Month: February 2011

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Herbs & Plants

Eclipta alba

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Botanical Name : Eclipta alba
Family: Asteraceae
Genus: Eclipta
Species: E. alba
Kingdom: Plantae
Order: Asterales
syn. : Eclipta prostrata L.
Common Names: False Daisy , yerba de tago, and bhringraj

Habitat :Eclipta alba grows in E. Asia – China, Japan and Korea to Australia.Wet places in the lowlands of Japan, especially by paddy fields.

It grows commonly in moist places as a weed all over the world. It is widely distributed throughout India, China, Thailand, and Brazil.

Description:
Eclipta alba is an Annual plant growing to 0.6m by 0.6m.  Root well developed, cylindrical, greyish. It is also named ‘kehraj’ in Assamese and karisalankanni in Tamil. Floral heads 6-8 mm in diameter, solitary, white, achene compressed and narrowly winged. .
Click to see the pictures..>....(01).....(1).……...(2)……...(3).….(4)
It is hardy to zone 9. It is in flower in August. The flowers are hermaphrodite (have both male and female organs)
The plant prefers light (sandy), medium (loamy) and heavy (clay) soils. The plant prefers acid, neutral and basic (alkaline) soils. It can grow in semi-shade (light woodland). It requires moist or wet soil.

Cultivation:
Requires a damp to wet soil and a position in some shade. This is a tropical species and it might need more summer heat and a longer growing season than is normally available in British summers.

Propagation:
Seed – sow spring in a greenhouse and only just cover the seed. When they are large enough to handle, prick the seedlings out into individual pots and plant them out into their permanent positions in early summer, after the last expected frosts. Give the plants some extra protection, such as a cloche, until they are established and growing away well.

Edible Uses: Tender leaves and young shoots – cooked and used as a vegetable

Medicinal Uses:
Antiseptic; Astringent; Depurative; Emetic; Febrifuge; Ophthalmic; Purgative; Styptic; Tonic.

This species is widely used in traditional Chinese herbal medicine, and in Ayurveda. It is considered to be the best remedy for the hair and is also used as a rejuvenative and liver tonic. The whole plant contains the alkaloids nicotine and ecliptine as well as coumarin. It is astringent, deobstruent, depurative, emetic, febrifuge, ophthalmic, purgative, styptic and tonic. It is used internally in the treatment of dropsy and liver complaints, anaemia, diphtheria etc, tinnitus, tooth loss and premature greying of the hair. Externally, it is used as an oil to treat hair loss and is also applied to athlete’s foot, eczema, dermatitis, wounds etc. The plant juice, mixed with an aromatic (essential oil?), is used in the treatment of catarrhal problems and jaundice. The leaves are used in the treatment of scorpion stings. They are used as an antidote for snake bites in Korea. The plant is harvested as it comes into flower and is dried for later use. The roots are emetic and purgative. They are applied externally as an antiseptic to ulcers and wounds, especially in cattle

In ayurvedic medicine, the leaf extract is considered a powerful liver tonic, rejuvenative, and especially good for the hair. A black dye obtained from Eclipta alba is used for dyeing hair and tattooing. Eclipta alba also has traditional external uses, like athlete foot, eczema and dermatitis, on the scalp to address hair loss and the leaves have been used in the treatment of scorpion stings. It is used as anti-venom against snakebite in China and Brazil (Mors, 1991). It is reported to improve hair growth and colour

The herb Eclipta alba contains mainly coumestans i.e. wedelolactone (I) and demethylwedelolactone (II), polypeptides, polyacetylenes, thiophene-derivatives, steroids, triterpenes and flavonoids. Coumestans are known to possess estrogenic activity (Bickoff et al. 1969) Wedelolactone possesses a wide range of biological activities and is used for the treatment of hepatitis and cirrhosis (Wagner et al. 1986), as an antibacterial, anti-hemorrhagic (Kosuge et al. 1985). and for direct inhibition of IKK complex resulting in suppression of LPS-induced caspase-11 expression (Kobori et al. 2004)

Folkloric:
Plant is bitter, hot, sharp, dry in taste and is used in ayurveda & “siddha” for the treatment of Kapha and Vata imbalances. In India, the plant is known as bhangra, “bhringaraj” or bhringraja. Another plant Widelia calendulacea is also known by the same name, but Eclipta has white flowers so called white bhangra and Widelia has yellow flower so it is called yellow Bhangra (Puri 2003).

