Hiatus Hernia

[femi fan]

Although we shall go to the hospital in a day or two to get it confirmed, it seems certain to me my wife has hiatus hernia. She has had this for a few months now, but only mentioned it to me the other day (we did go to the hospital about six months ago, she got some pills, they helped a bit for a while, then it was back to the 'uncomfortable' feeling again. But because she said nothing more, i had no idea she was still living with the problem).

She feels a 'blockage' just below her ribcage, at about the point where oesophogus meets stomach.

She can feel this all the time, but especially after eating meals. It is not so much painful, rather just uncomfortable.

She mentions that breathing can be laboured at times; or just short of breath i guess.

She has to burp a lot after meals.

Her heart often is beating quicker than what should be normal.

Sometimes has problems with swallowing.

Coughs a bit at bedtime and during the night.

Now from my research, and my instincts, i would prefer to find ways to alleviate and/or cure this problem outside of a drug route, which seems to me it can only stop it for a while.

I would also like to find out the causes of it, to help mitigate the effects for the future. I have done some research on both causes and treatments, but am most keen to hear of posters' own experiences and advice. A search on this forum did not really turn up much.

Could i stress that it is the personal experience and knowledge/understanding that i'm looking for?! Thanks! I say this because i have read plenty on the internet, but as we all know, this is not always necessarily correct, or specific enough.

Is it something we can cure, or is it something that we discover what the causes are, stop that activity, and live with it in this way?

Final question: what might the best procedure be to ensure we get all the correct checks done at the hospital? In other words to make sure there is no possible cancer on its way, to make sure we find out anything specific to her we need to know.

Many thanks in advance for any help that comes my way.

[meatboy]

i have suffered from hiatus hernia for over 35 years this was diagnosed by 2hospitals,but the symptoms you are describing are not what i get. who told you that your wife has h.h.and what medication is she taking and what is she doing to help the suffering,eg her bed should be elavated,the times she eats,what food is she eating,let me know who told her she has h.h.and i will try to help.

[femi fan]

i have suffered from hiatus hernia for over 35 years this was diagnosed by 2hospitals,but the symptoms you are describing are not what i get. who told you that your wife has h.h.and what medication is she taking and what is she doing to help the suffering,eg her bed should be elavated,the times she eats,what food is she eating,let me know who told her she has h.h.and i will try to help.

No-one told me, it's just my own considered opinion. But that's not enough for me, hence the need for us to get her to a hospital to be properly diagnosed. It's just that i don't have a huge faith in mainstream medical care on the whole, although for some areas it is of course very useful. Hence i try to do some research before.

What i'm really keen on is, once we know the diagnosis, that i can find alternative ways to treat whatever it is from just accepting the usual three kinds of pills, no questions asked, no answers given.

She did see the doctors on this end of last year and was given pills, but they only made it a bit less worse. Unfortunately she never mentioned it again until this week. I strongly suspect that whatever it is is in part stress-related, because she's very carefree on holidays, and she has told me that our last holiday in january she felt much better, and that was when eating not such a good diet as we normally have.

She's on no medication, although she also has to be careful of anemic conditions. We try to cover things with diet.

[Sheryl]

Could also be GERD.

In terms of tests, endoscopy and a Barium swallow. Endoscopy will rule out malignancy and also show any inflammation of the esophagus or stomach. Barium swallow will show if there is a hiatus hernia.

The 2 conditions often coexist. And many of the same measures help both, although in the case of the hernia it is only s symptomatic relief:

- avoid or minimize caffeine

- if a smoker, stop smoking

- avoid eating for several hours before bedtime, and never lie down after eating, always stay upright for at least an hour, preferrably two

- avoid large meals, if necessary increase frequency of eating so as to decrease portions.

- if overweight, loose weight (very important!)

I used to have GERD, these measures worked for me without any need of medication (which is good as I can't tolerate PPIs)

[femi fan]

Thank you sheryl.

I guess we definitely ask for endoscopy, for i definitely want to discover if cancer is part of the equation.

If you or anybody can answer me on my main doubt:

what is the expected procedure and sequence of events once we enter the hospital? I'm in chiang mai and guess we'll go to chiang mai ram, if only because they're geared for both the english language and the farang's nature of asking questions. I can't bear to go to a hospital again where i'm left out due to language and when i ask the doctor for a translation he gets all huffed up about being questioned, with his ego colliding with my need to know exactly the nature of the problem.

From my description of her symptoms, am i to therefore expect the problem to either be hh or gerd? Or could it be something else?

She is of normal weight.

When you say stay upright, does that include sitting?

Does she need to cut down on her chili intake?!

