What Can One Do About A Hiatal Hernia?

[Ashoka]

Hello there,

I have a lot of confidence in Peat's thinking to address malfunction in the body, but recently I think I'm dealing with a hiatal hernia and it's been a massive blow to my confidence to take on other aspects of my health that are suffering. For this I feel I have limited answers. This condition basically means chronic heartburn and indigestion, which both came on rather suddenly for me along with heart palpitations, chest pressure, anxiety, tightness in the throat, and shallow breathing. Most common now is indigestion and chest pressure that inhibits abdominal breathing. I have never had real problems with indigestion, even though my hormones are messed up. As a result of all this, recently I'm often hungry and don't know what to eat. Nearly every food seems to aggravate me, even with the addition of Hcl or apple cider vinegar (although these seem to help). I have trouble digesting most foods, and no matter what digestion almost always feels incomplete. Of course, the conventional medicine argument to this condition is to have surgery or take antacids.

These two links proved to be the most inspiring:

A chiropractor who treats Hiatal Hernia -
https://www.youtube.com/watch?v=EynT8nG3qKs

This EastWest article that discusses the condition -
http://eastwesthealing.com/hiatal-herni ... f-disease/

In the comment section of one of the only helpful books available, someone posted a supposed natural recovery through 19 months of effort.
http://www.amazon.com/review/R1GM5TM8EB ... hisHelpful

If I wasn't in such a bad state otherwise, I would consider surgery, but I'm very hypo and complications exist. The hernia can actually resurface. Does anyone have any idea how they would approach this, or have any experience for that matter? What can one actually do here, because the Internet has utterly muddled ideas on issue?

 

[tara]

Good article you linked.
I am not knowledgable about hiatial hernias, but if it were me I think I'd be considering some of the postural and self-manipulation ideas and trying to find a chiropractor or other relevant expert with a record of success at manipulating it back into it's rightful place.
Sounds like surgery is a bit of a gamble - could be helpful, but might cause more problems than it solves.

If you can find someone to help with that, it might make a huge difference in your health.
Good luck, and let us know what else you learn/try

 

[Such_Saturation]

With better metabolism and skipping allergenic foods mine settled itself. I went to an osteopath (non-USA) for it and he thought about it for a moment, then he immediately knew what to do. It did help, but the whole body was more relaxed, so I can't claim that he was able to specifically target that issue. The approach is very holistic, so this should be normal. The osteopath will even tackle the feet for this problem. The best thing is the glass of water with dropping on your heels, anyway.

 

[Ashoka]

Hey again,

Sorry I disappeared for a while - I really should've thanked you both for responding. Maybe you both know what it's like when you are dealing with something like this; you can't spend all day dwelling on it and searching about it, but you have to go out and attempt to apply something of what you learned. It's difficult to find a discussion online that puts people in an active role in approaching this problem, although I must admit I have found some helpful advice, which I'm prepared to share. It's the type of thing you really must search for.

So far I've visited an experienced chiropractor twice and the results are uncertain. I just had an episode a couple hours ago after potentially eating too much at once, so seemingly things aren't entirely resolved :p.

Such_, would you care to say more about your experience with the osteopath and what you mean by "he immediately knew what to do"? What I'm getting from what you said is mainly that you think the holistic approach, even regarding whatever mechanical manipulations were made, was helpful.

I'm going to provide a couple of images I took browsing forums that I think may be informative in the long run or for anyone else commenting. I think perhaps a smaller side question I'm asking here is about what relation we can draw between certain alternative therapies like chiropractic medicine, yoga, qi gong, acupuncture/acupressure, etc. and Peat's work.

 

[Ashoka]

Wow, I should really include this video from EastWest Healing too - I just watched now and almost missed it entirely. Truly the only thing I've seen that gets to explaining what may be going on, and I have been researching in different ways for a while:

https://www.youtube.com/watch?v=3P4AMjciq7c.

 

[Such_Saturation]

The doctor, like any doctor, enquired about the issue and then got to work. He never really explained anything.

 

[Parsifal]

With better metabolism and skipping allergenic foods mine settled itself. I went to an osteopath (non-USA) for it and he thought about it for a moment, then he immediately knew what to do. It did help, but the whole body was more relaxed, so I can't claim that he was able to specifically target that issue. The approach is very holistic, so this should be normal. The osteopath will even tackle the feet for this problem. The best thing is the glass of water with dropping on your heels, anyway.

Same here, mine settled just with better metabolism and diet.