The expressed leaf juice, applied along with honey, is a popular remedy for catarrh in infants. A preparation obtained from the leaf juice boiled with sesame or coconut oil is used for anointing the head to render the hair black and luxuriant. An oil prepared with amla, bhringraj and sometimes with brahmi is well known in India as Amla Bhringraj oil, which is said to blacken the hair. Plant is rubbed on the gums in toothache and applied with a little oil for relieving headache and with sesame oil in elephantiasis. Roots of Eclipta alba are emetic and purgative.

In Ayurveda the plant is considered a rasayana for longevity and rejuvenation. Recent studies have shown that it has a profound antihepatotoxic activity. A cardiodepressant activity was also observed in it when used for hepatic congestion. A complete symptomatic relief in epigastric pain, nausea and vomiting in ulcer patients has also been observed (Puri 2003). Also it is one among 10 flowers called as ‘Dasapushpam’ (Ten auspicious flowers) in Kerala, the southern state in India

In Taiwan, entire plant is used as a remedy for the treatment of bleeding, haemoptysis, haematuria and itching, hepatitis, diphtheria and diarrhoea; in China, as a cooling and restorative herb, which supports the mind, nerves, liver and eyes. The leaf extract is considered to be powerful liver tonic, rejuvenative, and especially good for the hair. A black dye obtained from Eclipta alba is also for dyeing hair and tattooing. Eclipta alba also has traditional external uses, like athlete foot, eczema and dermatitis, on the scalp to address hair loss and the leaves have been used in the treatment of scorpion strings. It is used as anti-venom against snakebite in China and Brazil (Mors, 1991).

Other Uses: A black dye is obtained from the plant. It is used as a hair dye and for tattooing.

Disclaimer:
The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider

Resources:
http://digedibles.com/database/plants.php?Eclipta+prostrata
http://en.wikipedia.org/wiki/Eclipta_alba

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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

Binswanger’s Disease

Alternative Name: Subcortical vascular dementia.

Definition:
Binswanger’s disease is a form of small vessel vascular dementia caused by damage to the white brain matter. White matter atrophy can be caused by many circumstances including chronic hypertension as well as old age. This disease is characterized by loss of memory and intellectual function and by changes in mood. These changes encompass what are known as executive functions of the brain. It usually presents itself in 54 and 66 years of age, and the first symptoms are usually mental deterioration or stroke.

Click to learn more & see the picture

Click for picture………..(1.)………(2)…………….

A  form of multi-infarct dementia caused by damage to the white brain matter.

Binswanger’s disease is a particular type of atherosclerosis-related dementia, in which there are widespread, microscopic areas of damage to the white matter below the outer layer or cortex of the brain. This is called subcortical dementia and produces a particular pattern of symptoms which is somewhat different to other types of dementia.

The disease may develop gradually or seem to be triggered or rapidly aggravated by a stroke or other event that leads to brain damage.

It was described by Otto Binswanger in 1894, and Alois Alzheimer first used the phrase “Binswanger’s disease” in 1902.  However, Olszewski is credited with much of the modern-day investigation of this disease which began in 1962

Symptoms:
Binswanger’s disease affects the speed at which the brain can process information and this typically causes problems with higher brain functions such as:

•Organisation
•Planning
•Decision making
•Attention
•Concentration (all of which impinge on intellectual function)
•Mood (typically apathy, irritability, and depression)
•Behaviour
Memory loss can occur but is not usually as bad as in other forms of dementia such as Alzheimer’s, while a feature known as psychomotor slowness (where a person takes longer than normal to turn a thought into an action) is common in Binswanger’s disease.

click & see

There may also be changes in speech, an unsteady gait, shaking similar to that seen in Parkinson’s disease, clumsiness or frequent falls and loss of bladder control. These symptoms are not always present in all patients and may sometimes appear only as a passing phase. Seizures may also occur.

