Sunday, December 17, 2006

hiatal hernia contributes to the acid reflux

Some people with acid reflux have hiatal hernias and some do not. Hiatal hernias are not a pre-requisite for acid reflux, but a large amount of people with acid reflux DO have hiatal hernias. A hiatal hernia disrupts the location of the LES but due to the hiatal hernia the LES is pushed up and lies in the chest. This is a problem because the diaphragm is a large part of helping the LES to prevent reflux. Now the pressure of both the LES and diaphragm are not working as a strong unit. The hiatal hernia contributes to the reflux because of the decreased pressure.

Acid reflux can also be caused by a hiatal hernia due to the hernial sac. The location of the sac is near the esophagus. Acid gets trapped in the sac. Because the sac is so close to the esophagus, when the LES relaxes, it is easy to reflux.

Monday, November 13, 2006

Hiatal hernia can cause acid reflux

Hiatal hernia can cause acid reflux in adults and is becoming common in the world of today. Eating spicy food may cause acid reflux and can also manifest itself as heartburn.

Looking after your diet intake is one best approaches of preventing acid reflux. avoild food that likly to cause acid reflux are spicy food, fatty fried food, coffee, chocolate onion and garlic.

Change your life style on your diet and drink and live a healhty life.

Tuesday, October 17, 2006

Smoking can lead to heartburn

People who experience chronic symptoms of burn heart indigestion have other more serious diseases which may not be relieved by changes in eating habits or lifestyle. These include acid reflux disease, hiatal hernia and diseases of the esophagus. In addition, any non-burning chest pain, pressure, heaviness or nausea associated with chest pain could be related to the heart, rather than the throat and stomach. It is important to err on the side of caution whenever chest pain is involved. It could be simple burn heart indigestion or something much more serious.

Tomatoes and citrus fruits are foods that cause heartburn in some people. These highly acidic foods can lead to excess stomach acid and may cause heartburn. The causes of heartburn vary from individual to individual. Some people are not bothered by tomatoes or oranges, but may be bothered by fried or spicy foods. It is sometimes necessary to keep a food diary to isolate the foods that cause heartburn in your own diet. You may notice that you only experience heartburn after eating Mexican or Italian foods.

Smoking can lead to heartburn. And, there are other more serious medical conditions that are causes of heartburn, particularly heartburn that is experienced frequently. Hiatal hernia is one example of a medical condition that often presents with frequent heartburn. If you experience heartburn once or more per week, you should have your symptoms evaluated by your physician to rule out the presence of another health problem.

It may not be necessary to remove all of the foods that cause heartburn from your diet. It may simply be a matter of eating less of them or eating them less often.

Thursday, October 05, 2006

Hiatal hernias people of all ages

Hiatal hernias may develop in people of all ages and both sexes, although it is considered to be a condition of middle age. In fact, the majority of otherwise normal people past the age of 50 have small hiatal hernias.

Hernia can be of the following types: Indirect, Direct, Inguinal, Obturator, Spigelian, Umbilical, Incisional and Femoral. Hernia can be caused by many factors. The main ones are obesity, coughing, weight lifting exercises, lung ailments, exertion of pressure on the abdomen during pregnancy and the presence of hernia in the umbilical cord which may then pass on to the baby.

Hernia can occur if anyone keeps on putting too much of strain on the bowel or the kidneys during bowel movement or urination during Straining during a bowel movement or urination. Moreover, hernia may take place if there is too much of fluid in the cavity that makes up the abdomen.

Tuesday, September 26, 2006

Hiatal hernia common in overweight people

Most hernias occur in the abdominal area. Hiatal hernia appears in the upper parts of the abdomen, at the diaphragm. A simple definition of hernia is that it is a disease that appears when a certain part of the body loses its resistance, because it gets old in most cases, and another part of the body that is in contact with the first one slips through a small hole that appears in the first part. Depending on the body parts involved in this hernia can be divided into more types.

Hiatal hernia affects both sexes equally. Although it can occur at any age, the disorder has the highest incidence in elderly people. Hiatal hernia is also common in overweight people and in people who frequently sustain intense physical effort like weight lifting.

Uncomplicated hiatal hernia can be effectively cured by making lifestyle improvements. An appropriate diet and a healthy eating schedule have proved to be very effective ways of correcting hiatal hernia. Also, people who suffer from hiatal hernia are recommended to avoid weight lifting and straining in order to prevent complications.

Some people who suffer from hiatal hernia usually don’t have any symptoms at all. However, hiatal hernia can generate symptoms such as heartburn, abdominal pain and discomfort and nausea. Most people affected by hiatal hernia suffer from heartburn, which usually intensifies after meals. This common symptom of hiatal hernia occurs due to reflux of the stomach content inside the esophagus.

Friday, September 15, 2006

Children suffer from acid reflux

When you suspects that a child is afflicted with acid reflux, should have the child seen by his or her pediatrician. After examining the child and evaluating the symptoms, the doctor may run tests to diagnose whether acid reflux is present. Often, the doctor will begin treatment before testing for acid reflux.

Acid reflux is a condition normally associated with adults. Sadly, many children also suffer the effects of acid reflux.
Though quite common in children, most people are not aware of it's occurrence. In most cases, the process of gastro-esophageal reflux occurs quickly, the acid comes up into the esophagus and then rapidly goes back down into the stomach. In this case, the esophagus suffers no damage. However, if the stomach acid stays in the esophagus, it damages the esophagus lining. This process causes a number of symptoms such as a chronic cough, or a hoarse voice. More serious symptoms can include difficulty in swallowing, wheezing, and chronic pneumonia.

Hiatal hernia are also at a greater risk of developing acid reflux than those person who are not.

Acid reflux in children may manifest in frequent spitting, throwing up repeatedly, coughing and other respiratory problems. Children suffering from acid reflux may also experience weight loss.

Sunday, September 10, 2006

hiatal hernia : Adjustable Beds - More Popular Than Ever

We have all heard of them but how many people have actually considered buying one? Well it is really something to think about if you are considering buying a new bed and/or mattress set. In the last few years there has been such advancement in adjustable beds. More people than ever before are purchasing them.

Just think, with the touch of a button you can change positions and ease that tired back. Most people wake up more refreshed and ready to begin a busy day. Unlike flat beds, adjustable beds support the curvatures of your body.

Some of the benefits of adjustable beds are easier breathing and pressure point reduction. Being able to change your sleeping position at the touch of a button can relieve pain in the back, neck, shoulder and hip. Most people with these problems do not get a good restful night's sleep.

Blood circulation to the legs is less impaired with adjustable beds.

An adjustable bed can make many positive changes in your life such as:

- Getting more sleep

- Improves overall health

- Wake up refreshed

- Getting more sleep may help you think clearer

- Better concentration

The adjustable beds with the new mattresses helps to ease lower back pain by eliminating the pressure points and providing the support you need to get good nights sleep. And adjustable beds are just the thing for a person confined to a bed. It makes their life easier and it makes it easier on the person tending them.

They also make watching television easier and you can easily sit up for reading. Many people report less acid reflux and less trouble with a hiatal hernia when sleeping on an adjustable bed. These beds also make it easier for a person that has had surgery. And if one suffers from knee pain it can be adjusted to relieve even this annoying pain.

Most people think adjustable beds are very expensive, but this doesn't have to be the case. Shop around and you may find them at online stores which can save you hundreds of dollars. Stores on the internet are sometimes able to keep their own costs down which cuts the cost for the purchaser.

There are many types of mattresses to go on adjustable beds. Some mattresses have what is call memory. These mattresses return to there normal shape without sinking like a normal mattress. Some have air that allows you to adjust them to suit what is comfortable for you. Some can be adjusted for a couple sleeping in the same bed. If one person wants firm and the other soft, it can be arranged with a simple push of a button.

The makers of the adjustable bed have made it so simple to get relief from pain, hernia, acid reflux and sleepless nights.

So if you have never tried one and you suffer from neck aches, back aches, knee aches or just plain don't sleep well, it might be in your best interest to check one out. There is nothing to lose but sleepless nights and the elimination of pain.

by Michael Russell

hiatal hernia : Change Your Lifestyle and Control Hiatal Hernia

Hiatal hernia (often referred to as hiatus hernia) is the protrusion (or hernia) of the upper part of the stomach into the thorax through a tear or weakness in the diaphragm

Hiatal hernias may develop in people of all ages and both sexes, although it is considered to be a condition of middle age. In fact, the majority of otherwise normal people past the age of 50 have small hiatal hernias.

Lifestyle adjustments to control a hiatal hernia

If you're overweight, losing weight alone may relieve your symptoms.

If you smoke, quit.

Do not wear tight clothes around your chest or abdomen (belly). They put pressure on your stomach.

Elevate the head of your bed 6 inches by placing blocks under the bed frame. Gravity will help prevent stomach acid from moving up into your esophagus as you sleep. Using a foam wedge to raise your mattress also may help. Don't try to use pillows, which tend to increase pressure on your abdomen.

It is important to avoid large meals. Eating small, frequent, bland meals to keep pressure on the esophageal sphincter.

Do not eat for at least 2 hours before going to sleep.

Avoid spicy and acidic foods.

Do not bend over or lie down after eating.

By Uthkusa Gamanayake

Tuesday, August 29, 2006

hiatal hernia : Associated Diseases

Associated Diseases
Barrett’s oesophagus - 96% of Barrett’s oesophagus patients have a hiatus hernia3
Oesophageal adenocarcinoma - increase in risk x6 with hiatus hernia but no reflux and x8 if reflux as well.4

Management
Non-Drug Patients with hiatus hernia should be advised to avoid any factors likely to increase intra-abdominal pressure e.g. tight clothing, corsets.

Nocturnal symptoms may be helped by elevating the head of the bed to reduce postural reflux.

Weight loss should be advised in obese patients and patients who smoke and /or drink should be encouraged to stop.

Drugs Symptomatic relief may be gained by the use of alginates +/- use of proton pump inhibitors, although patients with hiatus hernia may require larger doses for symptom control.

Surgical The presence of a hiatus hernia is a marker for severe GORD .Patients with a hiatus hernia tend to have more severe symptoms and a poorer response to treatment, but it’s presence per se does not alter management strategies.