[meatboy]

take all the advice that sheryl gives you,one of the main symptoms of h.h. is heartburn,does she suffer from it ,when she lies down or sleeps does she suddenly wake up with a burning sensation in the throat this is when the build up of acid is released in the stomach this is why i said to elavate your bed,also she must avoid excessive bending,try not to wear tight clothing on her waist and exspecaily a belt,and stop taking fizzie drinks,my quality of life has improved 150% since i took to,not eating after 6pm,taking small mealsquite frequent,now this is going to hurt cut down on spicy food,i was over 50kilos overweight but when i cut down on every thing,just eating small amounts,and plenty of fruit when hungary i lost 40kilos,the one medication that i have been taking the last 12years has been lansaprozole i am now down to 3per week,so you see i was given different tabs,medicine but none of them worked for me,so until she has her tests just try and get her to do whats been advised,regarding docs in los i have no faith in them atall but i have found the hospices to be first class.also avoid alcohol and currys,cream cakes and butter if she has h.h. she will get better.in 2007 i had a double by-pass and a valve replacement in the uk so i have spent quite a bit of time at clinics and hospices and since moving to los i have improved again,keep us informed.

[femi fan]

Thank you meatboy for your comments.

I too have little faith in doctors in general, and that applies to thailand too. I don't blame them, just the system that trains them this way!

However, i do hope they are able to at least diagnose things properly. We are in chiang mai, and are going to chiang mai ram hospital this afternoon for the reasons i stated in the past above. I'm hoping above all to get a reliable and accurate diagnosis by prefessionals trained to use English.

I don't think she wakes up with sudden burning sensations in her throat. Her main complaint is that the area directly below the upside down V shape of her ribcage feels blocked, obstructed, and that this is uncomfortable rather than painful. This in a way is perhaps a bad thing because had it been painful she may well have alerted me to this a few months ago. It is this description that lead me to thinking HH is the problem. But other things could involved acid reflux, gerd, even ibs perhaps.

What i'm hoping is that she gets a diagnosis that avoids suggesting she has six months to live (!), and to then, probably with the help of this forum, and perhaps with resort to ayurvedic wisdom, seek ways to alter her lifestyle and diet to help her lose the problem, or at least live with it more comfortably.

I shall be back with the results from this afternoon. Thanks again for your valuable input. Forums like these are an excellent resource for those who have a dislike of the system that promotes pills and procedures as a be all and end all.

[Sheryl]

Yes, upright includes sitting. Just no lying down.

Some people also find it useful to sleep with more pillows arranged such that the upper half of the body is a bit elevated, it gets gravity on your side both with regard to GERD (which occurs when gastric contents seep back up into the lower esophagus) and hiatus hernia (which occurs when the stomach slides partially up through the diaphragm.

[meatboy]

good luck,you might get to see an indian doc.i saw one twice in bkk.but i am sure the thai doctors in hospices are quite capable.

[Tolley]

I have mentioned it before here many times but Slippery Elm powder is very good for gastric reflux and has no side effects.

You would also need to eat small meals and stay away from the following:

Chocolate ,Beer and excessive alcohol intake, bread,dairy cept low fat yogurt and limit red meat intake.

Take bifidius acidophilius to keep good bacteria in the gut.

Reflux can be made worse by liver underfunctioning so clean the liver out as well. Take milk thistle for this.

Finally don't bend down too much or take too much strenuous exercise until symtoms ease.

And try to reduce stress by meditating or low impact yoga exercises.

[femi fan]

Cheers tolley.

We went to the hospital today, and the suspicion by the doctor is digestion-related. Tomorrow my wife will have an ultrasound followed by a gastroscopy.

I gained confidence from the doctor we saw, and am happy that the right procedures have been suggested.

Interestingly when we went to her hospital a few months ago where insurance pays for it, pills were the order of the day. Anyway, perhaps no room for a cynical head right now!

Thank you posters for your helfpul input. Assuming we get a good diagnosis of the problem, and no doubt an allopathic description of the causes, i shall be back here to see what people might suggest we do in terms of lifestyle and diet, not withstanding the advice already given. We do take care of diet in our lives, so i'm hoping there won't be too many changes there.

I just fear for her sake if chillis have to go...!

[meatboy]

hope its good news and like you said take the advice on t. v. i had to find out the hard way i,ignored it.

[Suradit]

Could also be GERD.

- avoid or minimize caffeine

- if a smoker, stop smoking

- avoid eating for several hours before bedtime, and never lie down after eating, always stay upright for at least an hour, preferrably two

- avoid large meals, if necessary increase frequency of eating so as to decrease portions.

