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The Hiatal Hernia is sometimes called a Diaphragmatic Hernia.  What happens when this type of hernia happens is that the upper most portion of the stomach gets trapped up above the diaphragm.  This is the most common location for this to happen is at the esophageal hiatus.  This is the main thing that I am talking about in this blog post here.

The 3 main types of esophageal hiatal hernias are the sliding hernia, the paraesophageal hernia and the congenitally short hiatal hernia.  The majority of the hiatal hernias are the sliding type.  This type of hernia comes and goes.  The gastroesophageal junction slides into the thoracic area —- this means that it slides up.  To repeat, part of the stomach ends up above the diaphragm where it is not supposed to be.

Many researchers deny the existence of the congenitally short esophagus.  This is partly because it is so rare.

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Sometimes that hiatal hernia is referred to as “the great mimic” because of the many symptoms it can create that often lead diagnosis astray.  The symptomatic picture can relate to apparent digestive disturbances, heart problems, and shoulder, neck, jaw pain as well as difficulties with swallowing and hiccups.  When considering the hiatal hernia it is a good idea to look at an anatomy text book or discuss the matter with a doctor who is familiar with the anatomy.  I have done my best to include a few diagrams here for you to try to make it easier to understand what is happening.

The digestive disturbances that come from a hiatal hernia may mimic gallbladder or stomach disease, and there may be regurgitation and belching.  There is often regurgitation of irritating gastric contents that may cause burning of the sternal area.  this pain can then radiate down he back, neck, jaw, ear, palate, shoulders, or arms.  Sometimes people refer to this as “dyspepsia” or they might call it “acid reflux.”  These terms could be used synonymously.  Symptoms of hiatal hernia are often created or intensified by a large meal.  As a result, “food fear” may be noted in the patient.  Sometimes patients will lose weight because of this.  One thing that can really irritate the hiatal hernia condition is eating a large meal and then going to lie down right afterwards.  This may cause the weight of the meal in the stomach to push the top of the stomach up through the opening where the esophagus travels to the top of the stomach.  Gravity may cause this to happen.  If the psoas muscles dysfunction and cause something called “reciprical muscle inhibition” with the diaphragm, then you end up with dysfunctional psoas muscles due to diaphragmatic dysfunction or dysfunctional diaphragmatic function due to improperly functioning psoas muscles.  When this happens, both psoas muscles and the diaphragm need to be considered when the correction is made.  The diaphragm is related to several different vertebrae: C3, T3, L3, T8.  The nervous supply to the diaphragm known to exist from basic anatomy is spinal nerves C3, C4 and C5.  There are multiple inter-relationships as stated earlier.

So, why does all of this happen?  What are some other causes of hiatal hernia?

Let me ask you this:  What structures protrude through the diaphragm?  The answer is:

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  1. The arch of the aorta (heart) – responsible for bringing blood to a very large portion of the body.
  2. Esophagus – responsible for bringing food to the stomach
  3. Inferior Vena Cava – blood supply return to the heart.  This is used blood that has already been deoxygenated.  This is the main venous return to the heart.

diaphragm-thoracic-surface

What is one of the main functions of the diaphragm?  I already shared this with you.  It aids the lungs in bringing air in and out of the lungs.

I thought you would never ask.  Everything in the body is related to everything else.  The human body is composed of all sorts of inter-relationships.  The diaphragm pumps energy through the body.  It is largely responsible for healthy lung function.  the diaphragm and the psoas muscles (which are related to the kidneys) have a tendon in common that they attach to.  This tendon is called the “crux.  ”

What rests on top of the diaphragm?  The heart and lungs.

One of the most important therapeutic modalities when treating someone for a hiatal hernia is to consider their emotions.  Diet and emotions are intimately related.  Emotions and lungs are closely related (grief, sadness, despair, agony).  Asthma is a lung condition due to poor diet – it is an auto-immune condition.  The heart is dramatically effected by emotions.  In fact, in Chinese medicine the heart and brain are directly connected.  In fact, there are really 3 brains in the body: the heart, the brain, and the gut.  There are more nerve connections in the gut than there are in the brain!  Who would have figured.  There are a number of books written on this subject.

When we begin the treatment of our Hiatal Hernia patient we need to consider a series of things all at once:

  1. Diet
  2. Allergies
  3. Parasites
  4. Emotions
  5. Fungus / Mold / Yeast / Candida
  6. Lifestyle changes
  7. Water allows for healthy digestion so we consider water.  In fact, the enzyme “lyase” cannot function without water being present.
  8. Blood Sugar
  9. Ileo Cecal Valve
  10. Valves Of Houston
  11. Cardiac Spasm and Sphincter
  12. Pyloric Sphincter
  13. Sphincter of Odi
  14. Protein digestion
  15. Any infections in the digestive tract
  16. Digestion as a whole
  17. Immune function as a whole
  18. Whether or not Barrett’s Esophagus is present and if it is then the cause of the condition will be addressed.
  19. pH
  20. Zinc and other nutritional deficiencies such as iodine, B-Vitamins, Calcium, Magnesium, Chromium and other minerals
  21. Inflammation
  22. Bones of the upper cervical vertebrae.
  23. The Sacrum, Coccyx, sphenoid, jaw, muscles of mastication, and cranial bones.

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