Patients usually show other signs of atherosclerosis and cardiovascular disease such as:

•Raised blood pressure
•Stroke
•Blood abnormalities
•Disease of the large blood vessels in the neck
•Disease of the heart valves
Brain scans such as CT scans or magnetic resonance imaging (MRI) show a characteristic pattern in Binswanger’s disease.

Causes:
Atherosclerosis, a disease process that narrows the blood vessels and cuts off the blood supply to the neurons or nerve cells of the brain, causing death of those cells, is a common cause of dementia.

Binswanger’s disease is a particular type of atherosclerosis-related dementia, in which there are widespread, microscopic areas of damage to the white matter below the outer layer or cortex of the brain. This is called subcortical dementia and produces a particular pattern of symptoms which is somewhat different to other types of dementia.

Diagnosis:
Binswanger’s disease can usually be diagnosed through a CT scan, MRI, and a proton MR spectrography. Indications include infarctions, lesions, or loss of intensity of central white matter and enlargement of ventricles, and leukoaraiosis or white matter atrophy. click & see

Click to see the picture

CT Brain Scan showing active NCC (left) and lacunar infarction on the head of the caudate nucleus (right) and lecoara.

Presentation:
Leukoaraiosis (LA) are white matter changes that are common in Binswanger’s Disease. However, LA can be found in many different diseases and even in the general population, especially in people older than 65 years of age.

There is controversy whether LA and mental deterioration actually have a cause and effect relationship. Recent research is showing that different types of LA can affect the brain differently, and that proton MR spectroscopy would be able to distinguish the different types more effectively and better diagnosis and treat the issue.[8] Because of this information, white matter changes indicated by a MRI or CT cannot alone diagnose Binswanger’s disease, but can aid to a bigger picture in the diagnosis process. There are many diseases similar to Binswanger’s disease including CADASIL syndrome and Alzheimer’s disease which makes this specific type of white matter damage hard to diagnose.Binswanger’s disease is best when diagnosed of a team by experts including a neurologist and psychiatrist to rule out other psychological or neurological problems. Because doctors must successfully detect enough white matter alterations to accompany dementia as well as an appropriate level of dementia, two separate technological systems are needed in the diagnosing process.

Technology:
Much of the major research today is done on finding better and more efficient ways to diagnose this disease. Many researchers have divided the MRIs of the brain into different sections or quadrants. A score is given to each section depending on how severe the white matter atrophy or leukoaraiosis is. Research has shown that the higher these scores, the more of a decrease in processing speed, executive functions, and motor learning tasks. Other researchers have begun using computers to calculate the percentage of white matter atrophy by counting the hyper-intense pixels of the MRI. These and similar reports show a correlation between the amount of white matter alterations and the decline of psychomotor functions, reduced performance on attention and executive control. One recent type of technology is called susceptibility weighted imaging (SWI) which is a magnetic resonance technique which has an unusually high degree of sensitivity and can better detect white matter alternations.

Recently a Mini Mental Test (MMT) has been created to accurately and quickly assess cognitive impairment due to vascular dementia across different cultures. Binswanger’s disease has been shown to be the most severe impairment of all of the vascular dementia.


Treatment:
There is no specific treatment for Binswanger’s disease. What treatment there is consists of keeping associated symptoms under control and supporting the patient with their activities of daily living such as dressing, washing and preparing meals.

Medications may be used to treat symptoms such as depression, or generally treat arterial disease and its effects throughout the body (so helping to preserve blood flow to the brain and delay the progression of Binswanger’s).

Specific drugs called “cognitive enhancers” used generally in dementia may be given but the results with them are variable and many people get little benefit.

It has been shown that current Alzheimer’s medication, Aricept, may help Binswanger’s Disease patients as well. Aricept increases the acetocholine in the brain through a choline esterase inhibitor which deactivates the enzyme that breaks down acetocholine. Alzheimer as well as Binswanger patients have low levels of acetocholine and this helps to restore the normal levels of neurotransmitters in the brain. This drug may improve memory, awareness, and the ability to function. If no medical interception of the disease is performed then the disease will continue to worsen as the patient ages due to the continuing atrophy of the white matter from whatever was its original cause.

