Sunday, June 25, 2006

hiatal hernia : The use of surgical mesh to repair hernias

Is gaining in popularity with surgeons. Most meshes currently on the market are made from synthetic materials such as polypropylene, polyester, silicone or polytetrafluoroethylene (PTFE), commonly known by the DuPont brand name Teflon®. While these meshes have good strength characteristics, they remain in the body as permanent implants and sometimes can cause adverse reactions when the surrounding tissue identifies these materials as foreign bodies.

In order to avoid adverse reactions to synthetic materials, some surgeons prefer to use meshes made of biomaterials which are gradually resorbed by the body over time and are then eliminated through biological processes. Since these meshes are not permanent implants, they generally only offer temporary repair of abdominal wall defects and additional surgical procedures are sometimes required to replace the absorbed mesh.

An alternative to synthetic and absorbable mesh is human tissue. There are a handful of companies that are now marketing processed, freeze-dried human dermis for soft tissue repair and augmentation. This material is implanted using the same technique as other meshes and provides for revascularization, cellular ingrowth and "remodeling" into the patients tissue. While this option generally provides a permanent repair with few adverse reactions, the processing and distribution of human tissue is not regulated by the Food and Drug Administration (FDA) as are most other products that are implanted in the human body. In fact, there have been a number of recent cases of serious infections and even deaths resulting from the implantation of human cadaveric tissue during surgical procedures.

New technologies have recently been developed to solve the problems associated with the use of synthetic substances, absorbable materials and human tissue in hernia repair procedures. Scientists in Europe have been conducting research and development into alternatives to these products over the past two decades and have made major breakthroughs in this area over the past several years. New ways of collecting and processing natural materials have led to a series of products that offer the strength of synthetic compounds, the biocompatibility of biomaterials and the regenerative properties of human tissue.

What material can offer all of the benefits of the previously mentioned products without the corresponding disadvantages? Porcine dermal collagen has an architectural structure very close to human tissue, and is therefore readily recognized as friendly by the human body. A leading medical technology company in Europe has developed a patented process by which a sheet of porcine dermis is converted into a safe and effective surgical implant for soft tissue repair and augmentation. The process, which takes several weeks to complete, removes all non collageneous material from the sheet except elastin, and stabilizes the material through a cross-linking process. The result is an acellular, non reconstituted, non allergenic membrane which has excellent strength characteristics, is completely biocompatible and provides a permanent solution for the repair of abdominal wall defects. Since the material itself is a byproduct of the meat packaging industry, it is more readily available than human tissue. In addition, the harvesting and processing of the material is strictly regulated by local government, as well as international directives and quality standards.

This collagen surgical implant has been used in Europe for these types of procedures for several years and there is strong clinical evidence of the safety and effectiveness of the product. In fact, the implant has been approved for sale in the U.S. by the FDA and there have not been any adverse reactions reported after several thousand implantations in Europe. Not only is it safe, since the structure of the collagen is so similar to human tissue, once it is implanted the sheet provides the basis for cellular ingrowth and revascularization. This results in a permanent fix in even the most difficult cases. In addition to the positive clinical outcomes, surgeons like the fact that they do not need to change their surgical technique to use this product. They can use the same exact same steps they would use for synthetic or absorbable surgical mesh in both open and laparoscopic procedures.

Only physicians can properly diagnose and appropriately treat hernias. However, patients have the right to actively participate in decisions that affect their health or quality of life. Information about the various treatment options that are currently available can play an important part in the discussions between patients and their physicians regarding the best surgical treatment option for them.

by Joseph R. Lopez

hiatal hernia : New Surgical Treatment

Hernia repair is one of the most commonly performed surgical procedures worldwide. In fact, there are over 600,000 hernia repair surgeries performed each year in the U.S. alone. A hernia is a weakness or defect in the abdominal muscles which can result in the protrusion of tissue through an opening in the outer layers of the abdominal wall. Hernias can develop at any part of the abdominal wall, but generally occur in areas that have a natural tendency to be weak. These areas include the groin (inguinal hernias), umbilicus (umbilical hernias), hiatus (hiatal hernias) and incisions from previous surgeries (incisional or ventral hernias). While hernias generally do not pose serious long-term health problems, they can cause severe pain and discomfort for those suffering from this condition.

