What do we mean by a hiatal hernia?

The hiatus is an opening in the diaphragm (the muscular wall) which separates the chest cavity from the abdomen. Normally, the esophagus (food pipe) goes through the hiatus and attaches to the stomach. In a hiatal hernia, the stomach bulges up into the chest through that opening.

What does statistical data say about a hiatal hernia?

Statistically, approximately 60% of individuals who are above age 50 or older have a hiatal hernia.

In which age group is hiatal hernia very common?

The incidence of hiatal hernias increases with age. It is commonly seen in the older age people specifically in people who are above 50. 

What are the causes of hiatal hernia?

The most common risk factors are as follows: 

Obesity Congenital deformities, such as scoliosis
Certain types of surgery
Major trauma
Conditions which causes an increase in abdominal pressure within the abdomen, such as heavy lifting, or bending over, frequent or violent coughing, violent sneezing, violent vomiting, and straining during bowel movements
What are the types of a hiatal hernia?

There are four types of a hiatal hernia and they are as follows:

Sliding hiatal hernia: This is the most common variant of a hiatal hernia. It occurs when your stomach and esophagus slide into and out of your chest through the hiatus. It is usually asymptomatic.
Fixed hiatal hernia: It is also known as a paraesophageal hernia. In a fixed hernia, part of the stomach pushes through diaphragm and stays there.
Type III hiatal hernia: In this type, as a hernia goes on increasing, the phrenoesophageal ligament stretches and displaces the gastroesophageal junction above the diaphragm
Type IV hiatal hernia: Type IV hiatal hernia includes a large defect in the phrenoesophageal ligament causing other organs, such as colon, spleen, pancreas and small intestine to enter the hernia sac.
What are the sign and symptoms of hiatal hernia?

Common symptoms include:

Heartburn
Chest pain or epigastric pain, coughing
Difficulty in swallowing
Belching, eructation, and hiccups
How to diagnose the condition?

To diagnose this condition following tests or procedures are included:

X-ray of the chest and abdomen Barium follow-through examination of gastrointestinal tract (GI) to visualize GI tract.
Upper endoscopy for examining the esophagus and stomach from inside Esophageal manometry for measuring the rhythmic muscular contractions of esophagus while swallowing, and also, measuring the force exerted by the muscles of esophagus.
What is the treatment available for it?

It includes medications and surgery which are as follows:

Antacids to neutralize stomach acid and to reduce acid production
Medications that heal the esophagus 
Surgery of opening of diaphragm to make it smaller and for reconstruction of an esophageal sphincter

Hiatal Hernia - How Is it Diagnosed?

3 Foods to Avoid If You Have Hyperthyroidism

Hyperthyroidism causes the thyroid gland to produce excess hormones, which accelerates the metabolism, in turn affecting the heart, bone health, and mood. The symptoms of hyperthyroidism include increased heartbeat, insomnia, anxiety, heightened hunger, and weight loss, all of which can be controlled via medicines and a healthy diet plan.

However, there are certain foods that can worsen the condition and lead to the severity of the symptoms. These should be avoided at all costs by anyone suffering from hyperthyroidism.

- Caffeinated drinks

Caffeinated drinks can worsen hyperthyroidism symptoms by aggravating palpitations, anxiety and insomnia. These include energy drinks, coffee, black tea, alcohol, soda. It is advisable to replace these drinks with healthy herbal tea or lemon water, which are apt refreshments with multiple health benefits.

- Foods with high glycemic content

Processed refined grains lose their nutrients like vitamin B and become not only useless but harmful to the body. The high glycemic content in refined grains can cause fluctuations in your blood sugar level, which can trigger terrible mood swings. It is advised to swap these with whole grains, quinoa, oatmeal and wild rice.

- Trans fat and hydrogenated oil

Trans- fat and partially hydrogenated oil are the culprits of heart diseases. To ensure the health of your heart and reduce the chances of hyperthyroidism, it is important to minimize the consumption of all the foods that list hydrogenated oil in their ingredient list. These are cookies, margarine, cakes, donuts, French fries, crackers and many others.



3 Foods to Avoid If You Have Hyperthyroidism

Do you feel extremely tired many times in a day? Are you experiencing sudden weight gain, chills at night and hair loss? Is your neck a bit bloated up? If you are experiencing any of the mentioned symptoms, it might be that your body regulator- Thyroid- is unbalanced. Quick 3 tests can help you detect any abnormality - TSH, T3 and T4. Women were three times more likely to be affected by thyroid dysfunction than men. 1 in 10 adults in India suffers from hypothyroidism, with 50 per cent being women.