You may click to see :Homoeopathy and  Binswanger’s disease

Prognosis:
Binswanger’s disease has no cure and patients with the disorder usually die within five years of its onset.
The best way to manage the vascular risk factors that contribute to poor perfusion in the brain is to treat the cause, such as chronic hypertension or diabetes.

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/Binswanger’s_disease
http://www.bbc.co.uk/health/physical_health/conditions/binswangers_disease.shtml

Binswanger’s disease or Binswager’s Dementia

http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijn/vol2n1/bins.xml

http://www.walgreens.com/marketing/library/contents.html?docid=000002&doctype=10

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Ailmemts & Remedies Pediatric

Biliary Atresia

DEfinition:
Biliary atresia is a rare condition in newborn infants in which the common bile duct(that carry a liquid called bile from the liver to the gallbladder) between the liver and the small intestine is blocked or absent. If unrecognized, the condition leads to liver failure — but not kernicterus, as the liver is still able to conjugate bilirubin, and conjugated bilirubin is unable to cross the blood-brain barrier. The cause of the condition is unknown. The only effective treatments are certain surgeries such as the kasai procedure, or liver transplantation.

.….You may click to see the picture

Biliary atresia is a very rare disorder. About one in 10,000 to 20,000 babies in the U.S are affected every year. Biliary atresia seems to affect girls slightly more often than boys. Within the same family, it is common for only one child in a pair of twins or only one child within the same family to have it. Asians and African-Americans are affected more frequently than Caucasians. There does not appear to be any link to medications or immunizations given immediately before or during pregnancy.

This is now effective surgery which can relieve symptoms in most cases. Liver transplant is also an option, and as a result, survival rates are now above 90 per cent.

Causes & b Risk Factors:
Biliary atresia is due to a progressive fibrosis or scarring of the bile ducts responsible for draining bile from the liver, which eventually leads to atresia or loss of the biliary system. It’s not clear how or why this occurs, and many factors may be involved. It may be due to a problem in the developing embryo (10 to 20 per cent – other congenital abnormalities may also be present) or around the time of birth or shortly afterwards (80 to 90 per cent). It occurs more often in Asian and African-American newborns than Caucasian.

Bile is made by the liver and helps with the digestion of fats. If bile is not removed from the liver, it builds up and begins to damage it. The baby will then develop jaundice, or a yellow colour of the skin as levels of the bile chemical bilirubin rise in the blood. Other symptoms include dark coloured urine and pale stools. Many newborn babies become jaundiced but this is usually temporary. Jaundice lasting for longer than 14 days, especially if there are other symptoms such as an enlarged liver or failure to thrive, is a worrying sign and must be investigated further.

Pathophysiology:
There is no known cause of biliary atresia. There have been many theories about ethiopathogenesis such as Reovirus 3 infection, congenital malformation, congenital CMV infection, autoimmune theory. This means that the etiology and pathogenesis of biliary atresia are largely unknown. However, there have been extensive studies about the pathogenesis and proper management of progressive liver fibrosis, which is arguably one of the most important aspects of biliary atresia patients. As the biliary tract cannot transport bile to the intestine, bile is retained in the liver (known as stasis) and results in cirrhosis of the liver. Proliferation of the small bile ductules occur, and peribiliary fibroblasts become activated. These “reactive” biliary epithelial cells in cholestasis, unlike normal condition, produce and secrete various cytokines such as CCL-2 or MCP-1, Tumor necrosis factor (TNF), Interleukin-6 (IL-6), TGF-beta, Endothelin (ET), and nitric oxide (NO). Among these, TGF-beta is the most important profibrogenic cytokine that can be seen in liver fibrosis in chronic cholestasis. During the chronic activation of biliary epithelium and progressive fibrosis, afflicted patients eventually show signs and symptoms of portal hypertension (esophagogastric varix bleeding, hypersplenism, hepatorenal syndrome(HRS), hepatopulmonary syndrome(HPS)). The latter two syndromes are essentially caused by systemic mediators that maintain the body within the hyperdynamic states. There are three main types of extrahepatic biliary atresia:- Type I: atresia restricted to the common bile duct. Type II: atresia of the common hepatic duct. Type III: atresia of the right and left hepatic duct. Associated anomalies include, in about 20% cases, cardiac lesions, polysplenia, situs inversus, absent vena cava and a preduodenal portal vein.