Hernias may be present from birth, or can be caused by strain on the abdominal muscles. In either case, hernias do not go away by themselves and depending on the degree of bulging or pain, generally require a surgical procedure to be repaired. Hernia repairs are usually done on an elective basis, which means that the patient and physician decide whether or when the procedure should be performed. Emergency procedures are only done for strangulated hernias, which are hernias that have become pinched to the point that the blood supply is cut off. These hernias require immediate medical attention since they can become infected and lead to a life threatening condition very quickly.

Hernias are typically repaired through a surgical procedure called herniorrhaphy, in which the surgeon repairs the hole in the abdominal wall by sewing surrounding muscle together or by placing a patch called "mesh" over the defect. Most surgeons make an incision at the site of the hernia in order to gain access to the defect, although some surgeons prefer to do these procedures laparoscopically.

During a laparoscopic hernia repair, the surgeon makes very small incisions to pass through specialized instruments and an endoscope, a device that allows the surgeon to see the abdominal area without opening the patient up. Laparoscopic hernia repair generally results in less postoperative pain and recovery time than open surgery. There is still a great deal of controversy over the long-term benefits of laparoscopic hernia repair, however, and it is by no means an option for every patient.

by Joseph R. Lopez

Wednesday, June 21, 2006

hiatal hernia : Are there different types of hiatal hernias?

Hiatal hernias are categorized as being either sliding or para-esophageal. 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 protrude 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 up the stomach. When the swallow is finished, the herniated part of the stomach falls back into the abdomen. 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 compresses the adjacent esophagus, may impede 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 trauma caused by food that is stuck or acid from the stomach. Fortunately, large para-esophageal hernias are uncommon

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hiatal hernia : Hitus hernia and acid reflux problem

I am glad to note that ruth45 has recommended that you use the remedy that I believe I first suggested on this and another forum for acidity in the stomach which is usually accompanied by a feeling of fullness and puffiness which is most uncomfortable if as you state, this has resulted in Hiatus Hernia.

This condition usually arises as direct result of a hyperacidic condition in your stomach over a long period and your doctors would have first prescribed antacids which are usually tablets of aluminium hydroxide which neutralize the acid in the stomach. I note that you have recently been prescribed Nexium but this and the other drugs that you have used over the years cannot cure you and will only serve to palliate your ailment temporarily.

Over a period of years if this ailment is not rectified, the acid eats through the pyloric valve located at the botttom of the aesophagus and thereby makes a bad situation infinitely worse by pushing the acid up to your throat with as you would have realized, painful results.

Nat Phos 6x works in a different way by promoting peristalysis in the stomach and thereby helps the stomach to digest and propel the food out of the stomach thereby preventing the formation of acid.

If you decide to use Nat Phos 6x you must stop all other drugs. The dose is 2 tablets taken after lunch and 2 after dinner. I believe that you should find relief within 15 minutes after your meal when that uncomfortable feeling vanishes. You should carry a supply on your person if you are dine out to take within about 10 minutes after a meal.

There are a few points that you should observe to overcome your ailment.
Do not eat large meals as these contribute to acidity, gastric reflux and Hiatus Hernia. Avoid drinking water after a meal and only sip it for about 2 hours after a meal. Sit up erect on a chair after a meal for at least an hour preferably 2 hours and do not go to bed during this period till you feel that your food is all digested.

