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.

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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Categories
Ailmemts & Remedies

Achalasia

Other Name : Esophageal achalasia

Definition:
Achalasia is a disorder of the tube that carries food from the mouth to the stomach (esophagus), which affects the ability of the esophagus to move food toward the stomach.

Click to see Achalasia Image

At first it may only cause a minor problem, and often goes unnoticed. However, over time someone with achalasia finds it increasingly difficult to swallow food and liquid.

This is because the muscles in the oesophagus (gullet) which move foods and liquids into the stomach stop working properly. This leads to the oesophagus dilating, or stretching, which may lead to choking or coughing fits at night, triggered by food or liquids being regurgitated when a sufferer lies down at night.

Signs and symptoms:

The main symptoms of achalasia are dysphagia (difficulty in swallowing) and regurgitation of undigested food. Dysphagia tends to become progressively worse over time and to involve both fluids and solids.

•Backflow (regurgitation) of food
•Chest pain, which may increase after eating or may be felt in the back, neck, and arms
•Cough
•Difficulty swallowing liquids and solids
•Heartburn
•Unintentional weight loss

Causes:
A muscular ring at the point where the esophagus and stomach come together (lower esophageal sphincter) normally relaxes during swallowing. In people with achalasia, this muscle ring does not relax as well. The reason for this problem is damage to the nerves of the esophagus.

Cancer of the esophagus or upper stomach and a parasite infection that causes Chagas disease may have symptoms like those of achalasia.

Achalasia is a rare disorder. It may occur at any age, but is most common in middle-aged or older adults. This problem may be inherited in some people.

Diagnosis:
Due to the similarity of symptoms, achalasia can be mistaken for more common disorders such as gastroesophageal reflux disease (GERD), hiatus hernia, and even psychosomatic disorders. Specific tests for achalasia are barium swallow and esophageal manometry. In addition, endoscopy of the esophagus, stomach and duodenum (esophagogastroduodenoscopy or EGD), with or without endoscopic ultrasound, is typically performed to rule out the possibility of cancer. The internal tissue of the esophagus generally appears normal in endoscopy, although a “pop” may be observed as the scope is passed through the non-relaxing lower esophageal sphincter with some difficulty, and food debris may be found above the LES.

Barium swallow:
..CLICK & SEE
The patient swallows a barium solution, with continuous fluoroscopy (X-ray recording) to observe the flow of the fluid through the esophagus. Normal peristaltic movement of the esophagus is not seen. There is acute tapering at the lower esophageal sphincter and narrowing at the gastro-esophageal junction, producing a “bird’s beak” or “rat’s tail” appearance. The esophagus above the narrowing is often dilated (enlarged) to varying degrees as the esophagus is gradually stretched over time.[4] An air-fluid margin is often seen over the barium column due to the lack of peristalsis. A five-minute timed barium swallow can provide a useful benchmark to measure the effectiveness of treatment.

Esophageal manometry:
  CLICK & SEE THE PICTURE
Because of its sensitivity, manometry (esophageal motility study) is considered the key test for establishing the diagnosis. A thin tube is inserted through the nose, and the patient is instructed to swallow several times. The probe measures muscle contractions in different parts of the esophagus during the act of swallowing. Manometry reveals failure of the LES to relax with swallowing and lack of functional peristalsis in the smooth muscle esophagus.

Biopsy:
Biopsy, the removal of a tissue sample during endoscopy, is not typically necessary in achalasia, but if performed shows hypertrophied musculature and absence of certain nerve cells of the myenteric plexus, a network of nerve fibers that controls esophageal peristalsis

Treatment:
The approach to treatment is to reduce the pressure at the lower esophageal sphincter. Therapy may involve:

•Injection with botulinum toxin (Botox). This may help relax the sphincter muscles, but any benefit wears off within a matter of weeks or months.
•Medications, such as long-acting nitrates or calcium channel blockers, which can be used to relax the lower esophagus sphincter
•Surgery (called an esophagomyotomy), which may be needed to decrease the pressure in the lower sphincter. Click to see the pictures:
•Widening (dilation) of the esophagus at the location of the narrowing (done during esophagogastroduodenoscopy)
Your doctor can help you decide which treatment is best for your situation.

Alternative medicine:
Temporary improvement of achalasia symptoms in some cases has been reported with acupuncture


Possible Complications:

•Backflow (regurgitation) of acid or food from the stomach into the esophagus (reflux)
•Breathing food contents into the lungs, which can cause pneumonia
•Tearing (perforation) of the esophagus.

