Hiatus-Hernia from a Holistic Perspective

Hernia means the protrusion of a body part into another part of the body through a gap or opening. Hernias are commonly seen in the abdomen where there is muscle weakness. A Hiatus Hernia forms at the level of the diaphragm where the esophagus joins with the stomach. A part of the stomach herniates through the esophageal opening leading to Hiatus Hernia. Although Hiatal Hernias have been reported at all ages, they are most frequent between the age of 40 and 70 years.

Causes of Hiatus Hernia

The esophageal opening in the diaphragm is surrounded by muscles which prevent regurgitation of stomach content into the esophagus. Weakness of these muscles leads to herniation of the stomach through the hiatus. Such weakness is congenital, or may be acquired as a result of general laxity of muscle tone due to sedentary habits and increasing age.

Raised intra-abdominal pressure secondary to pregnancy, obesity, fluid retention or abdominal tumor is frequently responsible for Hiatus Hernia.

Types of Hiatus Hernia

The following varieties of Eesophageal Hiatal Hernias have been recognized:

• Sliding Variety: This is the type most commonly seen. The esophago-gastric junction is drawn into the thorax above the opening of the diaphragm and can slide back into the abdomen. There is free gastro-esophageal reflux, which causes symptoms of inflammation of the esophagus .

• Rolling Variety: The esophago-gastric junction is not drawn up in such cases. Only the stomach herniates into the thorax. This kind of hernia does not produce any symptoms. 

• Mixed type: Here, the features of both sliding and rolling varieties are seen together. 

• Hiatus Hernia with a short esophagus : This is very rare. Some cases are due to a congenital short esophagus , while others are secondary to inflammation of the esophagus, where it contracts and is pulled up into the thorax.

Large hernias can lead to several complications like bleeding in the stomach, reduced blood supply to the stomach or gastro-esophageal reflux disorder. Therefore, treatment should be sought as early as possible. Allopathic treatments for Hiatus Hernia include Famotidine (Pepcid) and Cimetidine (Tagamet). However, these conventional drugs only provide temporary relief from the symptoms and fail to address the root cause of the problem.

Tips to Help Hernia Patients

• Sleeping with the head end of the bed elevated on 20cm blocks is advised
• Regular use of antacids is recommended
• Meals should be small frequent and bland
• The patient should not sleep for at least 2 hours after a meal

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