From Joe De Livera

Friday, June 16, 2006

hiatal hernia : Screening and diagnosis

Your doctor may discover a hiatal hernia while trying to determine the cause of heartburn or chest or upper abdominal pain. In that case, it's likely to be found during one of the following procedures:

Barium X-ray. During this diagnostic test, you'll drink a chalky liquid containing barium that coats your upper digestive tract. This provides a clear silhouette of your esophagus, stomach and the upper part of your small intestine (duodenum) on an X-ray. A barium X-ray may help reveal whether the contents of your stomach are backing up into your esophagus.
Endoscopy. In this test your doctor passes a thin, flexible tube equipped with a fiber-optic light and video camera system (endoscope) down your throat and into your esophagus and stomach to check for inflammation. This not only can help detect a hiatal hernia, but also is the most sensitive way to check for damage to your esophagus from acid reflux.

hiatal hernia : Digestive Disorders

What is a hiatal hernia?
A hernia is a protrusion of part of an organ through the muscle wall that surrounds it. A hiatal hernia occurs when the upper part of the stomach pushes up into the chest through a small opening in the diaphragm, the muscle that separates the stomach from the chest. A hiatal hernia results in retention of acid and other contents above this opening. These acids and other substances can easily back up (reflux) into the esophagus.

Many people age 50 and over have small hiatal hernias; however, hiatal hernias may affect people of all ages.

What causes hiatal hernia?
Suggested causes of hiatal hernia include the following:
sudden physical exertion
Obesity and pregnancy can also contribute to this disorder.

Treatment for hiatal hernia:
Specific treatment for hiatal hernia will be determined by your physician based on:
your age, overall health, and medical history
extent of the condition
your tolerance for specific medications, procedures, or therapies
expectations for the course of the condition
your opinion or preference
Although hiatal hernias usually do not require treatment, treatment may be necessary if the hernia is:

in danger of becoming strangulated (twisted in a way that cuts off blood supply).
complicated by severe gastroesophageal reflux disease (GERD).
complicated by esophagitis (inflammation of the esophagus).
Surgery may be needed in these cases to reduce the size of the hernia, or to prevent strangulation.

© 1998 – 2006 by the Rector & Visitors of the University of Virginia

Friday, June 09, 2006

hiatal hernia : Hiatal Hernia

Any time an internal body part pushes into an area where it doesn't belong, it's called a hernia.

The hiatus is an opening in the diaphragm -- the muscular wall separating the chest cavity from the abdomen. Normally, the esophagus (food pipe) goes through the hiatus and attaches to the stomach. In a hiatal hernia (also called hiatus hernia) the stomach bulges up into the chest through that opening.

There are two main types of hiatal hernias: sliding and paraesophageal (next to the esophagus).
In a sliding hiatal hernia, the stomach and the section of the esophagus that joins the stomach slide up into the chest through the hiatus. This is the more common type of hernia.

The paraesophageal hernia is less common, but is more cause for concern. The esophagus and stomach stay in their normal locations, but part of the stomach squeezes through the hiatus, landing it next to the esophagus. Although you can have this type of hernia without any symptoms, the danger is that the stomach can become "strangled," or have its blood supply shut off.

Often, people with hiatal hernia also have heartburn or GERD. Although there appears to be a link, one condition does not seem to cause the other, because many people have a hiatal hernia without having GERD, and others have GERD without having a hiatal hernia.

People with a hiatal hernia may experience chest pain that can easily be confused with the pain of a heart attack. That's why it's so important to undergo testing and get properly diagnosed.

©2005-2006 WebMD, Inc. All rights reserved.

hiatal hernia : What causes GERD?

No one knows why people get GERD. A hiatal hernia may contribute. A hiatal hernia occurs when the upper part of the stomach is above the diaphragm, the muscle wall that separates the stomach from the chest. The diaphragm helps the LES keep acid from coming up into the esophagus. When a hiatal hernia is present, it is easier for the acid to come up. In this way, a hiatal hernia can cause reflux. A hiatal hernia can happen in people of any age; many otherwise healthy people over 50 have a small one.

