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.


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 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 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.


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.


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:

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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

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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

Patsy Hamilton writes informational articles for the Digestive Disorders Guide. Visit us at

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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.

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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

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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

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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

Patsy Hamilton writes informational articles concerning heart burn and other digestive disorders for the Digestive Disorders Guide. Visit us at

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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.

Wikipedia® is a registered trademark of the Wikimedia Foundation, Inc.

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.

Pale skin color
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

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.


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

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.

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.

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.

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.


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,

hiatal hernia : Heartburn

Heartburn is a painful burning sensation in the esophagus, just below or behind the breastbone. The pain often rises in your chest and may radiate to your neck or throat.

Common Causes

Almost everyone has occasional heartburn. If you have frequent, ongoing heartburn, you may have gastroesophageal reflux disease (GERD).

Normally, when food or liquid enters your stomach, a band of muscle at the end of your esophagus (called the lower esophageal sphincter or LES) closes off the esophagus. If this muscle fails to close tightly enough, stomach contents can back up (reflux) into the esophagus. This partially digested material is usually acidic and can irritate the esophagus, causing heartburn and other symptoms.

Heartburn is more likely to occur if you have a hiatal hernia, which is when the top part of the stomach protrudes upward into the chest cavity. This weakens the LES and makes it easier for acid to reflux from the stomach into the esophagus.

Heartburn can be brought on or worsened by pregnancy and by many different medications.

Such drugs include:

Calcium channel blockers for high blood pressure
Progestin for abnormal menstrual bleeding or birth control
Anticholinergics (e.g., for sea sickness)
Certain bronchodilators for asthma
Tricyclic antidepressants
Dopamine for Parkinson's disease
Sedatives for insomnia or anxiety
Beta blockers for high blood pressure or heart disease
If you suspect that one of your medications may be causing heartburn, talk to your doctor. NEVER change or stop medication you take regularly without talking to your doctor.

Saturday, July 01, 2006

hiatal hernia : When is surgery necessary?

If the hiatal hernia is in danger of becoming constricted or strangulated (so that the blood supply is cut off), surgery may be needed to reduce the size of the hernia.

In addition, people with a hiatal hernia who also have severe, chronic esophageal reflux may need surgery to correct the problem if their symptoms are not relieved through other medical treatments. If left untreated, chronic gastroesophageal reflux can cause complications such as esophagitis (inflammation), esophageal ulcers, bleeding or scarring of the esophagus.

During surgery, gastroesophageal reflux is corrected by creating an improved valve mechanism at the bottom of the esophagus.

Pre-surgical evaluation
The pre-surgical evaluation lasts about one day and is scheduled a few weeks before your surgery date.
During the evaluation, you will:

• Have a complete physical examination

• Have several tests to make sure you are physically ready for the surgery. Depending on your age and general health, the tests may include a chest X-ray, blood test, electrocardiogram (EKG) or other tests as ordered.

• Meet with several health care providers, including the surgeon, who will ask you questions about your condition and your health history

• Meet with an anesthesiologist (a physician who specializes in sedation and pain relief), who will discuss the type of pain medication (anesthesia) you will be given during surgery. You will also discuss the type of pain control after surgery.

• Have the opportunity to ask questions about the procedure

The day of surgery
• Do not eat or drink anything after midnight the evening before surgery
• Please do not bring valuables such as jewelry or credit cards

• Plan to arrive to the hospital at least two hours before your surgery time. Register at the admitting desk in the main lobby on the first floor of the H building.

• After registering, you will be taken to the TCI Center (“To Come In”). One family member or friend may come with you at this time. Others can join you once you are ready for surgery.

• In the TCI Center, you will be asked to change into a hospital gown and get into bed. You will be given a bag for your clothing; the person with you will be asked to take your personal belongings.

• An intravenous tube (IV) will be placed in your arm to deliver fluids and medication

• You will be asked to remove contact lenses and dentures

• A nurse may give you medication through your IV to help you relax

• Your family will wait in the family lounge; they will receive periodic reports about your progress throughout the surgery

• Once the surgeon is ready for you, you will be taken to the operating room

During the surgery
• An anesthesiologist will inject medication into your IV that will put you to sleep

• After you are asleep, the nurses will clean your abdomen with antibacterial soap and cover you with sterile drapes

• A six-inch vertical incision is made from the sternum to the navel. Frequently, surgical staples are used to hold the wound together.

• To correct GERD, the surgeon wraps the upper part of the stomach (called the fundus) around the lower portion of the esophagus. This creates a permanently tight sphincter so that food will not reflux back into the esophagus.

• Finally, your surgeon will check that there are no areas of bleeding, rinse out the abdominal cavity and then close the incision.