Indications for surgery in patients with severe GORD include:-

Patients who are unable to comply with therapeutic regimes
Patients who require high doses of drugs
Patients who wish to avoid lifelong medical treatment
The surgical procedure most commonly used involves mobilising the oesophagus in the thorax, bringing it down to restore the intra-abdominal portion and repairing the deficit (modified Nissen procedure).

Oesophageal lengthening combined with fundoplication may be performed during laparoscopic surgery.

Several novel endoscopic techniques have been used in the treatment of GORD with some success, but the results do not separate out patients with hiatus hernia.

Prognosis The majority of patients will gain symptomatic relief from medical or surgical intervention, although a few will go on to develop Barrett’s oesophagus or oesophageal adenocarcinoma.

© EMIS and Patient Information Publications 1997-2006

hiatal hernia : Epidemiology

Incidence The precise incidence of hiatus hernia is not known, as most studies have looked only at individuals who presented with symptoms of dyspepsia. Of patients undergoing investigation for dyspepsia in western populations approximately 15-25% are discovered to have a hiatus hernia.2 Males and females appear to be equally affected. The incidence increases with age and obesity but varies from country to country being more common in western societies and rare in the Far East.

The term hiatus hernia refers to the herniation of a part of the abdominal viscera through the oesophageal aperture of the diaphragm. The vast majority of hiatus hernias involve only the herniation of a part of the gastric cardia through the muscular hiatal aperture of the diaphragm, however rarely, hernias with a large defect can allow other organs to enter the thoracic cavity such as spleen and pancreas. A hiatus hernia may be caused by one or more of 3 possible mechanisms i) widening of the diaphragmatic hiatus. ii) pulling up of the stomach due to oesophageal shortening. iii) pushing up of the stomach by increased intra-abdominal pressure.1 The association between hiatus hernia and oesophagitis has been recognised for over 70 years, however it is only much more recently that the precise relationship between the two has been understood. It is now believed that the hiatus hernia has major pathophysiological effects resulting in gastro-oesophageal reflux and contributing to mucosal injury, particularly in patients with severe Gastro-oesophageal reflux (GORD or GERD)

Presentation Many individuals with a hiatus hernia will be totally asymptomatic, others may present with any of the following:-

Retrosternal burning sensation or "Heartburn" especially on bending or lying
Flatulance
Gastro-oesophageal reflux
Large hernias may cause difficulty in swallowing (rare)

Investigations Barium studies remain the only accurate method of measuring the size of a hiatus hernia

Upper GI endoscopy although commonly used for assessing symptoms of dyspepsia, it is not useful for assessing a hiatus hernia due to difficulties with measurement.

Oesophageal manometry, is not sufficiently sensitive for diagnostic purposes especially with small hernias

© EMIS and Patient Information Publications 1997-2006

hiatal hernia : Taming a Hiatal Hernia?

A hiatal hernia is a protrusion of a portion of the stomach through the muscular ring at the junction of the esophagus and stomach. Usually, this common occurrence causes no symptoms, but sometimes the lining of the protrusion becomes inflamed, causing heartburn, belching, distention, problems swallowing, and regurgitation.

For relief, I recommend deglycyrrhizinated licorice (DGL), which can soothe the lining of the esophagus and stomach. Chew two tablets slowly before each meal or between meals, or take one-half teaspoon of the powder before meals. Let it slowly trickle down your throat. You can continue to use DGL as long as you have symptoms. Here are some other lifestyle changes that can help:


Reduce or eliminate alcohol consumption. If you do take an occasional drink, be sure to eat something first.
If you smoke, stop -- tobacco can irritate the digestive system.
Avoid coffee and decaffeinated coffee. Caffeine can aggravate symptoms. Substitute chamomile tea, which is soothing.
Experiment with foods to see which ones trigger your symptoms and avoid any that do.
Don’t eat within two to three hours of bedtime, and don’t lie down after meals.
Eat frequent small meals rather than three large ones.
Elevate the head of your bed by six to eight inches (to prevent stomach acid from refluxing while you’re lying down).
You should also try to avoid drugs that can make reflux worse by decreasing the pressure of the lower esophageal sphincter. These drugs include calcium channel blockers, nitrates, sedatives, and theophylline. Peppermint can have the same undesirable effect.

Conventional doctors probably will prescribe acid-suppressive drugs. I recommend using them only short-term or not at all, as they have significant side effects, are not intended for long-term use, treat the problem superficially, and cause rebound increase in acid production when you stop taking them.

Dr. Andrew Weil

Wednesday, August 23, 2006

hiatal hernia : Causing Strain on Bowel or Kidneys

Hernia occurs when the abdominal wall structure ruptures or an opening takes place there. As a consequence thereof, the wall of the abdomen is destroyed and there is an outcropping via that membrane which is rather thin. The outcropped parts are mainly sections of the fatty tissue that make up the abdomen or certain parts of the intestine (small and large). Mention may be made of Hiatal hernia which happens when the tummy comes out through the diaphragm and rises till the chest. However, hernia can happen anywhere in the human body.

Hernias can lead to pain in the chest besides heartburn. Moreover, hernias can stop blood flow to that affected part, and during such abnormal situations surgeries are the only ways out.

Hernia can be of the following types: Indirect, Direct, Inguinal, Obturator, Spigelian, Umbilical, Incisional and Femoral. Hernia can be caused by many factors. The main ones are obesity, coughing, weight lifting exercises, lung ailments, exertion of pressure on the abdomen during pregnancy and the presence of hernia in the umbilical cord which may then pass on to the baby.

Hernia can occur if anyone keeps on putting too much of strain on the bowel or the kidneys during bowel movement or urination during Straining during a bowel movement or urination. Moreover, hernia may take place if there is too much of fluid in the cavity that makes up the abdomen.

Different types of hernia have different sets of symptoms. The commonly reported symptoms of hernia are belching, heartburn – especially when one lies down or while bending -- chest pain, groin pain during bending, groin soreness, appearance of lump which may be painless, esophagus blockage, swallowing problems, and/or protrusion(s) that may be just tender or swollen for that matter.

If hernia is diagnosed, strictly follow your physician’s schedule. Some of the commonly prescribed methods to check hernia is to say ‘NO’ to depression, cut down on the regularly taken diet, avoid non-digestible food items, quit smoking or/and alcoholic substances, never to lie down or even bend after meals, and avoid tight-fitting clothes. Moreover, ensure that you do not exert pressure on the abdomen while coughing and stop lifting heavy articles.

The best way to control hernia is to consume fibery items like grains (including millet and barley), vegetables (sweet potatoes, cabbage, artichoke, and dandelion), herbs (aloe vera, arrowroot, parsley, mint, asafetida, cumin, fennel, among others) and lots of fruits. To prevent constipation and thus obviate the possibility of putting undue pressure on the intra-abdominal area is to increase the amount of liquids especially water. Take to regular exercise. Sweating can also help excrete toxic items from the body. Go for six meals in lesser amounts instead of three large meals. But, remember to not consume such items you may be allergic to. Moreover laugh away your blues by enrolling yourself in the local laughter club.

One of the popular remedies for hernia is to consume Cayenne pepper, sweating out a lot by either exercising, brisk walking, or by drinking tea (warm) in a room that is hot. One can also get relief from hernia by placing a rupturewort tea-soaked cloth on the portion that is affected.

by Nilutpal Gogoi

hiatal hernia : All About Acid Reflux

Acid reflux is scientifically known as Gastroesophageal Reflux Disease (GERD). It is a disease characterized by the abnormal reflux of gastric contents into the esophagus resulting to chronic symptoms or mucosal damage.

Acid reflux is often caused by temporary or permanent alterations in the lining that separates the esophagus and the stomach. Ineffectiveness of the lower esophageal sphincter (LES) or a temporary LES relaxation connected with a hiatal hernia are just some of the common causes of acid reflux. The process can also lead to a backflow of gastric juices to the pharynx or mouth.

Among adults, the most common symptom of acid reflux is heartburn which is caused by the presence of acid in the esophagus. Heartburn is characterized by a painful burning sensation behind the sternum or breastbone. Another symptom or manifestation of acid reflux is esophagitis which is characterized by an inflammation of the lining of the esophagus which is also known as the mucosal lining. Esophagitis also causes swallowing difficulties and chronic pains in the chest area.

Sometimes, individuals suffering from acid reflux may also experience coughing, persistent pain in the ears, hoarseness or a change in the voice and even sinusitis. If acid reflux gets complicated it may lead to formation of a stricture or ulcers in the esophagus. It may also lead to a condition called Barrett’s esophagus and in worst cases to cancer of the esophagus.

It doesn’t mean however that a person who regularly suffers from heartburn is suffering from acid reflux. By all means, the heartburn may be from other causes. But if a person suffers from heartburn for more than once a week, then he or she is at a risk of acquiring acid reflux. Person with hiatal hernia are also at a greater risk in developing acid reflux than those who are not.

By Robert Thatcher

Tuesday, August 15, 2006

hiatal hernia : Heart Burn and Indigestion

There are many people who suffer from the symptoms of heart burn and indigestion. These symptoms may result from the foods we eat, the beverages we drink or our lifestyles, but symptoms of burn heart indigestion may also be related to other medical conditions and chronic symptoms should be reported to your doctor. Choosing a burn heart medication is a choice to be made by you and your doctor. Here is a look at some of the common heart burn medications and the side effects associated with them.

One of the most highly advertised heart burn medications is Prevacid. Prevacid burn heart medication should not be used by persons with liver disease or certain allergies. You have probably seen the commercials and may have heard the side effects associated with this popular treatment for burn heart indigestion. If your heart burn symptoms are mild, the side effects may not seem worth it. Constipation or diarrhea may occur when using Prevacid.

Another common burn heart medication is Pepcid. It should not be used by persons with liver problems, kidney disease, stomach cancer or those with certain allergies. Side effects that may be experienced include headache, constipation, diarrhea or dizziness. There are serious side effects that are rare, but have occurred in persons using Pepcid to treat burn heart indigestion symptoms.

Prilosec is a prescription medication used to treat heart burn symptoms. Users of this burn heart medication may experience constipation, cough, dizziness or back pain.

