Hiatus hernia could be one of the trickiest chest complaints

An old man of 72 years is a peasant farmer from Kabuye sector and has consulted the outpatient department of Rwanda Military Hospital since January 2012 for persistent chest discomfort. He complained of the pain and tingling sensation just behind the breast bone (sternum) towards the bottom of the chest wall. He reported to have difficulty in swallowing and felt like an obstruction in the lower chest wall. He felt some difficulties in food swallowing and could feel like an obstruction of the food passage to the stomach. He also reported to have a heart burning sensation. When the doctor carried out his investigations, he discovered hernia adjust to his stomach and diaphragm. This herniation is known as the hiatus hernia. A hiatus hernia is when a portion of the upper part of the stomach slides up through the esophageal hiatus in the diaphragm towards the chest cavity. The result is pressure on the walls of the esophagus that can lead to one or more of the symptoms mentioned above. A hiatus hernia is caused by any lifestyle factor that causes weakening of the diaphragm and the connective tissue that is in place and around the esophageal hiatus to help prevent a hernia. The diaphragm is a large flat muscle that separates the abdomen and the chest.The esophagus is the food pipe that sits above the diaphragm, and is therefore considered to be in the chest part. The diaphragm has a hole known as the esophageal hiatus that allows the esophagus to travel from the chest part into the abdomen where it immediately meets up with the stomach.Hiatus condition can be caused by emotional stress, physical stress, lack of adequate rest, and being overweight. Smoking cigarettes is also another common lifestyle factor that can contribute to the development of a hiatus hernia.Symptoms of heartburn that always accompany a hiatus hernia often respond positively to measures such as prevent of smoking cigarettes, limitations of caffeine intake and alcohol intake. Sometimes a hiatus hernia can be corrected with physical measures. You need to apply gentle massage to the uppermost portion of the abdominal cavity. To do this, a health expert will use his fingers to find the point at which the breast bone (sternum) ends, right where the bottom rib on each side of the chest cavity comes up to meet the breast bone. He then places his fingers just below this point, apply downward pressure, and move slowly towards the belly button. This principle can be repeated for several times while a patient or person in need is lying down with physical and emotional relaxation. This routine can be followed as often as one wishes to experience improvement in the symptoms. People need to try this routine two times per day, once in the morning, and once in the evening.After a relaxation session of at least five minutes during which time a patient has been lying down, he will need to drink a full glass of water. After consumption of water he will jump to the ground from a height that one is comfortable with and this could be anything ranging from the bottom step of a set of stairs to a steady sofa seat or chair. The water is to add some weight to the stomach. Jumping down from a height of a few inches to a few feet is to provide downward impact upon landing that can help the portion of the stomach that has herniated upward to slide back down, and away from the esophageal hiatus of the diaphragm.Because the tone and overall health of the digestive tract is very closely connected with the stress levels via the autonomic nervous system, one of the most important treatment considerations for a hiatus hernia is physical and emotional relaxation work. Taking as much time as is needed to address chronic emotional states like frustration, anger, sadness, and hatred can be critically important in allowing the digestive tract to experience optimal nerve tone.