After the surgery
When you wake up from surgery you will be in a recovery room called the Post Anesthesia Care Unit (PACU). You will have an oxygen mask covering your nose and mouth. This mask delivers a cool mist of oxygen which helps eliminate the remaining anesthesia from your system and soothes your throat.
Your throat may be sore from the breathing tube that was present during your surgery; this soreness usually subsides after one or two days.

Once you are more alert, the nurse in PACU will switch your oxygen delivery device to a nasal cannula, a small plastic tube that hooks over your ears and lies beneath your nose. Your nurse will frequently check your blood oxygen level. Depending on the percentage of oxygen measured in your blood, you may need to keep the oxygen in place after you are transferred to your hospital room.

Recovering from surgery
Once you have recovered from anesthesia, you will be transferred to your hospital room. After your surgery, the nurses will measure your “intake and output” – they will document all the fluids that enter your body and measure and collect any urine or fluids you produce, including those from tubes or drains placed during surgery. A tube that is passed from your nostril into your stomach (a nasogastric tube) during surgery will remain for several days.

You will begin to drink clear liquids once your bowel function returns. Once you have passed gas (flatus) from the rectal area or have had a bowel movement, you will gradually be able to eat more solid foods (within 3 to 4 days after surgery).

You will be encouraged to get out of bed, starting the first day after surgery. The more you move, the less chance for complications such as pneumonia or blood clots in the veins in your legs.

Your recovery at home
Normally, you will be discharged from the hospital 5 to 6 days after surgery, after a barium swallow test confirms that the surgical site is healing correctly.

For six weeks after surgery do not lift or push anything over 5 pounds. Avoid activities that increase abdominal pressure, especially sit-ups. For 8 to 12 weeks after surgery, continue to avoid strenuous activities. However, you are encouraged to gradually increase your activity level. Walking is great exercise! Walking will help your general recovery by strengthening your muscles, keeping your blood circulating to prevent blood clots and helping your lungs remain clear.

A registered dietitian will visit you on your day of discharge to review your dietary instructions. You will be following a soft diet; follow this diet until your next appointment. Also avoid caffeine, carbonated beverages and citrus drinks.
Incision Care
You may notice some minor swelling around the incision; this is normal. However, call your health care provider if you have a fever, excessive swelling, redness, bleeding or increasing pain.

Follow-up appointment
A follow-up appointment will be scheduled about one week after your surgery. You will have a chest X-ray and your surgeon will assess the wound site and your recovery. The surgeon will provide guidelines about your activity and diet at this time.

© Cleveland Clinic 2001

hiatal hernia : What can be done to avoid a hiatus hernia

Whilst there is nothing that one can do to prevent the occurrence of a hiatus hernia, there are three ways of dealing with the symptoms.

There are certain things one can do, some obvious and some less so. If one can identify, for example, that certain foods aggravate the condition whilst others do not, then simple avoidance of those foods is an easy way of avoiding discomfort.
Further, it is clear that to eat a heavy meal and promptly go and bend over digging the garden is not sensible if it is known to cause problems. Again, this is an example where one can spare one's self the symptoms by simple adjustment to the timing and choices of these activities. However, for some patients, even drinking a glass of water before lying down can cause hours of discomfort.

The answer here may, again, be to avoid eating or drinking for an appropriate amount of time before lying down. There are also certain adjustments one can make to one's bed in order to change the angle. This can also assist in reducing the occurrences of reflux.

The advantage of the 'lifestyle' approach is, mainly, that you might avoid medical or surgical intervention altogether and be able to live with the condition without suffering the symptoms. The disadvantages are that it may not be possible to find a 'lifestyle' that deals with the symptoms and also the inconvenience caused may be intolerable.

Some 'tips' are given later in this page, but read on first.

There are several different medicines available to deal with the symptoms of hiatus hernia. They work in different ways, but are normally of an antacid type, and some work better on certain patients and others better on other patients. You should ask your doctor to suggest one or other type and, if that does not help, he may suggest a different one.
The advantage of the medicinal approach is that, in certain cases, this allows the patient to avoid all symptoms without too much inconvenience. The disadvantage is that it may not be desirable to take medicine for the rest of one's life.
Some TIPS.
There are several foods and other matters that are commonly associated with aggravating the symptoms. Before considering medicines or surgery, it is often worthwhile making changes to avoid such things as:
Hot foods and drinks
Spicy foods
Acidic foods
Foods which are difficult to digest
Being overweight

What to do NEXT.

We advise people who contact us from all over the world that the best course of treatment is to have the endoscopy and x-ray tests and then have the surgery (if that is what is required) performed locally. Your own family physician should be able to recommend you to a specialist in this field of hernia work who is expert in modern techniques. Unlike for abdominal wall hernias, (where it might be well worth your while to come to us from any part of the world for our specialised approach) modern and successful hiatus hernia surgery is available in most places today, so unless you are in London it will be worthwhile looking locally.