Any over the counter or prescription burn heart medication may cause unwanted side effects. Only you and your doctor can decide if the benefits outweigh the possible risks. The symptoms of burn heart indigestion may be relieved by certain botanicals or health supplements and possibly prevented changing the diet and lifestyle.

Some people who experience chronic symptoms of burn heart indigestion have other more serious diseases which may not be relieved by changes in eating habits or lifestyle. These include acid reflux disease, hiatal hernia and diseases of the esophagus. In addition, any non-burning chest pain, pressure, heaviness or nausea associated with chest pain could be related to the heart, rather than the throat and stomach. It is important to err on the side of caution whenever chest pain is involved. It could be simple burn heart indigestion or something much more serious.

By Patsy Hamilton

hiatal hernia : Heart Burn Remedies

There are many heart burn remedies on the market. There are many heart burn home remedies, as well. Any may be effective. Here we look at some of each.

Heartburn is a burning sensation in the throat or chest that may or may not be accompanied by gas or bloating. It happens when stomach acid, which is normally confined to the stomach, bubbles up or leaks into the esophagus and is also referred to as indigestion. Effective heart burn remedies neutralize the acid and soothe the burning sensation. Some heart burn remedies will also relieve the gas and bloating. Many over the counter heart burn remedies contain calcium carbonate. One popular product even advertised itself as an effective calcium supplement. Effective heart burn home remedies include using peppermint or other mints to relieve the symptoms. Most over the counter heart burn remedies are mint flavored, but not all contain peppermint oil. The ones that do may be more effective in relieving gas and other symptoms of indigestion.

It is not uncommon to experience heartburn symptoms after a very large meal. These meals often make one feel sluggish as well, but taking a nap may bring on or worsen heart burn symptoms. Some people find that heart burn home remedies are unnecessary if they take a leisurely slow or sit quietly for a while following the meal. Even after symptoms are present, relaxing in a sitting position or strolling around the neighborhood may be effective heart burn home remedies.

Over the counter heart burn remedies include antacid products like Tums or Rolaids. There are other products that will relieve gas and bloating. Calcium carbonate is usually effective for neutralizing the stomach acid, but may leave a chalky taste in the mouth. Products that contain mint oil or peppermint may be a little harder to find, but will leave a pleasant taste in the mouth. Heart burn home remedies containing fennel and other herbs have been used by Native Americans and Europeans alike to relieve the symptoms of indigestion. It is possible to make a soothing tea using fennel seeds. Drops containing fennel and other herbs are also available from companies that sell natural products. Relief may also be found in chewing on a piece of rhubarb or non-fruit flavored gum. The saliva created by the chewing action will help neutralize the acid. Smoking will worsen the heartburn symptoms, because it dries out the saliva in the mouth and throat. Experiencing frequent heartburn is one of many reasons to quit smoking.

Chronic heart burn may be a symptom of another more serious medical condition. For instance, a hiatal hernia pushes up against the stomach, causing the stomach acid to leak up into the esophagus. Anyone experiencing symptoms of heartburn more than once a week should have their symptoms evaluated by a physician. Heartburn may be a result of stress, overeating, drinking too much coffee or eating fried or acidic foods, but if heart burn remedies do not provide relief or if the heartburn is frequent, it could mean something else is going on.

By Patsy Hamilton

Tuesday, August 08, 2006

hiatal hernia : Ways to Reduce Heartburn

There are many ways to reduce heartburn frequency. There are some pretty safe foods for heartburn sufferers. However, it may be necessary to evaluate your lifestyle and overall health in order to prevent the frequency of heartburn. Sometimes it is necessary to keep a food diary or at least a mental note of what foods you ate before you experienced the heartburn symptoms. Most people experience heartburn occasionally. It is next to impossible to avoid everything that can cause heartburn all the time, but there are ways to reduce heartburn or at least the likelihood of experiencing heartburn symptoms.

Some ways to reduce heartburn include dietary changes. If your diet is high in fat and acidic foods like tomatoes and citrus fruits, reducing this and including more safe foods for heartburn sufferers may reduce the frequency of your heartburn. Experts may not always agree on what are safe foods for heartburn sufferers, but most agree that they are foods that are low in fat and low in acid. For instance, apples, bananas and pears are better choices than oranges. Baked, grilled or boiled skinless, white meat chicken and baked, boiled or broiled seafood are better choices than hamburgers and fried chicken. It is a sensible diet that you are looking for, not just a list of safe foods for heartburn sufferers.

Most treatment plans or recommended ways to reduce heartburn include lifestyle changes along with dietary changes. For example, eating several small meals every couple of hours is better than eating one or two large meals. Even if you only eat supposed safe foods for heartburn sufferers, but you overeat, you may experience heartburn. If you are overweight, eating smaller meals more frequently may help you lose weight by increasing your metabolism and maintaining proper blood glucose levels. People who are overweight suffer from heartburn more frequently than people who are at their ideal weight, so losing weight may be one of the ways to reduce heartburn.

If you experience heartburn at night, one of the ways to reduce heartburn is to eat your last meal three to four hours before going to bed. Elevating the head of your bed or sleeping on a specially designed wedge are other possible ways to reduce heartburn that is experienced at night. Overweight people are more likely to experience heartburn at night, it may interfere with their sleep or they may be unaware of it. Nighttime heartburn can lead to respiratory problems, as the acid can be inhaled. If you are eating small meals, trying to lose weight and including mostly safe foods for heartburn sufferers in your diet, but you know or believe that you are suffering from nighttime heartburn, it is advisable to see your doctor, before the problem becomes worse.

All of the above recommendations for ways to reduce heartburn assume that a person is in otherwise good health. Heartburn can be a symptom of more serious medical conditions including acid reflux and hiatal hernia. Treatment plans still generally include the above mentioned lifestyle changes and eating more safe foods for heartburn sufferers, but other medications may be recommended.

by Patsy Hamilton

Monday, August 07, 2006

hiatal hernia : Diet For Heartburn

Heartburn is a common digestive complaint which affects an estimated 15 million Americans every day, and 60 million once a month. Relief of mild heartburn is typically achieved through diet and lifestyle changes, although medication (eg. antacids) is usually necessary if the heartburn is caused by gastroesophageal reflux disease (GERD).


What is Heartburn? What Are The Symptoms?


Heartburn is a digestive problem: it has nothing to do with your heart. It occurs when small amounts of stomach acid accidentally rise up the esophagus (the food canal running from the mouth to the stomach) causing symptoms like a burning pain in the chest which rises towards the throat. Sufferers may even taste the fluid in the back of the mouth, and this is called acid indigestion. In many cases the pain and burning sensation is relatively mild, but sometimes is so severe that patients think they are experiencing a heart attack.


What Are The Causes Of Heartburn?


In general, the immediate cause of heartburn is the acidic digestive juices which leave the stomach and rise up the esophagus. The acid burns the tissue of the esophagus causing inflammation and pain - a condition called esophagitis. Heartburn may also occur in pregnancy when the baby is pressing up against the underside of the diaphragm and squeezing the stomach. An occasional episode of acid-regurgitation or indigestion is quite normal. But persistent heartburn (eg. twice a week), is usually a sign of something more serious. The two most common underlying causes of heartburn symptoms are gastroesophageal reflux disease (GERD), and hiatal hernia.


Gastroesophageal Reflux Disease


GERD is characterized by a failure of the muscular valve, known as the lower esophageal sphincter (LES), which is located at the bottom of the esophagus. The function of this valve is to keep acid in the stomach and prevent it leaking back up the esophagus. When this valve doesn't work properly, reflux (leak-back) and heartburn can occur. Factors that contribute to gastroesophageal reflux disease include obesity, pregnancy, smoking and, in particular, hiatal hernia.


Hiatal Hernia


Hiatus or hiatal hernia is a condition in which part of the stomach herniates (protrudes) upwards into the chest through the hiatus (opening) in the diaphragm normally only occupied by the esophagus. This puts extra pressure on the LES valve preventing it from closing properly. As a result, stomach acid leaks into the esophagus causing heartburn. The underlying cause of hiatal hernia is unknown. Contributory factors include: obesity, pregnancy, constipation, abdominal muscle strain, and smoking.


Dietary Treatment For Heartburn


In cases of persistent heartburn, dietary improvements are not sufficient. So as well as advocating a digestion-friendly diet, your doctor is likely to recommend one or more of the following types of medication. Antacids to neutralize the acid in your stomach; H2 blockers or proton pump inhibitors to reduce acid production; or prokinetics to strengthen the lower esophageal sphincter and expedite stomach-emptying. However, if heartburn symptoms are mild and occur only from time to time, usually you will be advised to make the following changes to your diet.


If Overweight, Switch To A Healthy Weight Loss Diet


Obesity, especially excess fat on the chest and abdomen, is a common contributory factor to GERD and hiatal hernia, and therefore to heartburn. So if you are obese (BMI > 30), take steps to normalize your weight and thus reduce your risk or symptoms of heartburn. Choose a healthy calorie-controlled diet and customize it by following the eating tips below.


Stop Eating Large Meals


A big meal distends the stomach and causes a rise in the production of stomach acid. Both these factors lead to an increased risk of heartburn. So opt for 4-6 small meals or snacks, and allow a maximum of 3 hours between eating. In addition, choose foods that are "easier on the stomach" and more more easily digested.


Avoid Acidic Food


Reduce your intake of very acidic foods by avoiding items such as: tomatoes, tomato-based sauces, citrus fruits, rhubarb, gooseberries, unripe fruit, vinegar and acidic pickles or relishes.


Cut Down On Fatty and Spicy Food


Fried or very fatty foods, including candy, encourage indigestion and should be avoided or eaten sparingly. So go easy on butter, mayo, sausages, salami, pate, meat pies, and full-fat cheese. The same applies to very spicy food such as: black pepper, chili peppers, curry, mustard and other hot spices, as well as raw onions and garlic.