Other factors that may contribute to GERD include

alcohol use
Also, certain foods can be associated with reflux events, including

citrus fruits
drinks with caffeine
fatty and fried foods
garlic and onions
mint flavorings
spicy foods
tomato-based foods, like spaghetti sauce, chili, and pizza

Monday, June 05, 2006

hiatal hernia ; Causes hiatal hernia

Your chest cavity and abdomen are separated by your diaphragm — a large dome-shaped muscle that's responsible for a good part of normal breathing. Your esophagus passes into your stomach through an opening in the diaphragm. Hiatal hernias occur when the muscle tissue surrounding this opening becomes weak and the upper part of your stomach bulges through the diaphragm into your chest cavity. Anything that puts intense pressure on your abdomen — including persistent or severe coughing or vomiting, pregnancy, straining while going to the bathroom, or lifting heavy objects — can contribute to hiatal hernias.

A hiatal hernia in turn can cause or contribute to gastroesophageal reflux.
This happens when a hernia slightly displaces the lower esophageal sphincter, a circular band of muscle around the bottom of the esophagus.

Ordinarily, the diaphragm is aligned with the lower esophageal sphincter, which relaxes to allow food and liquid to flow into your stomach when you swallow. The diaphragm supports and puts pressure on the sphincter to keep it closed when you're not swallowing. But a hiatal hernia raises the sphincter above the diaphragm, reducing pressure on the valve. This causes the sphincter muscle to open at the wrong time, allowing stomach acid to flow up into the esophagus.

A hiatal hernia can also cause heartburn if the herniated portion of your stomach becomes a reservoir for gastric acid, which can then easily travel up your esophagus.
When to seek medical advice
Many people discover they have hiatal hernias when they see their doctors about heartburn. Most cases of heartburn are mild and temporary. But if your symptoms are severe, occur often, or are accompanied by coughing, wheezing, asthma, a sore throat, difficulty swallowing or chest pain, talk to your doctor.

If you know you have a large hiatal hernia and experience severe chest pain, difficulty breathing or trouble swallowing, seek medical care immediately.

hiatal hernia : Hiatal hernia Overview

Hernias occur when one part of the body protrudes through a gap or opening into another part. And although a hernia can theoretically develop almost anywhere, most are in the abdominal area. This includes hiatal hernias — also known as diaphragmatic hernias — which form at the opening in your diaphragm where your food pipe joins your stomach.

Most small hiatal hernias don't cause any problems, and you may never know you have a hiatal hernia unless your doctor discovers it when checking for another condition. But a large hiatal hernia can allow food and acid to back up into your esophagus, leading to heartburn and chest pain. Self-care measures or medications can usually alleviate these symptoms, although very large hiatal hernias sometimes need surgical repair

Signs and symptoms
Most small hiatal hernias cause no problems. But larger hernias may cause heartburn, belching or chest pain when stomach acids back up into your food pipe (esophagus). These signs and symptoms tend to become worse when you lean forward, strain, lift heavy objects or lie down, and they can also worsen during pregnancy.

In rare cases, the part of your stomach that protrudes into your chest cavity may become twisted (strangulated) or have its blood supply cut off, leading to:

Severe chest pain
Difficulty swallowing (dysphagia)
Obstruction of your esophagus

Signs and symptoms
Most small hiatal hernias cause no problems. But larger hernias may cause heartburn, belching or chest pain when stomach acids back up into your food pipe (esophagus). These signs and symptoms tend to become worse when you lean forward, strain, lift heavy objects or lie down, and they can also worsen during pregnancy.

In rare cases, the part of your stomach that protrudes into your chest cavity may become twisted (strangulated) or have its blood supply cut off, leading to:

Severe chest pain
Difficulty swallowing (dysphagia)
Obstruction of your esophagus

Friday, June 02, 2006

hiatal hernia : Definition

Hiatal hernia is a condition in which a portion of the stomach protrudes upward into the chest through an opening in the diaphragm. The diaphragm is the sheet of muscle used in breathing that separates the chest from the abdomen.

