Hiatal hernia (Hiatus Hernia) – symptoms, causes and treatment
Hiatal hernia symptoms
Heartburn and belching. There may be difficulty in swallowing. Material from the stomach may suddenly return into the throat or mouth, causing a burning sensation. It may feel as if there is a lump in the throat, or that food is sticking at a point in the throat. Sometimes bloody mucous is coughed up.
The stomach pushes, or herniates, upward through an opening in the diaphragm into the chest cavity (the thorax). A weakness in the diaphragm as it leaves the esophagus may enlarge the opening, where the esophagus (food pipe) enters the stomach. This enables the stomach to slide up somewhat.
The weakness is often caused by increased pressure upward, from what is in or near the abdominal cavity: obesity, pregnancy, tumors, heavy lifting, overeating, straining at the stool, or tight clothing.
It is said that nearly half the people over 40, in the U.S., have hiatal hernias. But most are unaware of it, since these hernias are often quite small and are hardly noticed. They occur in women four times as often as in men, perhaps due to tight clothing. They generally first occur after the age of 40.
The acid material that comes up into the windpipe, from the larger hernias, frequently causes ulceration in the esophageal wall.
But ulcers can also occur in the duodenum, which is the top part of the small intestine, just below the stomach.
People with this condition have a tendency to have overacid stomachs.
Between the esophagus and stomach is the esophageal sphincter. This is a circular valve which can open and close. But its strength is damaged by drugs, tobacco (smoked or chewed), or certain foods. This weakening allows food and acid to go back up into the windpipe.
Those certain foods include coffee and chocolate (because of the methylxanthines in them), spicy foods, tomato, alcohol, peppermint, spearmint, and citrus juices. Tobacco and coffee are especially bad. Whole milk can also be a problem. Weakening of the sphincter occurs within 30 minutes after drinking coffee. One puff of a cigarette can lower sphincter pressure to zero; the result is called “smoker’s heartburn.”
• As soon as you sense heartburn coming on, drink 1-2 large glasses of water. This tends to wash the acid back down into the stomach.
• Eat nourishing food, plus vitamin/mineral supplements. Several small meals are best. Avoid overeating; it only intensifies the problem. Supper, if eaten at all, should be light and 2-3 hours before bedtime. Food in the stomach, after you are in bed, is more likely to flow back up into the windpipe. Stop eating supper entirely, and you are more likely to have success in overcoming hiatal hernia.
• Include extra fiber; this helps soak up some of the acid.
• Avoid fried food and fats; they slow down the digestion process in the stomach. Do not take tea, coffee, colas, alcohol, or tobacco. Avoid refined foods, including white-flour products and sugar.
• Avoid coffee, chocolate, spicy foods, alcohol, tomatoes, mint foods, whole milk, and possibly citrus juices.
• Avoid constipation by including fiber in the diet.
• Eat your meals on a regular schedule, and do not eat between meals. Eating between meals causes the stomach to stop partway through, and start all over again—still with everything from the previous meal in it.
• Even when not thirsty, drink a large glass of water every so often throughout the day.
• Avoid heavy lifting, and do not bend over more than you have to. Wait till 2 hours after a meal before starting heavy exertion.
• Bend from the knees, not from the waist, to avoid upward pressure on the stomach.
• Daily outdoor exercise will strengthen the muscles.
• Avoid stress and stressful situations.
• Avoid tight clothing (corsets, girdles, belts, etc.)
• You may need to raise the head of the bed 4-8 inches to avoid reflux of food upward at night.