama’ to increase, develop and control this life force. Normal breathing use only a fraction of our potential respiratory capacity. Pranayama helps to control this life force in a superior and extra ordinary way to reap maximum benefits.

Breathing is the process of taking in this vital energy and removing the waste products out of our body and mind. Generally breathing includes inhalation and exhalation but pranayama includes retention of breath (known as “Kumbhaka” in Sanskrit) as well. This is a very important process. The air can be retained in the lungs or out of the lungs. The ancient texts say that retention of air, increases the level of prana (energy) in the body, also it regulates the flow of pranic energy through out the body. So pranayama helps remove all the ailments and also can stop the aging process of the body.

All the inside activities of the body are due to the ever going process of combustion or oxidation in the body. And this process of combustion works with the help of the respiration and the blood circulation. Therefore, the moment there is internal or external movement of the body, it affects the process of blood circulation and respiration. As a result of this increasing the speed of the breathing provides the needed oxygen for the concerned movements.

Mind and breath
The mind, consisting of thoughts and emotions is closely related to the breath. When the mind is calm and relaxed, the breathing is smooth and slow. If you are stressed breathing is fast & shallow but mostly through chest. When one gets angry, the breathing becomes fast and forceful, in depressed states sighing, when in pain gasping, in anxiety shallow and rapid. In this way, the mental and emotional states affect breathing.

Since we want to control the breathing after studying the process or system of respiration, it is better to try deep breathing as the first state in that direction. We do not control the process of quiet breathing. But the control is to be exercised while practicing deep breathing. For this, two things are to be considered chiefly:First, the movements concerned with inhaling and exhaling are to be controlled in order to further slow down the breathing, at the same time the need of oxygen for the body is to be lessened, so that the speed of breathing can further, slowdown. The constitution of the body is such that if the need or use of oxygen is not reduced, it becomes difficult or rather impossible to control the process of breathing. The easy way to reduce the need of oxygen is to stop the movements of the body and try to relax all the muscles. Obviously, while practicing deep breathing, it is necessary to keep the body in the stable and relaxed position.

Rhythmic Breathing is Pranayama 

All the processes and organs like heart, brain, digestive organs, endocrine glands in the body have rhythms. Also the breathing has specific rhythms. Pranayama is Rhythmic breathing, bringing the breath in natural rhythm by controlling the process of inhalation, exhalation and retention.

After examining and understanding these basic systems of breathing, we may turn to the supplementary types of breathing: The breathing passage in the nasal cavity is divided into two owing to the mid partition between two nasal cavities, viz. the left and the right.

In Yoga, the left nasal cavity is called Chandra Nadi (The moon passage) or œIda Nadi” and the right nasal cavity is known is “Suryanadi” (The sun passage) or “Pingala Nadi”. Inhaling (Puraka) and Exhaling (Rechaka) can be done either through one of these nasal cavities or with both of them.

Physiology of Yogic breathing

In process of breathing, one uses diaphragm, intercostals muscles in the chest. The diaphragmatic breathing is called vertical breathing and is considered a more efficient way to inhale air than inhaling while expanding the chest which is called horizontal breathing. .
In pranayama, one should utilize the diaphragm efficiently to get more oxygen without making more efforts. The diaphragm is attached to the organs like heart and lungs, also the liver, spleen, pancreas and stomach from the bottom side. Efficient movement of the diaphragm makes the functioning of these organs more efficient.

There are various types of Pranayama. Some of the popular forms are Ujjayee, Shitali, VilomaKapalabhati, Anuloma, Suryabhedana Bhastrika etc. There are variations in performing different Pranayamas. Some of them can be done in a sitting position while others in a standing line or sitting position. Some of the Pranayama are difficult and complicated to perform while others are easy.

Pranayama can be mastered only gradually. It may take months or even years before the practitioner mind becomes receptive to the regulated flow of breath and he experiences the full benefits of pranayama. Proper practice of pranayama can control almost any disease but improper practice may give rise toall sorts of respiratory ailments. So one should take care to acquire control over his breath gradually.

Click to see:->

*Yogic Breathing & Pranayama
*The Proper Technique Of Brahmari Pranayama
*All About Power Pranayama
*Breathing Is An Integral Part Of Pranayama
*How To Do A Brahmari Pranayama
*brahmari-pranayama-for-migraineurs
*To Beat The Heat, Practice Pranayam
*7 Steps To Complete Pranayam
*Different Types Of Pranayams : The Correct Way To Perform Them
*Eight Supreme Benefits Of Pranayam

Resources:
*yogapoint.com
*http://yoga.am/2009/12/15/one-can-master-the-art-of-pranayama-only-gradually/

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