 

[Giraffe]

post 100216 I think perhaps a smaller side question I'm asking here is about what relation we can draw between certain alternative therapies like chiropractic medicine, yoga, qi gong, acupuncture/acupressure, etc. and Peat's work.

In practice they harmonize perfectly. When it comes to explanations on how alternative therapies work there are some gaps and weaknesses.

Please note that a chiropractor is not the same as an osteopath though they overlap quite a bit.

 

[Parsifal]

In practice they harmonize perfectly. When it comes to explanations on how alternative therapies work there are some gaps and weaknesses.

Please note that a chiropractor is not the same as an osteopath though they overlap quite a bit.

Robert Becker's books are a good start to understand how these therapies work.

 

[Ashoka]

It's good to know that with better metabolism and diet it can settle. Really good to know, thanks guys. I've seen a few people say that already, but hearing it here is different. I will check out the books by Robert Becker at some point; it's something I've wanted to read but didn't know that was covered. The distinction between chiropractor and osteopath is explained by Josh Rubin in the video and was the first time I encountered that distinction by view of the osteopath's training.

I'm still a little confused knowing how to proceed with food. Although familiar with Peat and feeling better eating that way, I don't know how to approach this from a Peat perspective, and don't even know where to begin eliminating foods or adding new things in. Often I don't know what to eat, because suddenly out of nowhere this thing causes intense acid reflux and indigestion. The indigestion is bad enough that when it appears suddenly, I can't eat for the rest of the day. As soon as I discovered I had this, I realized how devastating it could be if not treated, because it's the type of thing thing that will ruin digestion lower in the tract over time through eating and also starve you at the same time. I've read a few times that most people with chronic illness have hiatal hernia (obviously that statistic is anecdotal from some people who practice alternative medicine). It's basically the fast lane to hypothyroidism.

One thing I will do is start eating smaller meals. It's something EastWest mentions in the video as actually helping. Also not eating before bed. Doing both of those things together is going to make me hungry though, at a time when I'm already eating well under requirements. I'm also underweight: 6 ft, weighing ~125 lbs.

Parsifal and Such_, if you care to reply again, any idea what a better diet might look like in this situation? Or even, what worked for you?

Lastly I asked a well known chiropractor/YouTube personality what he thought about the situation:

 

[Parsifal]

Unfortunately I still have digestive issues to settle (Undigested fruits in my stools, even ones with good fibers), constipation diarrhea even when I'm constipated, sometimes mucus and spasms so don't know if I can really help you :P.

I would say that starches are a no no in this situation.

 

[Ashoka]

Ha, I understand. I appreciate your help all the same.

 

[Giraffe]

post 100352 One thing I will do is start eating smaller meals. It's something EastWest mentions in the video as actually helping. Also not eating before bed. Doing both of those things together is going to make me hungry though, at a time when I'm already eating well under requirements. I'm also underweight: 6 ft, weighing ~125 lbs.

Do you tolerate dried fruits? I recently introduced them to my diet, because I was tending a little towards undereating.

 

[Ashoka]

It's hard to say. I've been eating dates occasionally and I really like them, but I know there's some downsides. I'll definitely consider it.

 

[Ashoka]

Update:

I'm going to keep this thread relevant and make sure that it's a collected source on the internet for actual ways to work through HH. Months after my initial post, I want to say that things have for the moment gotten much better. I've picked up yoga and breathing exercises. Sometimes the knot feels like it goes away, and then other times it seems to feel much as it did in its most stressed moments.

The interesting thing about HH, at least for me, is that it's both an emotionally and physically triggered phenomenon. So basically, I believe that calming my emotional states and putting myself in an environment where stress is less of an issue, I have to deal with it much less. When the conditions are opposite, I suddenly feel all the symptoms of palpitations, nausea, and acid reflux return. Developing a sense of agency and an openness to possibility has, at the very least, mitigated the symptoms. Basically I'm at the point where I can eat pretty much all the Peaty food we like except chocolate and coffee. I'll ask this question even though I don't think it'll receive an answer: Why would chocolate and coffee trigger HH so intensely even when other foods have stopped being an issue? For example, while before drinking OJ was a problem, it doesn't affect me anymore.

Peat's responded to me months ago in two emails, which I'm providing as a resource for others:

Me:

"Hi Dr. Peat,

I have a hiatal hernia that causes chest pains, chest and throat tightness, shallow breathing, occasional palpitations, constant heartburn, bloating, asthma-like symptoms, and other things. I went to the ER for the chest pains and it was judged as "non-cardiac" in origin. When hiatal hernia is suspected, general medicine doesn't offer an approach to recovery beyond symptom management or surgery.

