Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

‍What It Is:‍

A hiatus or diaphragmatic hernia is the result of a weakness in the diaphragm as it fits around the lower end of the esophagus. This allows a portion of the stomach to slide up above the diaphragm into the chest. The symptoms result from the acid stomach juices running into the lower end of the esophagus. At times swallowing can be very difficult and painful. Often at night, especially after a heavy supper, sour material comes up into the throat and may even gag or choke the person. Rarely, it can cause scarring with narrowing of the esophagus, ulceration, or bleeding.‍

Dietary Causes:‍

Hiatus hernias result from high pressures in the abdomen. Perhaps many individuals may have inherited a weakened area in the diaphragm which contributes to the problem. The reason for the increased pressure is the eating of highly refined foods, with insufficient fiber or bran which produces difficult bowel movements. Excessive gas is also produced by soft or sweet foods. Gas increases abdominal pressure. Further, few people drink sufficient water or get enough exercise to assure soft stools and easy elimination.‍

Other Causes:

‍Lying down with a full stomach increases the pressure on the diaphragm. Overeating, especially at night when the diaphragm is elevated by lying down, stretches and weakens the muscle fibers around the esophagus. The use of nicotine can cause all the symptoms of hiatus hernia, and presumably weakens the tissues. The wearing of tight bands (even thin elastic), belts, corsets, and other clothing around the abdomen increases both the weakening process and the symptoms. The lack of exercise promotes muscular weakness. If you want to know how soft your diaphragm is, squeeze your calf muscle.‍

Treatment:

• Eat a wide variety of unrefined foods, avoiding all white flour products and sugar. Whole grain breads and cereals are very efficient in relieving straining at stool. Fruits, vegetables, legumes, and nuts also contain good fiber.
• Add 1-3 tablespoons of wheat bran from the health food store to your diet each day; sprinkled on cereal, baked in bread, etc.
• Drink 6-8 glasses of water daily.
• Never overeat! Two meals are preferable to three.
• Supper, if eaten, must be small (fruit and bread); and several hours before retiring.
• Reduce your weight to its normal level. Avoid coughs.
• Avoid even the elastic of panties or shorts around the abdomen.
• Elevation of the head of the bed on 8-10 inch blocks may help.
• Try 3 charcoal tablets chewed 1-1.5 hours after meals to avoid gas.
• No spices, pepper, vinegar, highly seasoned foods, or baking powder.
• Do not smoke, drink alcohol or caffeine beverages, or take aspirin.
• Get plenty of exercise. Walking and gardening are especially good.
• Do no work requiring lifting or bending low just after meals.