A hiatal hernia occurs when the stomach gets pushed up into the chest cavity sometimes causing painful bouts of acid reflux. The stomach is held in place by the diaphragm (a sheet of smooth muscle tissue which separates the lungs from the stomach.) There is a small hole in the center of the diaphragm which allows the esophagus to connect to the stomach pouch. This hole is called the hiatus. If the hiatus becomes enlarged it can begin to slip up along the esophagus causing the LES (lower esophageal sphincter) to loosen. When this loosening occurs, acid can splash back up into the esophagus causing it to burn which is called acid reflux, or heartburn.
There are three kinds of hiatal hernias:
Sliding Hiatal Hernia: When the stomach is allowed to shift up and down, sideways or outward. This is the most common kind and normally has no symptoms.
Fixed Hiatal Hernia: The stomach gets pushed into the chest and becomes stuck there. This type can cause acid reflux.
Complicated or Serious Hiatal Hernia: Extremely uncommon, this type involves the stomach pushing deep into the chest cavity and can cause complications such as gastric strangulation.
What Causes a Hiatal (Hiatus) Hernia?
In conventional medicine the presumed causes of an enlarged hiatus or hiatal hernia are excessive strain within the abdomen due to heavy weight lifting or straining during bowel movement. For some it may be hereditary.
In traditional Chinese medicine (TCM) the cause is blocked energy.
Is a Hiatal Hernia Dangerous?
In a word, no. A herniated hiatus while painful for some people most will experience no symptoms and need to treatments. Except in complicated cases, even a painful one poses little or no danger especially when treated.
What are the Treatments for a Hiatal Hernia?
In conventional medicine the treatments for hiatal hernia are typical medications for GERD. These would include prescription PPI’s (proton pump inhibitors,) H-2 blockers or antacids. In extreme cases surgery is recommended. I would not recommend either of these treatments for several reasons. For more information on conventional meds for heartburn and GERD, please see my article on conventional meds for heartburn.
In TCM the treatment is acupuncture and specific herbal medications which not only end the acid reflux but will heal the herniated hiatus, bringing it back to its natural position.
Acupuncture Versus Acid Reflux: 40% Cut in Sphincter Relaxations Brings Hope for Relief
Posted on: Tuesday, 30 August 2005, 14:52 CDT
BETHESDA, Md. (August 30, 2005) – Even the U.S. National Institutes of Health doesn't know what causes gastroesophageal reflux disease, or GERD. And NIH's National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says there's an unclear relationship between GERD, heartburn and hiatal hernia (HH). Patients may have only one out of three, any two out of three, or all three.
An encounter between a Taiwanese gastroenterologist wanting to study acupuncture and an opening at the Royal Adelaide Hospital resulted in two experiments looking into how the traditional Eastern approach might affect transient lower esophageal sphincter relaxations (TLESRs). Since TLESRs are "the most important mechanism of acid reflux in normal subjects and patients with GERD," they were targeted for study.
The paper describing the study, "Inhibition of transient lower esophageal sphincter relaxations by electrical acupoint stimulation," appears in the August issue of the American Journal of Physiology-Gastrointestinal and Liver Physiology, published by the American Physiological Society.
In two separate studies, barely perceptible stimulation was applied at the acupoint known as Neiguan on the wrist. here is a rather interesting proof of concept, which tackles one of the approaches to acid reflux by controlling the valve that controls acid leak. If we can stop the events, that would be a major therapeutic gain. But it's a major leap from where we are to a real cure," knowledge of the underlying mechanisms of the effect of electric acupuncture may help to identify target sites for therapeutic intervention for TLESRs.