Causes, incidence, and risk factors Return to top

The cause is unknown, but hiatal hernias may be the result of a weakening of the supporting tissue. Increasing age, obesity, and smoking are known risk factors in adults.

Children with this condition usually have it from birth (congenital). It is usually associated with gastroesophageal reflux in infants.

Hiatal hernias are very common, especially in people over 50 years old. This condition may cause regurgitation of gastric acid from the stomach into the esophagus.

Symptoms Return to top

Heartburn, worse when bending over or lying down
Swallowing difficulty
Chest pain
A hiatal hernia by itself rarely causes symptoms -- pain and discomfort are usually due to the reflux of gastric acid, air, or bile. This happens more easily in the presence of hiatal hernia.

Signs and tests Return to top

Barium swallow x-ray
Esophagogastroduodenoscopy (EGD)
Treatment Return to top

The goals of treatment are to relieve symptoms and prevent complications.

Reducing regurgitation of stomach contents into the esophagus (gastroesophageal reflux) will relieve pain symptoms. Medications that neutralize stomach acidity, decrease acid production, or strengthen the lower esophageal sphincter may be prescribed.

Other measures to reduce symptoms include:

Avoiding large or heavy meals
Not lying down or bending over immediately after a meal
Weight reduction and smoking cessation
Failure to control the symptoms by general or medical measures, or the onset of complications may require surgical repair of the hernia.

Medical Encyclopedia

hiatal hernia : NO LONGER SUFFER from Acid Reflux, Heartburn, Hiatal Hernia, Gastritis,

You see, in 1976, I almost died during stomach surgery for some bleeding ulcers. The doctors operated on my stomach, but while in surgery, they connected a bile duct to my stomach, instead of my small intestine... which caused bile to creep up into my esophagus.

After surgery, I couldn't sleep on my right side without bile (bile is very acidic) building up... and the only way I could get rid of it was by vomiting.

For almost a year, I had to vomit about three or four times every day. It was disgusting, and I knew I couldn't go on like this forever - the acid was killing me!

I pretty much tried everything to overcome my reflux nightmare.

I tried using 13 pillows. Then I bought one of those "hospital beds" that adjust so your head is propped up all the time.

Then, a miracle happened.

One night, I really slept good. I didn't have any reflux! But I couldn't figure out... why!

So I back-tracked, and the only thing I could remember doing before going to bed was eating an apple! So, I started doing some experiments with different brands of apples... and discovered...

There was one specific brand of apple that helped me completely wipe out my reflux!

I started taking apples with me everywhere I went. And I found out I didn't need to eat an entire apple... just one slice would do the trick.

So, with the apple, I had a reflux remedy (hence, the name of my website)... but not a full-fledged cure (since I still needed to take apples with me everywhere I went).

About a year ago, my son & I decided we wanted to share this remedy with people on the internet, so we setup this website and wrote a report. That report is called the Heartburn & Acid Reflux Remedy Report.

At first, the report contained just my "apple remedy"... but now, after doing a lot more research, and getting a TON of feedback from other reflux sufferers,

I have released an entirely new & improved version of our report... that has more than just a remedy, but a cure!

That's right, our new report explains how you can cure your acid reflux, heartburn, bile reflux, esophageal reflux, and even hiatal hernia, using one of three different safe, natural remedies that we have discovered.

These three natural remedies have been proven to work thousands of times by our customers... quickly (within minutes), safely (no side effects), and without drugs!

We have taken the all of our research and put it into a report that you can order and read on your computer just minutes from right now...

I want to help you end the suffering, the painful burning feeling in your chest, just behind your breastbone after eating, the burning sensation in your throat. I want to help stop your chest pains, your difficulty swallowing, and your sleepless nights because I've been there before...
And there's really no good reason you should be taking drugs, when you can be cured using a natural remedy!

by And there's really no good reason you should be taking drugs, when you can be cured using a natural remedy!

by Carl Forman , New Jersey