Prognosis: The outcomes of surgery and nonsurgical treatments are similar. Sometimes more than one treatment is necessary.

Lifestyle changes:
Both before and after treatment, achalasia patients may need to eat slowly, chew very well, drink plenty of water with meals, and avoid eating near bedtime. Raising the head of the bed or sleeping with a wedge pillow promotes emptying of the esophagus by gravity. After surgery or pneumatic dilatation, proton pump inhibitors can help prevent reflux damage by inhibiting gastric acid secretion; and foods that can aggravate reflux, including ketchup, citrus, chocolate, alcohol, and caffeine, may need to be avoided.

Prevention:
Many of the causes of achalasia are not preventable. However, treatment of the disorder may help to prevent complications.

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/achalasia.shtml
http://en.wikipedia.org/wiki/Achalasia
http://www.nlm.nih.gov/medlineplus/ency/article/000267.htm

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Healthy Tips

Regular Moderate Exercise can cut the Risk of Acid Reflux

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For people with chronic heartburn, too much running and jumping can induce acid reflux. However, the right type of exercise may actually improve the condition.

CLICK & SEE

Short bouts of fairly moderate exercise at least a couple of times a week can cut the risk of gastroesophageal reflux disease, or GERD, in part because it reduces body mass index.

The New York Times reports:

“The specific exercise is crucial. Scientists found that aerobic exercises with the highest ‘agitation of the body,’ like vigorous running, consistently induced acid reflux, even in people who did not have chronic heartburn …

Another factor is body position. Bench presses, leg curls or any other exercise that involves lying flat sharply raise the risk of acid reflux.”

What Types of Activities Make Heartburn Worse?
As you might suspect, vigorous jumping, bouncing, running and other activities that cause agitation of your body can make heartburn worse, simply because it makes it easier for your stomach acid to move into your esophagus. For this reason, vigorous aerobics and other agitating exercise routines may exacerbate your symptoms, especially if you eat within two hours of your workout.

That said, heartburn also tends to flare up during other routine activities as well, such as:

•After eating a heavy meal
•Bending over
•Lifting
•Lying down, especially when laying on your back
If you know you have GERD, or even if you suffer from heartburn only occasionally, it makes sense to limit these activities, especially shortly after eating, or at least tailor them so they’re less likely to cause a problem.

For instance, by eating smaller portions at your meals it can help you to avoid overeating, which is a major trigger for heartburn. Likewise, if you wait two or three hours after dinner before lying down in bed, it will also give you some relief.

When you do lie down, elevating the head of your bed may make you more comfortable, as can squatting down when you need to pick something up (instead of bending over).

And just as you can modify these common activities so they don’t make your heartburn worse, you can modify your exercise program to follow suit as well.


But at the same time Exercise is Essential, Even if You Have Heartburn

One of my top recommendations for treating heartburn and GERD is to implement an exercise program.

Physical activity is an important way to improve your body’s immune system, which is imperative to fight off all kinds of infections. What does this have to do with GERD?

Source: New York Times July 26, 2010

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Categories
Ailmemts & Remedies

Indigestion

Indigestion, also known as upset stomach or dyspepsia, is discomfort or a burning feeling in the upper abdomen, often accompanied by nausea, abdominal bloating, belching, and sometimes vomiting. Some people also use the term indigestion to describe the symptom of heartburn.

Indigestion might be caused by a disease in the digestive tract such as ulcer or gastroesophageal reflux disease (GERD), but for many people, it results from eating too much, eating too quickly, eating high-fat foods, or eating during stressful situations. Smoking, drinking too much alcohol, using medications that irritate the stomach lining, being tired, and having ongoing stress can also cause indigestion or make it worse.

Some people have persistent indigestion that is not related to any of these factors. This type of indigestion—called functional or nonulcer dyspepsia—may be caused by a problem in the muscular squeezing action of the stomach (motility).

To diagnose indigestion, the doctor might perform tests for problems, like ulcers. In the process of diagnosis, a person may have x rays of the stomach and small intestine or undergo endoscopy, in which the doctor uses an instrument to look at the inside of the stomach.

Avoiding the foods and situations that seem to cause indigestion in some cases is the most successful way to treat it. Heartburn caused by acid reflux is usually improved by treatment with antacids, H2-blockers, or proton pump inhibitors. Smokers can help relieve their indigestion by quitting smoking, or at least not smoking right before eating. Exercising with a full stomach may cause indigestion, so scheduling exercise before a meal or at least an hour afterward might help.