What is the thyroid gland?
The thyroid is a butterfly shaped gland in the front of the neck. It produces hormones that control the speed of your metabolism - the system that helps the body use energy. Thyroid disorders can slow down or rev up your metabolism by disrupting the production of thyroid hormones. When hormone levels become too low or too high, you may experience a wide range of symptoms.

What are the Symptoms?
Thyroid can be of 2 types - Hyper (Overactive) and Hypo (Underactive) Thyroid.
Low and Underactive Thyroid High and Overactive Thyroid
Fatigue Nervousness
Dry Skin & Hair Tremors - Hand Shaking
Brittle Hair Hair loss or thinning hair
Constipation Diarrhea
Low Pulse High Pulse
Weight Gain Weight loss without trying
Intolerance to cold temperature Intolerance to hot temperature
Depression Sweatiness
Swelling in lower part of neck Swelling in lower part of neck

The swelling in the neck is a major and most significant feature. Hence one should always do the Self Neck Test.

Who should be tested?
Women aged 35 and above or those with symptoms/risk factors/family history are the right candidates for screening. It has been estimated that 75% of the people suffering from thyroid are undiagnosed.

Diagnosing thyroid disorders - A simple blood test can provide an answer. TSH (Thyroid Stimulating Hormone) levels determine thyroid hypo and hyper function as it regulates the work of thyroid gland. Rarely an imaging study or biopsy is needed. Two additional tests may be required - T3 and T4.

What happens if Thyroid remains undetected?
As Thyroid disorders are hormonal imbalances, undetection can lead to a number of secondary complications:
Obesity
High Cholesterol and Hypertension
Hair Fall
Heart Disease
Complications in pregnancy

Understanding Thyroid Problems in Women: Did You Get the Test Done?

Thyroid disorders are conditions that affect the thyroid gland, which is a butterfly-shaped gland in front of the neck. There are specific kinds of thyroid disorders that include:

Hypothyroidism
Hyperthyroidism
Goiter
Thyroid Nodules
Thyroid Cancer
Epidemiology, Incidence, and Prevalence
It has been estimated that about 42 million people in India suffer from thyroid diseases.

Hypothyroidism

Hypothyroidism occurs when the thyroid gland produces an insufficient amount of thyroid hormone. It can develop from problems within the thyroid gland, pituitary gland, or hypothalamus. 

Symptoms of hypothyroidism can include:

Fatigue
Poor concentration or feeling mentally "foggy"
Dry skin
Constipation
Feeling cold
Fluid retention
Muscle and joint aches
Depression
Prolonged or excessive menstrual bleeding in women
Common Causes of Hypothyroidism

Hashimoto's thyroiditis (an autoimmune condition that causes inflammation of the thyroid gland)
Thyroid hormone resistance
Other types involving inflammation of the thyroid, such as acute thyroiditis and postpartum thyroiditis
Hyperthyroidism

Hyperthyroidism refers to the excessive production of thyroid hormone, a less common condition than hypothyroidism. Symptoms of hyperthyroidism are usually related to increased metabolism. In mild cases, there may not be apparent symptoms.

Signs and symptoms of hyperthyroidism can include:

Tremors
Nervousness
Fast heart rate
Fatigue
Intolerance for heat
Increase in bowel movements
Increased sweating 
Concentration problems
Unintentional weight loss
Common causes of hyperthyroidism

Graves' disease
Toxic multinodular goiter
Thyroid nodules that overexpress thyroid hormone (known as "hot" nodules) 
Abnormal secretion of TSH
Thyroiditis (inflammation of the thyroid gland)
Excessive iodine intake
Goiter: A goiter is an enlargement of the thyroid gland, regardless of cause. A goiter may be associated with hypothyroidism, hyperthyroidism, or a normal thyroid function. 

Thyroid Nodules: Nodules are lumps or abnormal masses in the thyroid. Nodules can be caused by benign cysts, benign tumors, or less commonly, by cancers of the thyroid. If nodules are excessively large, they may cause symptoms related to compression of nearby structures. 

Thyroid Cancer: Thyroid cancer is more common among adult women than men or youth. About 2/3rd of cases occur in people under age 55. There are different kinds of thyroid cancers depending upon the specific cell type within the thyroid that has become cancerous. Most cases of thyroid cancer have a good prognosis and high survival rates, especially when diagnosed in its early stages.

Investigations

Blood tests are done to measure levels of thyroid hormones. Blood tests are also done to identify antibodies against thyroid tissue, such as titers of antithyroglobulin, antithyroperoxidase, or TSH receptor-stimulating antibodies.

Treatment

Thyroid disorders can be treated with medications or, in some cases, surgery. The treatment will depend on the particular disease of the thyroid.Medications can be given to replace the missing thyroid hormone in hypothyroidism. Synthetic thyroid hormone is given in pill form by mouth. When hyperthyroidism is present, medications can be used to decrease the production of thyroid hormone or prevent its release from the gland. 

