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The Holiday Gorger's Lament

Holiday time is a time for celebrating, being with loved ones and ... for overeating. So it is also a good time to discuss a condition that is aggravated by this national pastime.

Much time, money and thought are expended upon what type, texture, and taste of food we are to put into our mouths. But once it reaches the stomach it is completely forgotten, not unlike a deceased benefactor, unless it turns in the grave and excites remorse. Have you ever experienced difficulty swallowing, shortness of breath, aggravation of asthma, belching, burning pain or discomfort beneath the breastbone, nausea, vomiting or an acid taste after eating? Have you ever thought you might be having a heart attack but your EKG was normal? If so, then you may be suffering from hiatal hernia syndrome also called reflux esophagitis.

Your esophagus carries food from your throat to your stomach. On the way to your stomach, it passes through an opening in your diaphragm called a "hiatus." The diaphragm, a strong sheet of muscle separating your chest cavity above from your abdominal cavity below, is normally quite adept at keeping the stomach and its contents from backing up into the esophagus. However, with hiatal hernia, part of the stomach protrudes, or "herniates," into the chest cavity. This allows stomach acids to back up into the esophagus, causing burning beneath the breast bone. Heartburn may occur after meals, but it may also follow bending over, lifting or straining. It may occur when asleep in bed, relieved by sitting up. One might also experience the sensation of food sticking while swallowing. You might imagine how distressed a lung or the heart might be at finding itself with a new "neighbor" limiting its function and comfort.

The cause of a hiatal hernia may be a severe injury which has torn some of the muscle fibers of the diaphragm. Perhaps there is a congenital weakness of the diaphragm. More commonly, the cause is interference with or over-excitation of the nerve supply to the diaphragm or esophagus as a result of stress or spinal misalignments. If not treated, it will probably get worse and can lead to ulceration of the esophagus.

If your hiatal hernia is very severe, it may be visible on x-ray. Most of the time a hiatal hernia is not visible on x-ray, so it may go undetected for years. Also one might suffer from what is called "hiatal hernia syndrome," where the stomach is jammed up against the diaphragm but does not actually protrude above the diaphragm into the chest cavity. Or perhaps you suffer from a "sliding hiatal hernia," i.e., one that sometimes slides up above the diaphragm and other times slides back down into the abdominal cavity where it belongs.

What can be done about this holiday scourge? Medically it is often recommended that one eat only small meals, do not indulge in late meals, incline your bed so you sleep with your head higher than your stomach, avoid chocolate, cigarettes, or alcohol, don't overwork, worry, bolt your food or overeat. Some medication might be prescribed to combat the acid burning feeling. Possibly even surgery might be recommended to correct this problem.

Hiatal hernia can also be treated chiropractically with immediate and gratifying results. Your chiropractor can determine whether spinal misalignments are interfering with the nerve supply to the diaphragm, esophagus or the many muscles which assist in swallowing. The diaphragm can be relaxed and the stomach itself may be manipulated. Manipulation of the stomach is designed to return it to its normal position below the diaphragm.

Most hiatal hernias do not require surgery or medication. Returning the stomach to its proper position, relaxing the diaphragm and the muscles of swallowing, adjusting the spine to maintain proper nerve supply to the area are generally all that is necessary to correct this problem. Relief sometimes can be experienced immediately. Periodic repeat treatments may be required depending on the laxity of the diaphragm and on how well established bad habits have become.

If you suspect that you or a loved one may have a hiatal hernia, don't wait till it gets worse. There's a lot of holiday food out there. Call your chiropractor today.