To treat indigestion caused by a functional problem in the digestive tract, the doctor may prescribe medicine that affects stomach motility.

Because indigestion can be a sign of, or mimic, a more serious disease, people should see a doctor if they have :

1.Vomiting, weight loss, or appetite loss

2.Black tarry stools or blood in vomit

3.Severe pain in the upper right abdomen

4.Discomfort unrelated to eating

5.Indigestion accompanied by shortness of breath, sweating, or pain radiating to the jaw, neck, or arm

6.Symptoms that persist for more than 2 weeks

For More Information

International Foundation for Functional Gastrointestinal Disorders (IFFGD) Inc.
P.O. Box 170864
Milwaukee, WI 53217
Phone: 1–888–964–2001 or 414–964–1799
Fax: 414–964–7176
Email: iffgd@iffgd.org
Internet: www.iffgd.org

Additional Information on Indigestion

The National Digestive Diseases Information Clearinghouse collects resource information on digestive diseases for National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Reference Collection. This database provides titles, abstracts, and availability information for health information and health education resources. The NIDDK Reference Collection is a service of the National Institutes of Health.

To provide you with the most up-to-date resources, information specialists at the clearinghouse created an automatic search of the NIDDK Reference Collection. To obtain this information, you may view the results of the automatic search on Indigestion.

If you wish to perform your own search of the database, you may access and search the NIDDK Reference Collection database online

Ayurvedic & Natural Treatment For Indigestion……………...(1).…….(2)…...(3).……(4)

Homeopathic Treatment for Indigestion……………...(1).………...(2)……..(3)

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

Source:http://digestive.niddk.nih.gov/ddiseases/pubs/indigestion/index.htm

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Heartburn

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In many cases, this digestive problem can be prevented with some simple lifestyle changes. But when heartburn hits — as it does daily for more than 25 million Americans — natural remedies can provide quick relief from the disorder’s fiery sensations.

Symptoms
A burning sensation behind the breastbone lasting from a few minutes to several hours.

When to Call Your Doctor
If you have heartburn twice a week or more.

What It Is
To help digest food, the stomach produces about a quart of hydrochloric acid a day. Usually, the acid isn’t a problem, because the gastrointestinal tract is coated with a protective mucous lining. But when acid moves up the esophagus (the tube running from the throat to the stomach), look out. Lacking a protective coating, the delicate tissue of the esophagus is vulnerable to the acid’s corrosive action, which produces a burning sensation doctors label gastroesophageal reflux — and the rest of us call heartburn.

What Causes It
Stomach acid generally stays where it belongs, thanks to the lower esophageal sphincter (LES). This muscle relaxes only to admit food into the stomach and then shuts tightly. But sometimes the LES doesn’t close properly, allowing the stomach’s contents to wash up into the esophagus.

How Supplements Can Help

All the suggested supplements are effective for relieving heartburn — the first four immediately, the last three within a month or so. Try each methodically to see which one or combination works best for you. All can be used in addition to prescription or over-the counter heartburn drugs.

What Else You Can Do
Eat smaller, more frequent meals to minimize stomach acid production.

Supplement Recommendations

Calcium Carbonate
Licorice (DGL)
Aloe Vera Juice
Gamma-oryzanol
Choline
Pantothenic Acid
Thiamin

Calcium Carbonate
Dosage: 250-500 mg 3 times a day.
Comments: Chewable tablets provide the quickest relief.

Licorice (DGL)
Dosage: 2 deglycyrrhizinated licorice (DGL) wafers (380 mg).
Comments: Take 3 or 4 times a day between meals as needed

Aloe Vera Juice
Dosage: 1/2 cup juice 3 times a day between meals.
Comments: Contains 98% aloe vera and no aloin or aloe-emodin.

Gamma-oryzanol
Dosage: 150 mg 3 times a day on an empty stomach.
Comments: Also know as rice bran oil.

Choline

Dosage: 500 mg 3 times a day.
Comments: For chronic heartburn, use in combination with pantothenic acid and thiamin for 1 month to see if symptoms abate.

Pantothenic Acid

Dosage: 1,000 mg twice a day.
Comments: For chronic heartburn, use in combination with choline and thiamin for 1 month to see if symptoms abate.

Thiamin
Dosage: 500 mg a day, taken first thing in the morning.
Comments: Also called vitamin B1. For chronic heartburn, combine with pantothenic acid and choline for 1 month.

Click for home remedy  of Heartburn Relief

Source:Your Guide to Vitamins, Minerals, and Herbs (Reader’s Digest)

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