HIATUS HERNIA

HIATUS HERNIA

You often come across the classical dyspeptic pain that the doctor has diagnosed as hiatus hernia (hiatal hernia). Hiatus hernia means displacement of the upper part of the stomach through the gap of the diaphragm (the esophageal hiatus) into the chest cavity. This would be an unnatural location for the stomach to be in. With a part of the stomach in the chest, food digestion becomes painful. The acid in the stomach will freely push upward and touch the unprotected wall of the esophagus. It causes the pain of heartburn.

Normally, the content of the upper part of the stomach is sealed off and cannot pass upward into the esophagus when food is being digested. The normal direction of intestinal contractions is downward, from the mouth to the rectum. Furthermore, there are two valves that prevent the regurgitation of food upward. One valve is located in the wall of the tract between the esophagus and the stomach. This valve only relaxes when food is going into the stomach.

The other trap valve is located outside of the tract in the diaphragm, where the esophagus passes through its hiatus to join the stomach. This 'trap valve' is synchronized to relax every time the food that is being swallowed in the esophagus has to pass through it. At other times, it is tight and does not permit the content of the stomach to pass upward. This is the normal state of affairs for the two 'valves' that prevent the passage of food from reversing direction and passing upward.

The intestinal tract, from the mouth to the rectum, is a long tube. Different parts of it have developed special physical and functional attributes to make the process of food digestion and the evacuation of its waste products a well-integrated and smooth operation. There are many, many local hormones that make this operation possible. Local hormones are chemical messengers that signal and time the next stage of the process to 'kick in.' They cause the necessary enzymes to be secreted to further the breakdown and subsequent absorption of the active materials in food.

Early in the process of digestion, acid is secreted in the stomach to activate the enzymes and help in the breakdown of solid proteins such as meat and hard-to-digest foods. Normally, the liquefied but highly acidic content of the stomach is pumped into the first part of the intestine. There is a valve between the stomach and the intestine. It is called the 'pyloric valve.' The operation of this valve is regulated by the message system from either side of the 'tract.' It is one thing for the stomach to wish to empty its content into the intestine; it is another thing for the intestine to be ready to receive this highly corrosive and acidic gastric content

The pancreas is a gland that secretes insulin to regulate blood sugar. It also pours some essential digestive enzymes into the intestine. The pancreas has, at the same time, the physiological responsibility of rendering the intestinal environment alkaline before the acid from the stomach can reach the intestine. The most important function of the pancreas is its constant role of manufacturing and secreting of a 'watery bicarbonate solution'the alkaline solution that will neutralize the acid that enters the intestine. To manufacture the watery bicarbonate solution, the pancreas will need much water from the circulation. In dehydration, this process is not very efficient. For this reason, the pyloric valve will not receive the dear signals to open and allow stomach acid to pour into the intestine. This is the first step in the production of the dyspeptic pain, the initial thirst indicator of the human body.

When we drink water, depending on the volume of water that enters the stomach, a hormone/neurotransmitter called 'motilin' is secreted. The more water we drink, the more motilin is produced by the intestinal tract and can be measured in blood circulation. The effect of motilin on the intestinal tract, as its name implies, is to produce rhythmic contractions of the intestines peristalsisfrom its upper parts to its lower end. Part of this action would involve the timely opening and closing of the valves that are in the way of flow of the intestinal content.

Thus, when there is enough water in the body for all the digestive processes that depend on the availability of water, the pancreas will produce its watery bicarbonate solution to prepare the upper part of the intestinal tract to receive the acidic content of the stomach. Under such ideal circumstances, the pyloric valve is also allowed to open for the evacuation of the content of the stomach. Motilin has a major 'transmission' role in coordinating this action. Motilin is a satiety hormone secreted when water extends the stomach wall.

The problem begins when there is not enough water in the body for these digestive events to take place in a coordinated manner. In no way will the system allow the corrosive acid content of the stomach to reach the intestine if the mechanism to neutralize it is not effective. The damage would be irreparable. The walls of the intestines do not possess the same protective layer against acid that is available to the stomach. The first thing that happens is the reversal of the strength of contraction in the valves on either side of the stomach. The pyloric valve will constrict more and more.