Avoid Carbonated Drinks


Fizzy or carbonated soft drinks cause belching and upward pressure on the lower esophageal sphincter (LES), increasing the likelihood of heartburn. The best drinks include: water, herbal teas or diluted non-citrus fruit juices. Please also note that some soft drinks (eg. cocoa, coffee, orange juice) are not helpful for heartburn as they can over-relax the LES, thus encouraging the backward flow of acid from the stomach.

Eat More Fiber, Especially Soluble Fiber


Constipation can lead to extra strain on abdominal muscles and increase the risk of heartburn. To prevent constipation, eat more high-fiber foods such as: oats, apples, pears, dried apricots and vegetables. When increasing fiber intake it's also important to increase your water intake by at least 40 fl oz a day.


Reduce Alcohol Consumption


Alcohol is not helpful to heartburn for several reasons. So take steps to reduce your intake to one unit a day, or avoid it altogether. Alcohol is also a source of non-nutritious calories and can contribute to overweight.


Other Digestive Tips


For digestive disorders like heartburn, some dietitians and alternative health experts recommend patients to eat (or cook with) digestion-friendly aromatic herbs like basil, camomile, caraway, dill, fennel, rosemary and thyme. They also recommend that you end each meal with a glass of herbal tea (eg. camomile, fennel) to reduce acidity and wind.


Lifestyle Improvements To Reduce Heartburn


There are several lifestyle changes that can help to reduce the symptoms of heartburn. One obvious one is to stop smoking, as tobacco smoke increases acidity in the stomach. Other recommended changes include:


Avoid placing extra strain on your abdomen or chest. Wear loose-fitting clothes, and do not overstretch or lift heavy weights.


Do not lie down after eating, and try not to eat anything for at least three hours before going to bed. The less there is in your stomach when you come to lie down, the lower the risk of heartburn.


To minimize night-time discomfort, raise the head end of your bed by about 3 inches by using bed-blocks or by placing a solid object under the bed-legs. This helps to prevent stomach acid from leaking backwards into the esophagus. Do not use extra pillows - you simply end up with a stiff neck as well as heartburn!


Heartburn symptoms can be caused by certain over-the-counter drugs, such as aspirin, or other pain-killers or anti-inflammatories. So if you take this type of medication regularly, check with your doctor or pharmacist that it's safe to continue.

By Linda Smyth

Wednesday, August 02, 2006

hiatal hernia : What Are The Symptoms And How Does It Cause GERD?

The symptoms of a hiatal hernia

The vast majority of hiatal hernias are 'sliding' hiatal hernias in which the junction of the esophagus and stomach, referred to as the gastroesophageal junction, and part of the stomach protrudes into the chest. The larger the hernia, the more likely it is to cause symptoms. When hiatal hernias produce symptoms, they are almost always those of gastroesophageal reflux disease (GERD) or its complications.

This happens because the formation of the hernia often interferes with the barrier (lower esophageal sphincter) which prevents acid from refluxing from the stomach into the esophagus. Patients with GERD are more likely to have a hiatal hernia than individuals not afflicted by GERD. Although hiatal hernias contribute to GERD, it is not clear if hiatal hernias alone can result in GERD. Since GERD occurs in the absence of a hiatal hernia, factors other than the existence of a hernia can cause GERD.

How a hiatal hernia causes GERD

GERD is when acid flows backwards (refluxes) up into the esophagus. Normally, there are several devices to prevent this from happening.

One device involves a band of esophageal muscle, where the esophagus joins the stomach. This is called the lower esophageal sphincter; it remains contracted most of the time to prevent acid from refluxing or regurgitating.

The sphincter only relaxes when food is swallowed so that the food can pass from the esophagus and into the stomach. The sphincter is normally attached firmly to the diaphragm in the hiatus, and the muscle of the diaphragm wraps around the sphincter. The muscle that wraps around the diaphragm increases the pressure of the contracted sphincter to further prevent reflux of acid.

Another device that prevents reflux is the valve-like tissue at the junction of the esophagus and stomach just below the sphincter. The esophagus normally enters the stomach logically so that there is a sharp angle between the esophagus and stomach. The thin piece of tissue in this angle, composed of esophageal and stomach wall, forms a valve that can close off the opening to the esophagus when pressure increases in the stomach; during a belch, for instance.

When a hiatal hernia is present, two changes happen:

The sphincter slides up into the chest while the diaphragm remains stationery. As a result, the pressure normally generated by the diaphragm overlying the sphincter and the pressure generated by the sphincter no longer overlap. As a result, the total pressure at the gastroesophageal junction decreases. When the gastroesophageal junction and stomach are pulled up into the chest with each swallow, the sharp angle where the esophagus joins the stomach becomes less sharp and the valve like effect is lost.

Both changes promote reflux of acid, or GERD.

Hope for Hiatal Hernia!

Understanding the processes behind a hiatal hernia and GERD is the first step to treating it.

By Nick Willis

hiatal hernia : What Is It?

A hiatal hernia is an anatomical abnormality in which part of the stomach protrudes through the diaphragm and up into the chest. Although hiatal hernias are present in approximately 15% of the population, they are associated with symptoms in only a minority of those afflicted.

Normally, the esophagus or (food tube) passes down through the chest, crosses the diaphragm, and enters the abdomen through a hole in the diaphragm called the esophageal hiatus. Just below the diaphragm, the esophagus joins the stomach.

In individuals with hiatal hernias, the opening of the esophageal hiatus (hiatal opening) is larger than normal, and a portion of the upper stomach slips up or passes (herniates) through the hiatus and into the chest. Although hiatal hernias are occasionally seen in infants where they have probably been present from birth, most hiatal hernias in adults are believed to have developed over many years.

The Causes of a Hiatal Hernia.

It is thought that hiatal hernias are caused by a larger than normal esophageal hiatus, the opening in the diaphragm through which the esophagus passes from the chest into the abdomen. As a result of the large opening, part of the stomach "slips" into the chest.

Other contributing factors include:


A permanent shortening of the esophagus (perhaps caused by inflammation and scarring from the reflux or regurgitation of stomach acid), which pulls the stomach up.


An abnormally loose attachment of the esophagus to the diaphragm which allows the esophagus and stomach to slip upwards.

Different Types of Hiatal Hernias.

Hiatal hernias are either:

Sliding

Sliding hiatal hernias are those in which the junction of the esophagus and stomach, referred to as the gastro esophageal junction, and part of the stomach protrudes into the chest.

The junction may reside permanently in the chest, but often it juts into the chest only during a swallow. This occurs because with each swallow the muscle of the esophagus contracts causing the esophagus to shorten and to pull the stomach up.

When the swallow is finished, the herniated part of the stomach falls back into the abdomen.

Para-esophageal

Para-esophageal hernias are hernias in which the gastro-esophageal junction stays where it belongs (attached at the level of the diaphragm), but part of the stomach passes or bulges into the chest beside the esophagus. The para-esophageal hernias themselves remain in the chest at all times and are not affected by swallows.

A para-esophageal hiatal hernia that is large, particularly if it squeezes the adjacent esophagus, may hamper the passage of food into the stomach and cause food to stick in the esophagus after it is swallowed. Ulcers also may form in the herniated stomach due to the disturbance caused by food that is stuck or acid from the stomach.

Fortunately, large para-esophageal hernias are uncommon.

Hope for Hiatal Hernia!

Once you grasp the 'biology' behind a hiatal hernia, you can begin to understand the science behind some deceptively simple techniques to manage the condition. To find out more, check my review of my recommended resource on controlling a hiatal hernia.

by Nick Willis

Sunday, July 30, 2006

hiatal hernia : Natural Treatment Options for Prostate Bph

If your prostate diagnosis leaves you free of cancer, you may still have Benign Prostate Hypertrophy (prostate BPH). Rather than using hormonal or alpha blockers, many men have opted for a natural approach to avoid some of the unpleasant side effects of the drug therapy. The two prescription drugs, inasteride (Proscar) and terazosin (Hytrin) make lots of money for drug companies because they are the only two approved by the FDA to prevent prostatic proliferation (the growth of new prostate cells that cause prostate BPH in men over 50).

First we will look at 7 different therapy options for prostate BPH. These options are Ayurveda, Reflexology, Food Therapy, Imagery, Hydrotherapy, Vitamin and Mineral Therapy and Yoga. We present you with a brief synopsis of each therapy as it relates to prostate problems.

Ayurveda

The Ayurvedic approach to all disease is to first make certain that you have received an appropriate diagnosis from a medical professional. If the prostate diagnosis is benign the ''flowing'' approach can be used. Mix the following herbal powders: Punarnava, Gokshura and Shilajit. Ingest just 1/4 teaspoon a day either dry or added to warm water. An alternative is to drink any one of horsetail, ginseng or hibiscus tea, consumign as much as you wish each day. All of these herbs should be available at your health food store or by mail order.

Reflexology

Reflexology is the pratice of directing energy toward specific pressure points in the body. Reflexology sessions begin with relaxing the total body then shifting the focus of the reflex to those areas of greatest need. For our purposes that would be the prostate, endocrine, pituitary, parathyroid, thyroid and adrenal glands as well as the pancreas with the reflex in the hands or feet. You can find reflexology charts that give you the reflex points at most health food stores or schedule a session with a professional reflexologist.

Food Therapy

The key to affecting positive change in the prostate by eating specific foods is including any foods high in zinc. The properties in zinc have been proven beneficial in shrinking an enlarged prostate. Take a daily supplement of zinc. In addition to a low-fat diet, particularly avoiding saturated fats, consider adding one or two tablespoons per day of flaxseed oil to your diet as well as pumpkin and sunflower seeds, both know for their high content of zinc.

Imagery

Imagery is closely associated to hypnosis, both practices incorporating positive visualization techniques to effect positive changes. Here is one exercise proven beneficial for our purposes here:

Close your eyes breathe out three times and imagine entering your body through any opening you choose. Find your prostate and examine it from every angle. Next, envision putting a thin golden net around the gland. This net has a drawstring that you can tighten. Cinch the drawstring so that the net is wrapped snugly around the prostate. As you do this, picture the prostate shrinking to its normal size. Then imagine using your other hand to massage your prostate. Sense that urine can now flow evenly and smoothly. The recommendation for this exercise is to practice it twice a day, three to five minutes per session for six cycles of 21 days on and 7 days off.