- if overweight, lose weight (very important!)

I used to have GERD, these measures worked for me without any need of medication (which is good as I can't tolerate PPIs)

Yes that's what it sounds like to me too. Along with not eating just before lying down, I do best when avoiding or at least reducing intake of carbonated drinks.

[femi fan]

hope its good news and like you said take the advice on t. v. i had to find out the hard way i,ignored it.

At the moment it does look like good news, and thank you to all here who have tried to help me.

It has also been a lesson in trying to balance the mutual benefits of mainstream medical health care, while avoiding the same system's pitfalls. In addition, much as we may try to research things ourselves, it could be dangerous to rely upon what we think is the case...!

She was diagnosed, after an ultrasound and gastroscopy, with chronic gastritis caused by the bacteria helicobacter pylori, something which is apparently quite common in the modern day, and, so the doctor said, particularly in less developed nations. He also said it is typically picked up from dirty food or water.

So, not HH, as you initially correctly thought!

She has been given the dreaded pills (i hate pills, but sometimes they must be accepted) for ten days, and to see the doctor again after that. He rates the chance of cure in this time period at 80%, and if not, then stage two of the curing process will occur.

It is naturally very good news indeed that the darker corners of the mind which mull over cancer or any other terrible affliction have been silenced.

My pocket is 15,000 baht lighter, but my mind is even lighter than that!!

[meatboy]

good news femi fan if the tabs work find out what they are you should be able to get them at any good pharmacy,the lansoprazole i take are also prescribed for gerd,they were the most pricey ones i take 1360bht x28tabs hopefuly it will be short term treatment.

[femi fan]

good news femi fan if the tabs work find out what they are you should be able to get them at any good pharmacy,the lansoprazole i take are also prescribed for gerd,they were the most pricey ones i take 1360bht x28tabs hopefuly it will be short term treatment.

Thanks, and have yet to look the tabs up on the net.

[femi fan]

One thing that has me wondering... anybody able to comment...?

i understand all foods and drinks get burned to ash by our digestive system, and that this ash will either be alkaline or acidic. To live a healthy life, to give us a strong immune system we need to have a larger intake of alkaline-forming foods. Now, foods like lemons and limes and vinegar are acidic in nature, in their form as we ingest them, but once digested become alkaline-forming in our bodies, and are therefore the good guys.

But the advice given here, and on the net, for those suffering from GERD or HH is to avoid acidic foods. Is this advice given for the foods as we eat them, or as they are after we have digested them?

[Sheryl]

To live a healthy life, to give us a strong immune system we need to have a larger intake of alkaline-forming foods.....

All foods will temporarily make the stomach contents more alkaline. The products of digestion as absorbed into the body are varied compositions of amino acids, simple sugars, fatty acids, glycerol, and various micronutrients (vitamins, minerals). The initial pH of the foods consumed has nothing to do with the pH of the nutrients absorbed into the body after digestion...and the latter has no effect on the pH of the body's cells and fluids, which is maintained at a constant very narrow range through a complex set of regulatory functions of the kidneys and lungs. Pretty much everything you read about effects of foods on acidity/alkalinity of the body, a need to be concerned about the body's acidity/alkalinity etc is junk science in the extreme.

Foods do have a temporary effect on the pH of the stomach and to a lesser extent the intestinal tract. In a healthy person this is of no consequence, only in people suffering from inflammatory conditions.

The stomach contains HCL, a strong acid. After passing through the stomach, contents are always acidic. The highly acidic pH of the stomach serves valuable purposes (including killing off the majority of bacteria) and usually presents no problem. However if the stomach lining is inflamed (as in gastritis) it will be irritated by the acid and in that case raising the pH will reduce discomfort and promote healing. Drugs like PPIs do this. Consuming foods with a comparatively high pH will also do this although only temporarily, however just about any food is better than none, as you aren't going to eat anything that doesn't have a higher pH than stomach acids do. Eating frequently also helps avoid prolonged exposure of the stomach lining to stomach acids.

Frequent intake of foods that "soak up" the stomach acids will be most helpful, many people find for example that crackers, toast etc help.

Caffeine, alcohol and nicotine all increase gastric secretions. Indeed their effect is a lot more profound than any choice of food.

the advice given here, and on the net, for those suffering from GERD or HH is to avoid acidic foods. Is this advice given for the foods as we eat them, or as they are after we have digested them?