Symptoms:
Newborns with this condition may appear normal at birth. However, jaundice (a yellow color to the skin and mucous membranes) develops by the second or third week of life. The infant may gain weight normally for the first month, but then will lose weight and become irritable, and have worsening jaundice.

Other symptoms may include:

•Dark urine
•Enlarged spleen
•Floating stools
•Foul-smelling stools
•Pale or clay-colored stools
•Slow growth
•Slow or no weight gain

Diagnosis:
The health care provider will perform a physical exam, which includes feeling the patient’s belly area. The doctor may feel an enlarged liver.

Tests to diagnose biliary atresia include:

•Abdominal x-ray
•Abdominal ultrasound to examine the liver and bile ducts
•A blood test to look for raised levels of bilirubin and check liver enzyme levels and blood clotting
•Hepatobiliary iminodiacetic acid (HIDA) scan, also called cholescintigraphy, to help determine whether the bile ducts and gallbladder are working properly
•Liver biopsy to determine the severity of cirrhosis or to rule out other causes of jaundice
•An abdominal x-ray to look for an enlarged liver and spleen
•X-ray of the bile ducts (cholangiogram)
•An scan to determine how well bile is flowing (HIDA or TEBIDA)

Treatment :
TreatmentIf the intrahepatic biliary tree is unaffected, surgical reconstruction of the extrahepatic biliary tract is possible. This surgery is called a Kasai procedure (after the Japanese surgeon who developed the surgery, Dr. Morio Kasai) or hepatoportoenterostomy.

....

If the atresia is complete, liver transplantation is the only option(currently has a greater than 95 per cent survival rate at one year). Timely Kasai portoenterostomy (e.g. < 60 postnatal days) has shown better outcomes. Nevertheless, a considerable number of the patients, even if Kasai portoenterostomy has been successful, eventually undergo liver transplantation within a couple of years after Kasai portoenterostomy.

Recent large volume studies from Davenport et al. (Ann Surg, 2008) show that age of the patient is not an absolute clinical factor affecting the prognosis. In the latter study, influence of age differs according to the disease etiology—i.e., whether isolated BA, BASM (BA with splenic malformation ), or CBA(cystic biliary atresia).

It is widely accepted that corticosteroid treatment after a Kasai operation, with or without choleretics and antibiotics, has a beneficial effect on the postoperative bile flow and can clear the jaundice; but the dosing and duration of the ideal steroid protocol have been controversial (“blast dose” vs. “high dose” vs. “low dose”). Furthermore, it has been observed in many retrospective longitudinal studies that steroid does not prolong survival of the native liver or transplant-free survival. Davenport at al. also showed (hepatology 2007) that short-term low-dose steroid therapy following a Kasai operation has no effect on the mid- and long-term prognosis of biliary atresia patients.

Prognosis:
Early surgery will improve the survival of more than a third of babies with this condition. The long-term benefit of liver transplant is not yet known, but is expected to improve survival.

Possible Complications:
•Infection
•Irreversible cirrhosis
•Liver failure
•Surgical complications, including failure of the Kasai procedure

Prevention:
The earlier biliary atresia is detected, the less damage it will have done to the liver and the better the chance of a successful outcome to treatment. The current target is to treat babies before they are eight weeks old.

If the liver has not yet been damaged by cirrhosis, the condition is usually treated through an operation called a Kasai portoenterostomy (or a similar procedure). This involves using a loop of bowel to form a duct to drain the bile from the liver. The operation is named after the Japanese surgeon, Professor Morio Kasai, who developed it in 1959. It was first introduced in the UK in the 1960s.

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://www.bbc.co.uk/health/physical_health/conditions/biliary_atresia.shtml
http://www.nlm.nih.gov/medlineplus/ency/article/001145.htm
http://en.wikipedia.org/wiki/Biliary_atresia

http://www.mikylah.com/pictures.html

http://www.chw.health.nsw.gov.au/parents/factsheets/biliary_atresia.htm

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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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