Home > Uncategorized > So what is a hiatus hernia?

So what is a hiatus hernia?

I was asked the other day exactly what is a hiatus hernia & why does it cause me grief.

Basically a hiatus hernia is where part of the stomach moves (herniates or protrudes) upwards into the chest cavity via an enlarged hole (the hiatus) in the diaphragm.

The vast majority of people with a hiatus hernia don’t experience any problems.

But a lot of us do.

It’s probably easier to use a few diagrams to illustrate.  Let’s start with normal anatomy.

Your insides. Note that the stomach should be sitting below your diaphragm. This is normal.

There is no hiatus hernia here. The lower oesophageal sphincter can function like a valve with the help of the diaphrgam's pressure.

Notice that for most people the junction between the oesophagus & stomach (called the lower oesophageal sphincter) sits BELOW the diaphragm. This allows the sphincter to act as a valve & prevent reflux of food and acid back up the oesophagus.

Here’s what happens if you have an hiatus hernia, and there are a couple of varieties.

This is the most common hiatus hernia type, a sliding one. See what's happened to that lower oesophageal sphincter? Can't work as well if it's up in the chest cavity.

A different type of hiatus hernia, the rolling one. Not so common. It is possible to have a combination of rolling & sliding.

Notice this time that sphincter is now above the diaphragm, where it can’t function as a valve anywhere near as well. And the diaphragm isn’t able to assist with keeping pressure on the sphincter if it’s sitting above instead of below.  The result can be GORD or GERD (reflux disease).

In my case it means a lot of GORD symptoms & I have to take care when bending over (not good) & with heavy lifting (and that means being careful even when lifting a bag of groceries).

I have adopted some of the “lifestyle” advice: no alcohol, no fatty foods, no hot spices, no fizzy drinks etc. I eat a low-fat vegetarian diet with very small servings & watch my nutritional intake carefully. I use the services of qualified dietician to guide me in food choices.

No, it can’t be treated with alternative therapies. And if you try to do “Visceral manipulation” as per the photo at Figure 5, I will scream. In pain.  Within hours I’ll have very nasty & painful reflux for a few days. And then I will commence litigation proceedings against you. Just saying.

Further information on hiatus hernias can be found at Patient UK, & that same site has some good info on acid reflux & oesophagitis which often accompany hiatus hernia. I particularly like that site’s information as it provides clinical references.

Note on treating GORD (GERD) & hiatus hernias with alternative therapies:

When I was first diagnosed I was a great user of an assortment of alternative therapies to treat any ailments I might have. I look back at those years & see that most of those ailments were self-limiting. They were going to get better with or without any complementary therapies I might choose to swallow or dabble with.

Initially I used herbal medicine to complement my medical treatment. In the first few weeks it worked, it eased my painful symptoms. But I continued to get symptoms and the herbal treatments were doing nothing (yes my doctor knew I was using). The sheer cost of alternative therapies was such that I felt I had to go with the treatment that was having a positive impact on me. That was the scientifically proven, evidence-based MEDICINE.

I do however continue to use peppermint oil to massage lightly over my stomach & abdomen most nights as it takes the edge off the painful bloating pain (& feels nice).  And if I am experiencing oesophagitis (with throat/voice pain) I will drink slippery elm powder mixed with a little apple juice. Because that temporarily eases that pain.  But they are adjuncts to my medical therapy. And I won’t have it any other way.

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