Hydrotherapy

A hot sitz bath comes highly recommended for the treatment of an inflammed prostate. Sit down in a tub filled with comfortably hot water to a depth of your navel. Soak for twenty to forty-five minutes and follow with a cold bath or shower. This treatment should be done once a day for thirty days or until the symptoms are gone.

Vitamin and Mineral Therapy The ideal vitamin and mineral treatment for prostate problems incorporates herbal medicine. The following regimen is recommended to help control symptoms:


a) 400 international units of Vitamin E per day
b) 30 milligrams of zinc twice a day
c) 1 milligram of copper twice a day
d) One tablespoon of flaxseed oil a day
e) 160 milligrams of saw palmetto twice a day.

Flaxseed oil and saw palmetto are easily obtainable in any health food store.

Yoga

Certain Yoga poses can increase blood flow to the groin, thereby relieving certain prostate problems. You can find books on Yoga that include these poses, as well as many others, at any herbal or homeopathic store. The two poses that will benefit prostate problems are the "knee squeeze" and the "seated sun" along with the "stomach lock."

To do the "stomach lock," lie on your back and take a deep breath. Breathe out until all air is expelled from your lungs, then pull in hard on your buttocks, groin and stomach muscles. Hold this pose for a count of three then release the muscles. It is recommended that this session is repeated two or three times a day, three times a session to help prevent prostate trouble. You should not use this yoga pose if you suffer from high blood pressure, hiatal hernia, ulcers or heart disease.

It must be perfectly understood that there is no substitute for your physician. These options are presented as just that. . .options and you should consult your physician before undertaking any new treatment options prostate BPH whether medical or homeopathic.

Mihail Fortomas is a teacher of Biology in a High School of Athens Greece. Free information on prostate diseases, symptoms and treatments of prostate problems , visit:
http://1source-body-health.com/prostate-health.html

Article Source: http://EzineArticles.com/?expert=Mihail_Fortomas

hiatal hernia : Some Cases of Acid Reflux May be Cured Naturally with Better Lifestyle Choice

Acid reflux is a growing concern among adults and children today, and there are more and more over the counter and prescription remedies available now than ever. But some experts feel that a natural approach to combating and preventing acid reflux may be a better and safer bet.

Acid reflux can occur if an adult has a hiatal hernia, or in children if their esophagus is not developed completely after birth. The result is that stomach acid, instead of stopping in the esophagus, comes up into the throat and burns. Acid reflux can be particularly painful to newborns, and it is becoming more and more common in them today. In adults, acid reflux can also manifest itself as heartburn after eating spicy food.

One of the first natural approaches to curing acid reflux is to look at your diet. Some foods that may prompt an acid reflux attack are: citrus, caffeine, chocolate, fatty fried foods, garlic, and onions. Avoiding these foods is a good first natural step to preventing future acid reflux episodes.

Some other approaches for natural acid reflux cures and prevention are: losing weight if you are overweight, avoiding alcohol, eating small meals, not lying down to sleep for at least three hours after a meal, and raising the head of your bed by six to eight inches.

Making some of these simple lifestyle changes may help you to avoid further bouts of acid reflux pain and may also be your chance to avoid or get off of acid blockers and H2 blockers, which may come with their share of side effects.

For more information on Acid Reflux, Heartburn and GERD, their causes, dietary guidelines and acidity, plus information on acid reflux cures and relief visit http://www.acidrefluxsolutions.com

Article Source: http://EzineArticles.com/?expert=Jill_Dow

Thursday, July 27, 2006

hiatal hernia : hitting the head on the nail

Medicine; With YOUR Dignity In Mind

When in the E.R., O.R. and exam rooms, is it too difficult to cover a man’s pride or a woman’s dignity?

Less than a second’s effort isn’t worth a touch of human kindheartedness?

Whether seeing the patient’s naked body affects the medical team is not the issue, I’ve been told they (the medical teams) don’t see the patient that way (nude)… the patient does!

(By the way, I’ve personally over heard nurses and doctors discussions of sexuality… My mom was a nurse… I’ve heard the stories)

A simple cloth covering a patient’s genitals will not stop medical teams from observing that patient’s nudity, it does however leave the patient an air of dignity… conscious or not.

Other than the obvious external ailment, like an open sore or a rash… what is the necessity in X-Rated photographs of the patient’s naked body in sexually explicit positions? I don’t care that Doctors “think” no one sees the X-Rated photographs… What I want to know is, Why do they need them? What purpose do they perform? Do Doctors have to disrespect the patient, when a single in line photo of a sign stating “COLONOSCOPY” would suffice?

You can pull up tens of thousands of men and women that boisterously state that nudity and X-Rated images of their bodies, posted in publicly accessible records, is OK, and doesn’t bother them.

There are Millions that SILENTLY disagree. MILLIONS of potential patients… are avoiding all medical confrontations and disgustingly envisioned procedures, like colonoscopies, due directly to the prospect of such improper concerns for ones dignity by the medical profession. Simply corrected… by protecting the patient’s self-respect and controlling the degree of nudity.

Would you rather have 30% of the thousands or the same percentage of the millions? Paying patients! The ones with insurance! Simply stop the X-Rated, naked photographs and unnecessarily indignant exposures… you will see an improvement of your “Bottom” line. Advertise with the title of this letter!

In the exam room offer the male patient a wrap for around his waist… You don’t really NEED to visually see his genitals… and a woman can be examined for the most part with the paper robe in place. If they opt for the exposure… no problem, but for those that want their privacy… You just gained, everyone that satisfied patient knows, and they know, etc

Find, if you even care, a copy of the videotaped procedure of Katie Couric (of NBC) and see what I mean by dignifying the procedure.

She was laying on her side (not splayed like a gay w**** in heat), Covered with a blanket (not completely exposed to a room full of people), Only the necessary area exposed, then only to the doctor and assisting nurse (not the entire body with all that’s private to ones being dangling for all to gawk at), And no one was taking X-Rated pictures.

Just want to know… When a patient goes in for a Laparoscopic exam ordered by a Gastroenterologist, for GERD and a Hiatal Hernia, does an Urologist then come in to do the Colonoscopy? (Both were done in the same visit… I opted to be left unconscious). Or… does a single hospital surgeon do both procedures, and submit the findings to the appropriate specialists? ). I was OK with the procedure until I SAW the X-Rated photographs. Now I cannot bring myself to go back for a follow-up.

Telling a patient to “get over the embarrassment” just increases the delay in getting the normal man or woman to have sexually explicit procedures done… like the Colonoscopy.

It was not having that cable shoved up my r*****, it was being splayed and indignantly photographed as if a gay w****, that prompted this letter, and cost a Doctor a PAYING patient.

Terry Wilcox Anniston, AL

Comment provided April 30, 2005 at 11:04 am

hiatal hernia : Foods That Cause Heartburn

Tomatoes and citrus fruits are foods that cause heartburn in some people. These highly acidic foods can lead to excess stomach acid and may cause heartburn. The causes of heartburn vary from individual to individual. Some people are not bothered by tomatoes or oranges, but may be bothered by fried or spicy foods. It is sometimes necessary to keep a food diary to isolate the foods that cause heartburn in your own diet. You may notice that you only experience heartburn after eating Mexican or Italian foods.

If you cannot identify specific foods that cause heartburn in your case, it could be the size of the meal that you tend to eat. Overeating is one of the causes of heartburn. When the stomach is overly full, the stomach acid has more of a tendency to leak up into the lower esophagus or throat and cause the burning sensation. Many people experience heartburn after a big holiday dinner.

If you typically eat small meals and avoiding the foods that cause heartburn does not help, look at the beverages that you choose to drink. Coffee and carbonated beverages are causes of heartburn in some people. Alcoholic beverages and citrus drink are causes of heartburn in some people. Chocolate is one of the foods that cause heartburn in some people and drinking a chocolate flavored drink can also lead to heartburn.

If it is not what or how much you eat or drink, it could be the clothes that you wear. Believe it or not, wearing tight clothing is one of the causes of heartburn. Anything that puts pressure on the stomach can cause heartburn, whether it is the excess weight of an obese person, the enlarging abdomen of a pregnant woman or pants that fit too tightly.

If you have looked at the foods that cause heartburn, the beverages that cause heartburn, you eat small meals and wear loose clothing, but still experience heartburn, there are a couple of other things that may be causes of heartburn. Stress or eating quickly in a high-paced environment can lead to heartburn. Smoking can lead to heartburn. And, there are other more serious medical conditions that are causes of heartburn, particularly heartburn that is experienced frequently. Hiatal hernia is one example of a medical condition that often presents with frequent heartburn. If you experience heartburn once or more per week, you should have your symptoms evaluated by your physician to rule out the presence of another health problem.

It may not be necessary to remove all of the foods that cause heartburn from your diet. It may simply be a matter of eating less of them or eating them less often. If you like spicy foods, you may be willing to deal with the symptoms of heartburn in order to keep eating the foods that you like. There are many over the counter and herbal remedies that provide relief for those who occasionally suffer from heartburn. Occasional heartburn is not serious, but frequent heartburn can eventually erode the lining of the esophagus. The frequency and causes of heartburn vary from individual to individual and can only truly be evaluated by you and your doctor.

Other foods that cause heartburn in some people because of they are highly acidic include eggs, legumes, certain nuts, animal fats, vegetable oils, pasta, beef, pork, white flour, starches and sugars. As you can see, it is not possible to avoid all of these foods, all the time.

For more information about heartburn and other common digestive problems, visit www.digestive-disorders-guide.com.

Patsy Hamilton writes informational articles for the Digestive Disorders Guide. Visit us at http://www.digestive-disorders-guide.com.

Article Source: http://EzineArticles.com/?expert=Patsy_Hamilton

Wednesday, July 26, 2006

hiatal hernia : A New Approach in the Medical Treatment for Morgagni

Morgagni hernia is a type of hernia that occurs due to congenital abnormalities at the level of the retroxiphoid area. The congenital abnormalities presented by people with Morgagni hernia involve an unusual positioning of the diaphragm. In patients diagnosed with Morgagni hernia, the diaphragm takes the shape of a triangle, and this triangular region has been called “the foramen of Morgagni”. Morgagni hernia commonly occurs in the right side of the lower abdomen, although the congenital diaphragmatic defect is sometimes bilateral.