Is there anything to do for a hiatal hernia? For example, some chiropractors claim to be able to treat it. It seems this is a prevalent and dangerous illness and people have no idea how to approach it."

Peat:

"Have you had blood tests for hormones? The whole complex of symptoms including hiatal hernia is usually caused by a general weakness of digestive and hormonal processes, and it’s especaily imortant to check thyroid function carefully, with a blood test and recording waking and midday temperature and pulse rate, and average caloric requirement."

Me:

"Hi again Dr. Peat,

I had blood tests for hormones a couple of times about a year ago. I first started struggling with my health after taking the drug finasteride for two months. When I stopped the drug, almost overnight I developed low libido, brain fog, and fatigue. A year and a half since, I've started feeling slightly better but recently developed this HH. I find it difficult to eat to caloric needs due to the HH."

Peat:

"It is most likely to develop as a result of reduced thyroid hormone and increased stress hormones (especially cortisol, in relation to testosterone and DHEA), weakening connective tissues. Some foods that cause intestinal irritation can make it worse; a simplified diet makes it possible to identify any specific foods that make the problem worse. Keeping a record of temperature and pulse rate can help to recognize any hormonal problems."

I have other resources, but there's so many to review and I think the best advice I've seen (amazingly) comes from Peat, Josh Rubin, and anecdotal reports. Josh Rubin recommends finding a massage therapist trained in visceral manipulation (but personally I have yet to do this due to cost). There's also a lot of people who've found different ways to safely exercise the body and manually manipulate the HH back into place. I've used different search engines and crawled through many comment sections for novel approaches. Perhaps sometime this week I'll include the most important sources I've found on a list here. If anyone has any other advice or input, let me know here and I'd be happy to hear from you.

 

[haidut]

Peat is correct about thyroid and cortisol being causative. There is a very old study that I am struggling to find right now that showed 5mcg thyroid fully resolved it...but only temporarily. Taking 5mcg every 3 hours kept it gone for the day and then it reappeared at night consistent with higher cortisol and lower thyroid. T4/T3 combo did not have an immediate effect but the study only lasted 24 hours.
People with "autoimmune" conditions often have hiatal hernia and it disappears when they are in remission only to reappear in relapse. Trouble swallowing and GERD are all part of the same spectrum and it is all cough* curable * cough by thyroid and potentially higher doses of calcium. But of course ask your doctor first.

 

[Giraffe]

Peat's responded to me months ago in two emails, which I'm providing as a resource for others:

Thanks for sharing, Ashoka. I copied it to the Ray Peat Email Advice Depository.

 

[Giraffe]

chest and throat tightness, shallow breathing

I had these problems when I was severely hypothyroid. I did a lot of breathing exercises, qi gong and so on to tackle this (with moderate success). Swimming was very good (I am underwater most of the time). Finally I had it fixed it by a massage therapist trained in myofascial release massage.

Tara gave me an idea what I could have tried. It's very simple. Check her post:

My breathing got noticably heavier from when I put the cloth on till I fell asleep, and I found myself chest-breathing more than usual.

Ray Peat mentioned swimming under water in Buteyko Breathing - Bud Weiss, 2008-09-15.

 

[Ashoka]

Thanks for your comments.

A few other things I'd like to add, because they may be of interest too. When I developed this hernia, I was a smoker. I think I smoked around 5 cigarettes a day. I was under a lot of stress, living in terrible conditions (possibly a moldy basement), and eating infrequently. One day I tried to smoke a cigarette and I felt nausea and my heart rate responded negatively to the smoking. I may or may not have noticed this even before I had the acid reflux, but I think it was before. Maybe after a couple weeks like that I ended up with the recognizable chest pressure and inability to eat. I ask anyone who's in this situation to calm down and keep an open mind, because I truly thought I was condemned to this in a way that not even Peat could provide proper insight. What you read online is that there's not much to act on, but I can confirm, through many offhand almost word of mouth encounters, that this issue is even capable of resolving on its own. I haven't resolved it but it has improved. The more I learned that fear itself is habituated and that the HH is deeply exacerbated by mental stress, the more I improved. Once you wean out the physical triggers (which are very real), eat less allergenic foods (as per Such_'s recommendation), and make it through the most difficult early stages of HH, it begins to be clear that mental stress and the fear of this illness make it intractable and worse. It took me a long time to realize this. The moment of progress was when I was in process of engaging in other things and, if only for a moment, forgot about the problem altogether.

