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March 20, 2018  |  Login
Hiatal Hernia
by James F. Balch, M.D. and Mark Stengler, N.D.

A person is said to have a hiatal hernia when part of the stomach protrudes, or herniates, through the opening of the diaphragm and into the chest cavity. While almost half of all Americans over the age of forty have this disorder, many of these people experience few, if any, symptoms. Hiatal hernias are generally not considered dangerous unless they produce persistent or severe symptoms.

The food you eat starts its digestive journey in the mouth and then slides down the esophagus, a long tube that leads to the stomach. Because food is meant to travel through the digestive system in one direction only, the base of the esophagus is outfitted with a ring of muscles that acts as a sentry. At the stomach entrance, the muscles relax and allow the food to pass into the stomach, where acids start to break it down into a digestible stew. Once you're finished eating and the esophagus is empty, the muscular rings and valves tighten. This action keeps the food and the acids from backing up out of the stomach and refluxing into the esophageal tube.

Hiatal hernias can keep this system from working properly. When part of the stomach slides out of place (herniates), the ability of the muscular rings to keep food and acid in the stomach may be inhibited. In a phenomenon known as acid reflux, food and acid splash up into the esophagus, causing heartburn, chest pains, and belching. A person with severe symptoms may regurgitate stomach acid into the throat and the mouth. Sometimes the acid reflux leads to angina-like chest pains and spasms; the symptoms may be so intense that they are mistaken for a heart attack. Over long periods of time, the constant irritation of the esophagus can lead to inflammation, scarring, ulceration, hemorrhaging, and even esophageal cancer.

As with almost all digestive disorders, poor diet plays a large role in the unpleasant symptoms of hiatal hernias. Anything that contributes to an overly full stomach-eating too much, or eating foods that are not easily digested-encourages the stomach's contents to back up. In many cases, food allergies make the condition worse. Stress can trigger severe gastric upset as well. Anything that traumatizes the stomach muscles, such as injury, surgery, or pregnancy, can lead to hiatal hernias, as can the general weakening of muscles most people associate with aging. Finally, some people inherit a genetic tendency to this condition.

Bodywork therapies can be utilized to improve the structural problem that occurs with this condition. This involves manipulating the soft tissue, as well as the stomach itself, in a downward direction. This is described further in this chapter.

Acid reflux can also be caused by being overweight, from stomach infections, and from the effects of stress.

No matter what the cause, hiatal hernias respond well to dietary, herbal, and stress-reduction therapies. If you have this disorder, you'll also want to get regular checkups to monitor the health of your esophagus.

Next: What are the Symptoms of Hiatal Hernias

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