The process of diagnosing Morgagni hernia can be very problematic for doctors, as most patients with this type of hernia don’t always have specific symptoms. In some cases, the hernia can generate gastrointestinal or respiratory symptoms, rendering doctors unable to promptly establish a correct diagnose. Sometimes, Morgagni hernia can involve obstruction of the bowel, in which case the disorder is easier to identify. The most common symptoms of hernia in both children and adults are: abdominal pain that intensifies with movement, swollen abdomen, difficulty breathing, nausea and vomiting.

When doctors suspect the presence of Morgagni hernia in patients, they can reveal additional signs of the disorder by performing X-ray tests, computerized tomography, MRI (magnetic resonance imaging), or laparoscopy. In the last few years, laparoscopy has proved to be a very reliable medical procedure, suitable for both diagnosing and treating Morgagni hernia. Laparoscopic surgery is performed via a laparoscope, a thin, tube-shaped medical instrument that has a small camera attached to its lower end. The laparoscope is introduced inside the body through the oral cavity and down the esophageal tract, until it reaches inside the abdominal cavity. The doctors are able to observe the progress of the procedure on a TV screen, receiving real-time images captured by the laparoscopic video-camera.

Laparoscopic surgery has revolutionized the medical treatment for many types of internal disorders and nowadays this modern medical procedure is preferred by surgeons over traditional surgery. Traditional surgery, also referred to as open surgery, requires wide abdominal or thoracic incisions. Open surgery has a high morbidity rate, as patients can develop a wide range of post-operative complications (internal bleeding, infections, etc). People who suffer traditional, open hernia surgery recover slowly and need to remain in the hospital for a few weeks after the operation. Also, patients who suffer traditional surgery remain with large, prominent abdominal scars.

Laparoscopic surgery is much safer than the traditional approach, as the procedure can be performed a lot faster and requires smaller incisions. Laparoscopic surgery minimizes the risks of complications and hence, has a very low morbidity rate. Patients who suffer laparoscopic surgery recover a lot faster and they need a shorter period of hospitalization. Furthermore, thanks to the small incisions required in laparoscopic surgery, patients remain with minimal abdominal scars. Laparoscopic surgery is a reliable medical procedure in the treatment of Morgagni hernia. Due to its various advantages, this modern form of surgery is preferred both by surgeons and patients.

If you want to find great information on different hernia subjects check out this links. You can find great content regarding Morgagni hernia, hernia surgery and many more.

Article Source: http://EzineArticles.com/?expert=Groshan_Fabiola

hiatal hernia : Acid Reflux - Causes

Acid reflux or GERD (gastroesophageal reflux disease) occurs when the liquid that is in the stomach backs up into the esophagus. This is usually a condition which persists throughout the life of the individual. Because the acid backs up into the esophagus, the esophagus may be damaged.

Acid reflux (GERD) can have many causes. The action of the lower esophageal sphincter (LES) may be one cause. The esophagus connects to the stomach. There is a muscle ring that goes around the end of the esophagus at the point where it meets the stomach. This is the LES. When we eat or drink the LES allows the food to pass into the stomach and then the muscle ring closes so the food does not reflux. People with acid reflux (GERD) may have abnormalities with their LES. The LES may have a weak contraction so there is a very good chance of reflux. Or, the LES may be too relaxed. The longer the LES is open (relaxed) reflux can easily occur.

Another cause of acid reflux (GERD) is a hiatal hernia. Some people with acid reflux have hiatal hernias and some do not. Hiatal hernias are not a pre-requisite for acid reflux, but a large amount of people with acid reflux DO have hiatal hernias. A hiatal hernia disrupts the location of the LES. The LES should be on a level with the diaphragm but due to the hiatal hernia the LES is pushed up and lies in the chest. This is a problem because the diaphragm is a large part of helping the LES to prevent reflux. Now the pressure of both the LES and diaphragm are not working as a strong unit. The hiatal hernia contributes to the reflux because of the decreased pressure.

Acid reflux can also be caused by a hiatal hernia due to the hernial sac. The location of the sac is near the esophagus. Acid gets trapped in the sac. Because the sac is so close to the esophagus, when the LES relaxes, it is easy to reflux.

The hiatal hernia can lead to acid reflux in a third way. Normally the esophagus connects to the stomach at an angle creating a flap of tissue. The hiatal hernia leads to the flap becoming warped and therefore it is useless to stop reflux.

People with acid reflux have a problem with the contraction of the esophageal muscles when they swallow. This is an issue because the contraction pushes all of the items in the esophagus into the stomach. If there is not a good contraction then the acid does not get pushed back and remains in the esophagus. Smoking disturbs the clearing of the esophagus too. It takes about six hours from the last cigarette you smoke for the effect on the esophagus to wear off.

Acid reflux is most common after meals. It is always better to be vertical so gravity can help the acid move down into the stomach. Large meals are not recommended for people with acid reflux.

There are many different reasons people may have acid reflux. Learning the cause may help in your quest to relieve some of the discomfort of acid reflux.

Michael Russell
Your Independent guide to Acid Reflux

Article Source: http://EzineArticles.com/?expert=Michael_Russell

Monday, July 24, 2006

hiatal hernia : Adjustable Beds - More Popular Than Ever

We have all heard of them but how many people have actually considered buying one? Well it is really something to think about if you are considering buying a new bed and/or mattress set. In the last few years there has been such advancement in adjustable beds. More people than ever before are purchasing them.

Just think, with the touch of a button you can change positions and ease that tired back. Most people wake up more refreshed and ready to begin a busy day. Unlike flat beds, adjustable beds support the curvatures of your body.

Some of the benefits of adjustable beds are easier breathing and pressure point reduction. Being able to change your sleeping position at the touch of a button can relieve pain in the back, neck, shoulder and hip. Most people with these problems do not get a good restful night's sleep.

Blood circulation to the legs is less impaired with adjustable beds.

An adjustable bed can make many positive changes in your life such as:

- Getting more sleep

- Improves overall health

- Wake up refreshed

- Getting more sleep may help you think clearer

- Better concentration

The adjustable beds with the new mattresses helps to ease lower back pain by eliminating the pressure points and providing the support you need to get good nights sleep. And adjustable beds are just the thing for a person confined to a bed. It makes their life easier and it makes it easier on the person tending them.

They also make watching television easier and you can easily sit up for reading. Many people report less acid reflux and less trouble with a hiatal hernia when sleeping on an adjustable bed. These beds also make it easier for a person that has had surgery. And if one suffers from knee pain it can be adjusted to relieve even this annoying pain.

Most people think adjustable beds are very expensive, but this doesn't have to be the case. Shop around and you may find them at online stores which can save you hundreds of dollars. Stores on the internet are sometimes able to keep their own costs down which cuts the cost for the purchaser.

There are many types of mattresses to go on adjustable beds. Some mattresses have what is call memory. These mattresses return to there normal shape without sinking like a normal mattress. Some have air that allows you to adjust them to suit what is comfortable for you. Some can be adjusted for a couple sleeping in the same bed. If one person wants firm and the other soft, it can be arranged with a simple push of a button.

The makers of the adjustable bed have made it so simple to get relief from pain, hernia, acid reflux and sleepless nights.

So if you have never tried one and you suffer from neck aches, back aches, knee aches or just plain don't sleep well, it might be in your best interest to check one out. There is nothing to lose but sleepless nights and the elimination of pain.

Michael Russell Your Independent guide to Adjustable Beds

Article Source: http://EzineArticles.com/?expert=Michael_Russell

hiatal hernia : Heart Burn and Indigestion

There are many people who suffer from the symptoms of heart burn and indigestion. These symptoms may result from the foods we eat, the beverages we drink or our lifestyles, but symptoms of burn heart indigestion may also be related to other medical conditions and chronic symptoms should be reported to your doctor. Choosing a burn heart medication is a choice to be made by you and your doctor. Here is a look at some of the common heart burn medications and the side effects associated with them.

One of the most highly advertised heart burn medications is Prevacid. Prevacid burn heart medication should not be used by persons with liver disease or certain allergies. You have probably seen the commercials and may have heard the side effects associated with this popular treatment for burn heart indigestion. If your heart burn symptoms are mild, the side effects may not seem worth it. Constipation or diarrhea may occur when using Prevacid.

Another common burn heart medication is Pepcid. It should not be used by persons with liver problems, kidney disease, stomach cancer or those with certain allergies. Side effects that may be experienced include headache, constipation, diarrhea or dizziness. There are serious side effects that are rare, but have occurred in persons using Pepcid to treat burn heart indigestion symptoms.

Prilosec is a prescription medication used to treat heart burn symptoms. Users of this burn heart medication may experience constipation, cough, dizziness or back pain.

Any over the counter or prescription burn heart medication may cause unwanted side effects. Only you and your doctor can decide if the benefits outweigh the possible risks. The symptoms of burn heart indigestion may be relieved by certain botanicals or health supplements and possibly prevented changing the diet and lifestyle.

Some people who experience chronic symptoms of burn heart indigestion have other more serious diseases which may not be relieved by changes in eating habits or lifestyle. These include acid reflux disease, hiatal hernia and diseases of the esophagus. In addition, any non-burning chest pain, pressure, heaviness or nausea associated with chest pain could be related to the heart, rather than the throat and stomach. It is important to err on the side of caution whenever chest pain is involved. It could be simple burn heart indigestion or something much more serious.

For more information about burn heart, indigestion and other digestive problems, visit www.digestive-disorders-guide.com.

