03/27/2021
How To Help Avoid Hiatal Hernia
You may ask why is a dentist writing about a preventive measure for a medical condition. Well, it's because I had a malabsorption syndrome as a child which deprived my body of nutrients that would normally be reabsorbed in my intestines thus affecting my growth and maturation. My nurse mother was informed early in my life that I may not live to be 10 years old but, if I did, then the malady might subside as I age.......and it did. I was on a diet of goat's milk and ripe bananas for a few years because I either regurgitated my other food or had either constipation or diarrhea commonly. I was always hungry growing up. One advantage of my condition though was that I was recruited by my wrestling coach for the 98 LB weight class my freshman year in high school and I wrestled all four years of high school, graduating in the 119 lb weight class. It wasn't until I was in dental school studying pathophysiology that I began to understand my malady and that it could lead to a hiatal hernia. The body's abdominal cavity (housing the stomach and intestines) is separated from it's thoracic cavity (housing the lungs) by the diaphragm which is the main breathing muscle (accompanied by the intercostal (rib) muscles. The esophagus (a muscular tube connecting the throat with the stomach) passes through a ligamentous opening in the diaphragm called the Hiatus along with the main blood and lymph vessels and nerve trunk to the lower body. The physiology of breathing is such that when the diaphragm and intercostal muscles contract together, the chest cavity expands, creating a vacuum in the chest which sucks air into the lungs inflating them for oxygen/carbon dioxide exchange through capillaries in the alveoli of the lungs. The physiology of defecation, the final act of digestion by which waste (p**p) is expelled from the body, and, to an extent, urination is mainly through peristalsis (wave-like contraction) of weak muscles throughout the digestive system from esophagus to a**s. These weak contractions are aided by "straining at stool". But when there is constipation (thickened stool), straining at stool is more intense and still sometimes not enough, requiring the aid of stool softeners which take uncomfortable time to act. The food we eat is the main determinant of consistency of stool and amount of straining at stool. Starch-laden foods are the main culprit and fibrous foods are least responsible. When constipated AND straining at stool, there is immense pressure exerted from the abdominal cavity upward to the thoracic cavity, pushing the top of the stomach through the diaphragm hiatus thus creating the potential for "hiatal hernia". Surgery to correct this very uncomfortable condition is wrought with complications, often resulting in multiple surgeries and even medicolegal actions. So what can you do to help prevent a hiatal hernia to begin with........besides staying on stool softeners or avoiding starchy foods?? The answer is a very simple technique during stool.....minimize the pressure gradient from the abdominal cavity into the thoracic cavity while straining at stool. You do this simply by fully exhaling just before and during straining at stool and don't inhale until straining is over. Now, I must caution that this technique places more strain on the OTHER END, the a**s, potentially causing a hemorrhoid. But I had much rather have a hemorrhoidectomy than Hiatal Hernia repair. Try it today.