The ring valve between the esophagus and the stomach and the external 'valve' of the diaphragm will become more relaxed. Initially, some of the acid may flow into the esophagus when the person is lying down and produce a type of pain that is often called heartburn.

In some, the laxity of the 'valve' in the diaphragm may be such that a portion of the stomach may pass through it into the chest and achieve the title of hiatus hernia. When the valves reverse their mode of operation for the normal flow of the stomach content, in effect they are preparing for another eventual and unavoidable outcome: the evacuation of the stomach content through the mouth. If the stomach content cannot go into the intestine and it cannot indefinitely remain in the stomach, there is only one other way outthrough the mouth. For this action to take place, the intestinal tract is capable of reversing the direction of its contractions. The reversal of the contractions is called 'anti-peristalsis.'

One of the most misunderstood and upsetting conditions that is a complication of severe dehydration is bulimia. People who suffer from bulimiathe most notable of them is Princess Diana, who has been devastated with this problem and whose marriage to Prince Charles was destroyed because of this antisocial problemsuffer from constant 'hunger.' When they eat, they cannot retain the food and have an instant uncontrollable urge to vomit thus, their antisocial life-style. In these people, their sensation of 'hunger' is, in fact, an indicator of thirst, and their urge to vomit is the protection mechanism that is explained above. If bulimics begin to rehydrate their body well and drink water before their food, this problem will disappear.

In my opinion, because of the repeated corrosive effect of the regurgitating acid on the unprotected esophageal tissue, there is a strong relationship between heartburn of early life and eventual cancer of the lower end of the esophagus.

Dyspeptic pain, no matter what other pathological label is attached to it, should be treated by regular intake of water. The current treatment practice and the use of antacids and histamine-blocking agents is not to the benefit of a chronically dehydrated person whose body has resorted to crying for water.

A.B. is herself engaged in the promotion of alternative medicine. She is very strongly into chelation therapy. She has compiled other people's information and written a popular book on chelation. However, she had herself suffered for many years from excruciating pains from her hiatus hernia. Her husband, himself a most delightful author, tells me that A.B. could hardly sit through a meal and not suffer from such severe pains as to be able to complete her food and enjoy sitting down for a chat. At times, they would have to leave the restaurant because the pain would not allow her even a short respite to finish her meal.

A.B. tells me she hardly drank any water. Only after H.B. had by chance come across my book and read it, did they finally understand A.B.'s problem. She began drinking water. As she increased her water intake, she noticed her pain was less severe. In a matter of days it disappeared completely, never to come back. The husband and wife now enjoy going out to eat. My wife and I ate with them a few times. It appears her hiatal hernia and its pain are ancient history. It is interesting to note that even chelation, her pet treatment procedure for so many conditions, could not help her. It should become clear that the hidden merits of chelation therapy in most cases is in its required high-volume water intake during the actual treatment procedure. However in the past, increased water intake was not a routine recommendation for in-between the treatment sessions. But, as a result of my talks and reviews of my book in their favorite Journal of Townsend Letter for Doctors, most practitioners of 'Alternative Medicine' are now recommending increased water intake by their patients. Chelation therapy is most effective in extracting toxic metals out of the body.

In Summary: Dyspeptic pain is a thirst signal associated with chronic or severe dehydration in the human body. It could also exist in conjunction with other thirst pains of the body. Take a look at Mr. Liguori's letter on page 92. As you can see, Mr. Liguori had both the pain of hiatal hernia and also anginal pain. With increased water intake, one pain has disappeared and the other has diminished significantly in only one week of increased water intake. At the time of the final writing of this page, his pain seems to have completely cleared up.

'The worst sin toward our fellow creatures is not to hate them, but to be indifferent to them: that's the essence of inhumanity.' George Bernard Show, 1897