As above, the only relevance is the effect on the pH of the upper digestive tract, particularly the stomach. And while more alkaline foods will do so to a greater degree, even acidic foods will have an alkalizing effect on the stomach (since they all have higher pHs than HCL) and one is better off eating them than eating nothing. The most important thing is to avoid/minimize things that stimulate gastric secretions (caffeine/alcohol/nicotine)and avoid having the stomach empty for prolonged periods of time..and above all to eradicate the h. pylori infection.

People with gastritic conditions learn by experience which foods seem to give more relief and which don't, I'd rely more on how she feels after eating specific things than how acidic or alkaline they are.

[femi fan]

sheryl, thanks for the reply. My objective always is for greater understanding, not to protect any position i may have at any one time in my journey in life.

That said, it is surprising to me to hear of the acid/alkaline distinction on foods being labeled as junk science. This runs counter to a lot of what i have read and come to understand, including from what i have judged to be rather trusted sources. In addition, my understanding is helped from observing my own diet and its effects on my health, and that of others. In light of my opening comment, i'm happy to be corrected, and am most curious in what you have just said, but...

One thing i understood was that if one ate too many acid-forming foods, then due to the need for the body to maintain its neutral range it would need to work harder in order to negate the effects of too much acidic ash that was now affecting its constitution. In that hard work, the body's immune system is taxed more heavily than need be, and is therefore more open to infection, bacteria, virus, illness.

Stress and overthinking causes the body (stomach?) to release acids, thereby having a similar effect. I understood that calmness, happiness, and a positive mind in general were alkalizing.

Acid-forming foods include meat, dairy (except milk i believe), grains, and all processed foods. Obviously, in theory, meats and grains form part of an overall diet necessary to keep most people healthy. But it's no secret that the typical western diet (SAD) is full of acid-forming foods, and i need not go into the general health levels of people eating such a diet.

In short, and perhaps it's off topic, i'm simply curious on what basis evaluating foods and drinks on their alkaline/acid-forming nature can be considered as junk science? Can you point me in the direction of some reputable sources so i can further my own research on this topic?

[femi fan]

Caffeine, alcohol and nicotine all increase gastric secretions. Indeed their effect is a lot more profound than any choice of food.

the advice given here, and on the net, for those suffering from GERD or HH is to avoid acidic foods. Is this advice given for the foods as we eat them, or as they are after we have digested them?

As above, the only relevance is the effect on the pH of the upper digestive tract, particularly the stomach. And while more alkaline foods will do so to a greater degree, even acidic foods will have an alkalizing effect on the stomach (since they all have higher pHs than HCL) and one is better off eating them than eating nothing. The most important thing is to avoid/minimize things that stimulate gastric secretions (caffeine/alcohol/nicotine)and avoid having the stomach empty for prolonged periods of time..and above all to eradicate the h. pylori infection.

People with gastritic conditions learn by experience which foods seem to give more relief and which don't, I'd rely more on how she feels after eating specific things than how acidic or alkaline they are.

Why is it that caffeine, alcohol, and nicotine increase gastric secretions? We are taking both tea and alcohol out of my wife's diet for now, but i'm interested in exactly why they get a bad rap! Does not meat and dairy from modern farmed, wrongly-fed animals cause just as much gastric secretions from the stomach? Are not processed foods just as harmful as alcohol?

When i posed the question, i was thinking more in terms of whether she could have a glass of water with lime squeezed in it, or a spoonful of apple cider vinegar. Both are acidic in nature, but alkaline-forming upon digestion. But will the acidic nature of them hit the stomach and cause gastric secretions, or not?

[Soutpeel]

good news femi fan if the tabs work find out what they are you should be able to get them at any good pharmacy,the lansoprazole i take are also prescribed for gerd,they were the most pricey ones i take 1360bht x28tabs hopefuly it will be short term treatment.

Omeprazole is very similar and generic versions can be bought in Thailand for about THB140 for 28 (comes in packs of 14) -ie Omesec, Ozid

[meatboy]

good news femi fan if the tabs work find out what they are you should be able to get them at any good pharmacy,the lansoprazole i take are also prescribed for gerd,they were the most pricey ones i take 1360bht x28tabs hopefuly it will be short term treatment.

Omeprazole is very similar and generic versions can be bought in Thailand for about THB140 for 28 (comes in packs of 14) -ie Omesec, Ozid

thanks for that this is the first time i have had to buy med.in los as i bought 2years supply with me,i have cut down to one every other day,so far so good,i have been on lans.for 12years,back in the uk.i got the generic version in 2005 these were ok.what makes me annoyed is i know the price on all the drugs i take,eg.lans.£1.60x28tabs=aprox.80bht,so theres a big diff,the ones i got from the pharmacy were prevacid,man.by takeda,as i dont need any of these for 6months i will enquire about omeprazole.