Giraffe,

Finally I had it fixed it by a massage therapist trained in myofascial release massage.

I've had what I'd consider moderate success with breathing exercises, stress reduction, and time too. Couldn't tell you exactly what helped the most, but I actually think those are all so uniquely interwoven that I can fairly confidently say it was all of them together. I've actually tried swimming a few times with HH and found it very difficult, especially swimming underwater or even breathing with my chest fully submerged in the water. I hadn't heard of myofacial release massage. I remember someone mentioned SET massage, Applied Kinesiology, even Rolfing being effective. There's probably others but those off the top of my head.

haidut,

There is a very old study that I am struggling to find right now that showed 5mcg thyroid fully resolved it...but only temporarily.

That's really interesting. Any idea what the mechanism of calcium and thyroid would be here? I don't know much about anatomy, but it seems in this situation the esophagus is shortened (I think I read that), the diaphragm weakened, and/or the lower digestive organs are affected by something causing them to push upward. (Of course that's just an abbreviated context.) Are all or any of those things the problem? Can the diaphragm be repaired or is it more about getting the stomach to stay in position? I understand if you don't have a concrete answer to that, but I thought I might ask anyway. I've been keeping up with your talks with Danny Roddy and just wanted to let you know I really appreciate that you both are/were doing that. This may sound funny, but if it weren't for Danny, you, and Peat I simply wouldn't have had the assured confidence to deal with these issues that I do have.

 

[haidut]

Thanks for your comments.

A few other things I'd like to add, because they may be of interest too. When I developed this hernia, I was a smoker. I think I smoked around 5 cigarettes a day. I was under a lot of stress, living in terrible conditions (possibly a moldy basement), and eating infrequently. One day I tried to smoke a cigarette and I felt nausea and my heart rate responded negatively to the smoking. I may or may not have noticed this even before I had the acid reflux, but I think it was before. Maybe after a couple weeks like that I ended up with the recognizable chest pressure and inability to eat. I ask anyone who's in this situation to calm down and keep an open mind, because I truly thought I was condemned to this in a way that not even Peat could provide proper insight. What you read online is that there's not much to act on, but I can confirm, through many offhand almost word of mouth encounters, that this issue is even capable of resolving on its own. I haven't resolved it but it has improved. The more I learned that fear itself is habituated and that the HH is deeply exacerbated by mental stress, the more I improved. Once you wean out the physical triggers (which are very real), eat less allergenic foods (as per Such_'s recommendation), and make it through the most difficult early stages of HH, it begins to be clear that mental stress and the fear of this illness make it intractable and worse. It took me a long time to realize this. The moment of progress was when I was in process of engaging in other things and, if only for a moment, forgot about the problem altogether.

Giraffe,

I've had what I'd consider moderate success with breathing exercises, stress reduction, and time too. Couldn't tell you exactly what helped the most, but I actually think those are all so uniquely interwoven that I can fairly confidently say it was all of them together. I've actually tried swimming a few times with HH and found it very difficult, especially swimming underwater or even breathing with my chest fully submerged in the water. I hadn't heard of myofacial release massage. I remember someone mentioned SET massage, Applied Kinesiology, even Rolfing being effective. There's probably others but those off the top of my head.

haidut,

That's really interesting. Any idea what the mechanism of calcium and thyroid would be here? I don't know much about anatomy, but it seems in this situation the esophagus is shortened (I think I read that), the diaphragm weakened, and/or the lower digestive organs are affected by something causing them to push upward. (Of course that's just an abbreviated context.) Are all or any of those things the problem? Can the diaphragm be repaired or is it more about getting the stomach to stay in position? I understand if you don't have a concrete answer to that, but I thought I might ask anyway. I've been keeping up with your talks with Danny Roddy and just wanted to let you know I really appreciate that you both are/were doing that. This may sound funny, but if it weren't for Danny, you, and Peat I simply wouldn't have had the assured confidence to deal with these issues that I do have.

T3 will immediately lower cortisol and it even acts like glucocorticoid antagonist in some tissues. So, whatever muscular structure in the GI tract is weakened will benefit from this effect of T3. Why calcium helps I don't know but if cortisol is indeed the issue other anti-cortisol substances like vitamin B6 and DHEA should also help.