Thyroid Disorder - What All Should You Know 

Many women experience a temporary encounter with hemorrhoids when they are pregnant. Quite surprisingly, most people tend to experience this in their daily lives. By the age 50, majority of people have encountered one or more symptoms of this ailment, including rectal pain, bleeding, itching and may be prolapse where the hemorrhoids protrude out of the anal canal. Though this ailment can be rarely detrimental, it can be a painful intrusion. But thankfully, there are a lot of things we can do about them.

How may this be diagnosed?
Hemorrhoids are usually diagnosed from a plain medical history and health exam. External hemorrhoids, more commonly known as piles, are normally apparent, particularly if a blood clot is formed. Your physician shall perform a digital rectal test to detect blood in the stool. Then the physician may also inspect the anal tube with the aid of an anoscope, which is a short plastic channel interjected into the rectum with illumination. If he finds any evidence of microscopic blood or rectal bleeding in the stool, then there may be a need to perform colonoscopy or flexible sigmoidoscopy to determine the probable causes of bleeding like cancer or colorectal polyps, specifically in women aged over 50.

Is it possible to treat hemorrhoids at home?
Most of the common symptoms of piles can improve drastically with simple in-home measures. If you are suffering from occasional flare-ups, you may try the following:

    Eat a lot of fibre: It is recommended to add fibre in the diet; may be a fibre supplement like Citrucel, Fibre con, etc. When you drink a lot of water along with loads of fibre, stools get softened making them effortless to pass, which will reduce the pressure on the swollen veins. Eating broccoli, wheat, oats, beans, fresh fruits every day will help in decreasing bleeding caused due to piles. It also reduces swelling and inflammation. If you feel digestive issues with a sudden splurge of fibre in your diet, you may start slowly and gradually increase the amounts.
    Take a sitz bath: A sitz bath is a lukewarm water bath for the lower back portion of the body, which can help in relieving irritation, itching as well as spasms occurring in the sphincter muscle. You can either get small plastic tubs for a sitz bath or sit in a normal bath tub. Most physicians suggest a half an hour sitz bath after every bowel movement. Then tenderly dry the area and avoid wiping it hard.

There are several invasive treatments that can be opted if these conservative treatments are not able to help your condition. In such an instance, it is always wise to seek advice of a medical practitioner. 

How to Deal with Hemorrhoids?

Anal Fissure is a small tear in the anal area. This can happen due to injury while passing hard formed stool or even by repeated bowel motion. It may be very painful especially at the time of passing hard stool. 

Symptoms

Most commonly sought symptoms in Anal Fissure are as given below: 

  A noticeable tear in the skin close to the anus. 

  Cutting or burning pain in anal passage while passing stool which may persist for a considerable time

  Sometimes pain is so severe that patient stops eating in an attempt to avoid defecation to avoid pain

  Blood stains on stools may also be there

  If not treated in time; skin starts growing from the lower end of fissure to form a tag known as sentinel tag/sentinel piles.

  At times; sentinel tag may get inflamed.

Causes

  Passage of hard stool through anus. 

  Chronic Diarrhoea

  Trauma to the anus and anal canal like during childbirth

  Inflammation in anus because of crohn's disease or some other inflammatory disease 

Anal Fissure treatment: Diet: High fiber diet like green leafy vegetables, salads, fruits like papaya, chikku are advised. Resins with milk can also be taken in night. Adequate quantity of liquids especially butter milk is advised. Banana, apple etc. should be avoided. 

Graded Kshar Karma & Ksharsutra: Anal Fissure can be completely treated by Graded Kshar Karma and Ksharsutra treatment. In acute anal fissure; stool softener along with Graded Kshar Karma is advised. In this treatment; Graded Kshar - a specialized Ayurvedic medicine is applied in fissure region. This medicine debrides the fissure and induces healing. Usually pain subsides in a week or 10 days time period when fissure is still in healing phase.

Considering pain has subsided; some patients discontinue the treatment to further aggravate and complicate the problem. For complete healing of anal fissure usually 3-5 Graded Kshar Karma sittings are required at a weekly interval. In between these weekly sittings patients are advised to apply certain medicines in anal passage by themselves. If anal fissure has progressed to development of sentinel tag then Graded Ksharsutra TM treatment is the treatment of choice. 

In this treatment Graded Ksharsutra TM is ligated at the root of sentinel tag. Medicine released from Ksharsutra blocks the blood supply of sentinel tag and it sheds off in a week or 10 days time period. No hospitalization or bed rest is required in this treatment. Patient can continue his normal routine activities as usual during his treatment. So, you can say no to surgery in Anal fissure.

Anal Fissure - Say No To Surgery!

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