Patsy Hamilton writes informational articles concerning heart burn and other digestive disorders for the Digestive Disorders Guide. Visit us at http://www.digestive-disorders-guide.com

Article Source: http://EzineArticles.com/?expert=Patsy_Hamilton

Monday, July 17, 2006

hiatal hernia : Other types of hernia

Since many organs can herniate through many orifices, it is very difficult to give an exhaustive list of hernias, with all synonyms and eponyms. Some are listed below, in alphabetical order:

Brain hernia: herniation of part of the brain because of excessive intracranial pressure. This may be a life-threatening condition, especially if the brain stem (responsible for some important vital signs) is involved.
Cooper's hernia: A femoral hernia with two sacs, the first being in the femoral canal, and the second passing through a defect in the superficial fascia and appearing immediately beneath the skin.
epigastric hernia: hernia through the linea alba above the umbilicus.
Littre's hernia: hernia involving a Meckel's diverticulum
lumbar hernia: hernia in the lumbar region, contains following entities:
Petit's hernia - hernia through Petit's triangle (inferior lumbar triangle)
Grynfeltt's hernia - hernia through Grynfeltt-Lesshaft triangle (superior lumbar triangle)
obturator hernia: hernia through obturator canal
pantaloon hernia: a combined direct and indirect hernia, when the hernial sac protrudes on either side of the inferior epigastric vessels
perineal hernia: A perineal hernia protrudes through the muscles and fascia of the perineal floor. It may be primary but usually, is acquired following perineal prostatectomy, abdominoperineal resection of the rectum, or pelvic exenteration.
properitoneal hernia: rare hernia located directly above the peritoneum, for example, when part of an inguinal hernia projects from the deep inguinal ring to the preperitoneal space.
Richter's hernia: strangulated hernia involving only one sidewall of the bowel, which can result in bowel perforation through ischaemia without causing bowel obstruction or any of its warning signs.
sliding hernia: occurs when an organ drags along part of the peritoneum, or, in other words, the organ is part of the hernia sac. The colon and the urinary bladder are often involved. The term also frequently refers to sliding hernias of the stomach.
sciatic hernia: this hernia in the greater sciatic foramen most commonly presents as an uncomfortable mass in the gluteal area. Bowel obstruction can occur, and it is a rare cause of sciatic neuralgia.
Spigelian hernia, also known as spontaneous lateral ventral hernia

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hiatal hernia : Individual hernias

Disc herniation
In this condition, the central weak part of the intervertebral disc (nucleus pulposus, which helps absorb shocks to our spine) herniates through the fibrous band (annulus fibrosus) by which it is normally bound. This usually occurs low in the back at the lumbar level (=lumbar disc hernia), and can cause back pain which may radiate downwards. When the sciatic nerve is involved, this may cause sciatic pain.

Inguinal hernia
Diagram of an indirect, scrotal inguinal hernia ( median view from the left).By far the most common hernias (up to 75% of all abdominal hernias) are the so-called inguinal hernias. For a thorough understanding of inguinal hernias, much insight is needed in the anatomy of the inguinal canal. Inguinal hernias are further divided into the more common indirect inguinal hernia (2/3, depicted here), in which the inguinal canal is entered via a congenital weakness at its entrance (the internal inguinal ring), and the "direct" type (1/3), where the hernia contents push through a weak spot in the back wall of the inguinal canal. Inguinal hernias are more common in men than women while femoral hernias are more common in women.


Femoral hernia
Femoral hernias occur just below the inguinal ligament, when abdominal contents pass into the weak area at the posterior wall of the femoral canal. They can be hard to distinguish from the inguinal type (especially when ascending cephalad): however, they generally appear more rounded, and, in contrast to inguinal hernias, there is a strong female preponderance in femoral hernias. The incidence of strangulation in femoral hernias is high. Repair techniques are similar for femoral and inguinal hernia.


Umbilical hernia
Umbilical hernias are especially common in infants of African descent, and occur more in boys. They involve protrusion of intraabdominal contents through a weakness at the site of passage of the umbilical cord through the abdominal wall. These hernias often resolve spontaneously. Umbilical hernias in adults are largely acquired, and are more frequent in obese or pregnant women. Abnormal decussation of fibers at the linea alba may contribute.

Incisional hernia
An incisional hernia occurs when the defect is the result of an incompletely healed surgical wound. When these occur in median laparotomy incisions in the linea alba, they are termed ventral hernias. These can be the most frustrating and difficult to treat, as the repair utilizes already attenuated tissue.

Diaphragmatic hernia
Diagram of a hiatus hernia (coronal section, viewed from the front).Higher in the abdomen, an (internal) "diaphragmatic hernia" results when part of the stomach or intestine protrudes into the chest cavity through a defect in the diaphragm.

A hiatus hernia is a particular variant of this type, in which the normal passageway through which the esophagus meets the stomach (esophageal hiatus) serves as a functional "defect", allowing part of the stomach to (periodically) "herniate" into the chest. Hiatus hernias may be either "sliding," in which the gastroesophageal junction itself slides through the defect into the chest, or non-sliding (also known as para-esophageal), in which case the junction remains fixed while another portion of the stomach moves up through the defect. Non-sliding or para-esophageal hernias can be dangerous as they may allow the stomach to rotate and obstruct. Repair is usually advised.

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Thursday, July 13, 2006

hiatal hernia : Anemia - iron deficiency

Anemia is a condition where red blood cells are not providing adequate oxygen to body tissues. There are many types and causes of anemia. Iron deficiency anemia is a decrease in the number of red cells in the blood caused by too little iron. (See also Iron-deficiency anemia - children.)

Causes, incidence, and risk factors

Iron deficiency anemia is the most common form of anemia. Approximately 20% of women, 50% of pregnant women, and 3% of men are iron deficient. Iron is an essential component of hemoglobin, the oxygen-carrying pigment in the blood. Iron is normally obtained through the food in your diet and by recycling iron from old red blood cells. Without it, the blood cannot carry oxygen effectively -- and oxygen is needed for the normal functioning of every cell in the body.

The causes of iron deficiency are too little iron in the diet, poor absorption of iron by the body, and loss of blood (including from heavy menstrual bleeding). It can also be related to lead poisoning in children.

Anemia develops slowly after the normal stores of iron have been depleted in the body and in the bone marrow. Women, in general, have smaller stores of iron than men and have increased loss through menstruation, placing them at higher risk for anemia than men.

In men and postmenopausal women, anemia is usually caused by gastrointestinal blood loss associated with ulcers, the use of aspirin or nonsteroidal anti-inflammatory medications (NSAIDS), or certain types of cancer (esophagus, stomach, colon).

High-risk groups include:

Women of child-bearing age who have blood loss through menstruation
Pregnant or lactating women who have an increased requirement for iron
Infants, children, and adolescents in rapid growth phases
People with a poor dietary intake of iron
Risk factors related to blood loss are peptic ulcer disease, long term aspirin use, and colon cancer.

Symptoms
Pale skin color
Fatigue
Irritability
Weakness
Shortness of breath
Sore tongue
Brittle nails
Unusual food cravings (called pica)
Decreased appetite (especially in children)
Headache - frontal
Blue tinge to sclerae (whites of eyes)
Note: There may be no symptoms if anemia is mild.
hiatal hernia

Copyright U.S. National Library of Medicine,

hiatal hernia : MESH IMPLANT TIMESH

REVOLUTION IN MODERN HERNIA SURGERY
Titanium and synthetics are two materials that have been used with great success in implant medicine for decades and enjoy an excellent reputation. The applications and properties of the two materials are very different. Titanium is used primarily because of its excellent body acceptance. Hernia mesh consists of synthetic material, which is an indispensable component of modern hernia surgery due to its flexibility.

GfE Medzintechnik has now succeeded in combining both properties - excellent biocompatibility and the highest level of flexibility.

Properties

TiMESH offers excellent biological and body acceptance
TiMESH consists of one monofile thread with a mesh size of more than 1 mm. It easily integrates into the body.
TiMESH extralight weighs only 16 g/m2 and is the lightest hernia mesh on the market - TiMESH light weighs only 35 g/m2
TiMESHimplants can be implanted just like all other hernia mesh; surgeons do not need to change their operating techniques
Perfect handling and excellent modeling capabilities due to the high wettability (hydrophilic) and anti-static properties of the titanium layer.
The titanium layer of TiMESH is so thin (approx. 30 nanometers) that it is as flexible as the synthetic material
The titanium layer of TiMESH is solidly connected with the synthetic material; they form a compound material

http://www.gfe.com/opencms2/opencms/en_gfe-medical.de/Netzimplantat_TIMESH.html

Monday, July 10, 2006

hiatal hernia : Complications

Some large hiatal hernias create friction that causes lesions in the upper stomach. If severe, these lesions can bleed and lead to iron deficiency anemia from chronic blood loss.

Other hernias become so large that one-third or more of the stomach protrudes through the diaphragm, putting extra pressure on the diaphragm or lungs. And occasionally, the part of the stomach that protrudes into the chest cavity becomes twisted or cuts off blood flow to the rest of the stomach, producing severe chest pain and difficulty swallowing. If this occurs, see your doctor without delay. You may require immediate surgical repair of the hernia.

The most common complication of hiatal hernia is probably gastroesophageal reflux disease (GERD). At one time it was thought that hiatal hernias caused most cases of GERD. Now doctors believe that only larger hiatal hernias play a role. Recurrent GERD itself can lead to complications, including:

Difficulty swallowing. Stomach acid backing up into your esophagus can cause inflammation and scarring. This narrows your esophagus, making it hard for you to swallow.
Barrett's esophagus. Occasionally, people with gastroesophageal reflux develop Barrett's esophagus from repeated, long-term exposure to stomach acid. In this condition, cells similar to those in the stomach lining develop in the lower esophagus. If you have Barrett's esophagus, you're at increased risk of developing esophageal cancer. A doctor who specializes in stomach and intestinal problems (gastroenterologist) can advise you how best to manage the condition to lessen this risk.
Esophageal cancer. Most people with Barrett's esophagus don't develop esophageal cancer, but for those who do, the prognosis is often poor. An esophageal tumor makes swallowing increasingly difficult and for some people, eventually impossible.


© 1998-2006 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

hiatal hernia : Self-care

A variety of lifestyle changes can help ease the gastroesophageal reflux that may accompany a hiatal hernia. Some or all of the following measures may help:

Eat small meals. Large meals can distend your stomach, pushing it into your chest.
Avoid problem foods and alcohol. Try to avoid alcohol, caffeinated drinks, chocolate, onions, spicy foods, spearmint and peppermint — all of which increase production of stomach acid and relax the lower esophageal sphincter. Even decaffeinated coffee can be irritating to an inflamed esophageal lining. Also try to limit citrus fruits and tomato-based foods. They're acidic and can irritate an inflamed esophagus.
Limit fatty foods. Fatty foods relax the lower esophageal sphincter and slow stomach emptying, which increases the amount of time that acid can back up into your esophagus.
Sit up after you eat. Wait at least three hours before going to bed or taking a nap. By then, most of the food in your stomach will have emptied into your small intestine, so it can't flow back into your esophagus. Eating a bedtime snack stimulates acid formation and further aggravates acid reflux.
Don't exercise immediately after eating. Try to wait at least two to three hours before you engage in any strenuous activity. Low-key exercise, such as walking, is fine.
Lose weight. If you're overweight, slimming down helps reduce the pressure on your stomach. This may well be the most important thing you can do to relieve your symptoms.
Stop smoking. Smoking increases acid reflux and dries your saliva. Saliva helps protect your esophagus from stomach acid.
Avoid certain medications, if possible. Medications to avoid include calcium channel blockers, such as diltiazem; the antibiotic tetracycline; nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen and naproxen sodium; quinidine; theophylline; sedatives and tranquilizers; and alendronate. If you take any of these medications and suffer from heartburn, talk to your doctor. You may be able to take other drugs instead.
Elevate the head of your bed. If you elevate the head of your bed 6 to 9 inches, gravity will help prevent stomach acid from moving up into your esophagus as you sleep. Using a foam wedge to raise your mattress also may help. Don't try to use pillows, which tend to increase pressure on your abdomen.
Avoid tightfitting clothes. They put pressure on your stomach.
Take time to relax. When you're under stress, digestion slows, which makes GERD symptoms worse. Relaxation techniques such as deep breathing, meditation or yoga may help reduce acid reflux


© 1998-2006 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

Thursday, July 06, 2006

hiatal hernia : Upper GI Series

The upper gastrointestinal (GI) series uses x rays to diagnose problems in the esophagus, stomach, and duodenum (first part of the small intestine). It may also be used to examine the small intestine. The upper GI series can show a blockage, abnormal growth, ulcer, or a problem with the way an organ is working.

During the procedure, you will drink barium, a thick, white, milkshake-like liquid. Barium coats the inside lining of the esophagus, stomach, and duodenum, and makes them show up more clearly on x rays. The radiologist can also see ulcers, scar tissue, abnormal growths, hernias, or areas where something is blocking the normal path of food through the digestive system. Using a machine called a fluoroscope, the radiologist is also able to watch your digestive system work as the barium moves through it. This part of the procedure shows any problems in how the digestive system functions, for example, whether the muscles that control swallowing are working properly. As the barium moves into the small intestine, the radiologist can take x rays of it as well.

An upper GI series takes 1 to 2 hours. X rays of the small intestine may take 3 to 5 hours. It is not uncomfortable. The barium may cause constipation and white-colored stool for a few days after the procedure.

Preparation
Your stomach and small intestine must be empty for the procedure to be accurate, so the night before you will not be able to eat or drink anything after midnight. Your physician may give you other specific instructions.

National Digestive Diseases Information Clearinghouse

hiatal hernia : Upper Endoscopy

Upper endoscopy enables the physician to look inside the esophagus, stomach, and duodenum (first part of the small intestine). The procedure might be used to discover the reason for swallowing difficulties, nausea, vomiting, reflux, bleeding, indigestion, abdominal pain, or chest pain. Upper endoscopy is also called EGD, which stands for esophagogastroduodenoscopy (eh-SAH-fuh-goh-GAS-troh-doo-AH-duh-NAH-skuh-pee).

For the procedure you will swallow a thin, flexible, lighted tube called an endoscope (EN-doh-skope). Right before the procedure the physician will spray your throat with a numbing agent that may help prevent gagging. You may also receive pain medicine and a sedative to help you relax during the exam. The endoscope transmits an image of the inside of the esophagus, stomach, and duodenum, so the physician can carefully examine the lining of these organs. The scope also blows air into the stomach; this expands the folds of tissue and makes it easier for the physician to examine the stomach.

The physician can see abnormalities, like inflammation or bleeding, through the endoscope that don't show up well on x rays. The physician can also insert instruments into the scope to treat bleeding abnormalities or remove samples of tissue (biopsy) for further tests.

Possible complications of upper endoscopy include bleeding and puncture of the stomach lining. However, such complications are rare. Most people will probably have nothing more than a mild sore throat after the procedure.

The procedure takes 20 to 30 minutes. Because you will be sedated, you will need to rest at the endoscopy facility for 1 to 2 hours until the medication wears off.

Preparation
Your stomach and duodenum must be empty for the procedure to be thorough and safe, so you will not be able to eat or drink anything for at least 6 hours beforehand. Also, you must arrange for someone to take you home—you will not be allowed to drive because of the sedatives. Your physician may give you other special instructions.

Upper endoscopy enables the physician to look inside the esophagus, stomach, and duodenum (first part of the small intestine). The procedure might be used to discover the reason for swallowing difficulties, nausea, vomiting, reflux, bleeding, indigestion, abdominal pain, or chest pain. Upper endoscopy is also called EGD, which stands for esophagogastroduodenoscopy (eh-SAH-fuh-goh-GAS-troh-doo-AH-duh-NAH-skuh-pee).

For the procedure you will swallow a thin, flexible, lighted tube called an endoscope (EN-doh-skope). Right before the procedure the physician will spray your throat with a numbing agent that may help prevent gagging. You may also receive pain medicine and a sedative to help you relax during the exam. The endoscope transmits an image of the inside of the esophagus, stomach, and duodenum, so the physician can carefully examine the lining of these organs. The scope also blows air into the stomach; this expands the folds of tissue and makes it easier for the physician to examine the stomach.

The physician can see abnormalities, like inflammation or bleeding, through the endoscope that don't show up well on x rays. The physician can also insert instruments into the scope to treat bleeding abnormalities or remove samples of tissue (biopsy) for further tests.

Possible complications of upper endoscopy include bleeding and puncture of the stomach lining. However, such complications are rare. Most people will probably have nothing more than a mild sore throat after the procedure.

The procedure takes 20 to 30 minutes. Because you will be sedated, you will need to rest at the endoscopy facility for 1 to 2 hours until the medication wears off.

Preparation
Your stomach and duodenum must be empty for the procedure to be thorough and safe, so you will not be able to eat or drink anything for at least 6 hours beforehand. Also, you must arrange for someone to take you home—you will not be allowed to drive because of the sedatives. Your physician may give you other special instructions.
hiatal hernia
National Digestive Diseases Information Clearinghouse

Monday, July 03, 2006

hiatal hernia : INTRODUCTION

Background: A hiatal hernia occurs when a portion of the stomach prolapses through the diaphragmatic esophageal hiatus. Although the existence of hiatal hernia has been described in earlier medical literature, it has come under scrutiny only in the last century or so because of its association with gastroesophageal reflux disease (GERD) and its complications. By far, most hiatal hernias are asymptomatic and are discovered incidentally. On rare occasion, a life-threatening complication, such as gastric volvulus or strangulation, may present acutely.


Pathophysiology: The esophagus passes through the diaphragmatic hiatus in the crural part of the diaphragm to reach the stomach. The diaphragmatic hiatus itself is approximately 2 cm in length and chiefly consists of musculotendinous slips of the right and left diaphragmatic crura arising from either side of the spine and passing around the esophagus before inserting into the central tendon of the diaphragm. The size of the hiatus is not fixed, but narrows whenever intra-abdominal pressure rises, such as when lifting weights or coughing.

The lower esophageal sphincter (LES) is an area of smooth muscle approximately 2.5-4.5 cm in length. The upper part of the sphincter normally lies within the diaphragmatic hiatus, while the lower section normally is intra-abdominal. At this level, the visceral peritoneum and the phrenoesophageal ligament cover the esophagus. The phrenoesophageal ligament is a fibrous layer of connective tissue arising from the crura, and it maintains the LES within the abdominal cavity. The A-ring is an indentation sometimes seen on barium studies, and it marks the upper part of the LES. Just below this is a slightly dilated part of the esophagus, forming the vestibule. A second ring, the B-ring, may be seen just distal to the vestibule, and it approximates the Z-line or squamocolumnar junction. The presence of a B-ring confirms the diagnosis of a hiatal hernia. Occasionally, the B-ring also is called the Schatzki ring.

Any sudden increase in intra-abdominal pressure also acts on the portion of the LES below the diaphragm to increase the sphincter pressure. An acute angle, the angle of His, is formed between the cardia of the stomach and the distal esophagus and functions as a flap at the gastroesophageal junction and helps prevent reflux of gastric contents into the esophagus (see Image 1). The gastroesophageal junction acts as a barrier to prevent reflux of contents from the stomach into the esophagus by a combination of mechanisms forming the antireflux barrier. The components of this barrier include the diaphragmatic crura, the LES baseline pressure and intra-abdominal segment, and the angle of His.


Frequency:


In the US: Hiatal hernias are more common in Western countries. The frequency of hiatus hernia increases with age, from 10% in patients younger than 40 years to 70% in patients older than 70 years.
Internationally: Burkitt et al suggest that the Western, fiber-depleted diet leads to a state of chronic constipation and straining during bowel movement, which could explain the higher incidence of this condition in Western countries.
Mortality/Morbidity: Paraesophageal hernias generally tend to enlarge with time, and sometimes the entire stomach is found within the chest. The risk of these hernias becoming incarcerated, leading to strangulation or perforation, is approximately 5%. This complication is potentially lethal, and surgical intervention is necessary. Because of the high mortality associated with this condition, elective repair often is advised wherever a paraesophageal hernia is found.

Sex: Hiatal hernias are more common in women than in men. This might relate to the intra-abdominal forces exerted in pregnancy.

Age: Muscle weakening and loss of elasticity as people age is thought to predispose to hiatus hernia, based on the increasing prevalence in older people. With decreasing tissue elasticity, the gastric cardia may not return to its normal position below the diaphragmatic hiatus following a normal swallow. Loss of muscle tone around the diaphragmatic opening also may make it more patulous.


by Waqar A Qureshi, MD,