GERD Protocol 12 – Hiatal Hernia

A hiatal hernia is the protrusion of the upper part of the stomach into the thoracic cavity through a weakness in the diaphragm. There are two different types of hiatal hernias.1

  • Sliding Hiatal Hernia – A sliding hernia is the most common hiatal hernia and represents close to 99% of all cases of hiatal hernias.2 A sliding hernia occurs when the gastroesophageal junction slides back and forth above the diaphragm. When this happens, some of the upper part of the stomach is pulled through the opening, weakening the lower esophageal sphincter (LES). A sliding hiatal hernia rarely creates strangulation of the stomach or surrounding organs and therefore might not have to be surgically treated unless it is severely symptomatic.3
  • Rolling Hiatal Hernia – A rolling hernia occurs when a part of the upper stomach herniates through the esophageal hiatus that lies beside the esophagus. This form of the hiatal hernia is a lot more serious because the top part of the stomach may become twisted when the stomach occasionally moves to the side and behind the lower part of the esophagus. A rolling hiatal hernia needs to be immediately repaired upon diagnosis because of the risk of strangulation in the stomach and the medical emergency that may arise from it.4

It has been theorized that developing a hiatal hernia might be a natural part of the aging process. Around 60% of individuals aged 50 or older have been diagnosed as having a hiatal hernia. This might occur because as we age we tend to gain more weight and the structural integrity of our organs and muscles, including the LES, decreases.5 It has also been theorized that lack of proper dietary fiber and the sitting position of defecation can be causes of hiatal hernias. The reasoning behind this theory is that hiatal hernias are quite rare in rural African communities compared to their first-world counterparts.6 Finally, frequent increases in pressure within the abdomen (such as heavy lifting, coughing, sneezing, and violent vomiting), obesity, genetics, smoking, and stress can also be risk factors for developing a hiatal hernia.7

Symptoms of a hiatal hernia are a dull pain in the chest, acid reflux, shortness of breath, heart palpitations, and pain in the esophagus after swallowing. Most hiatal hernias are asymptomatic, and often go undiagnosed. If you have been diagnosed with a hiatal hernia and at any time feel extreme pain or experience a large increase in the amount of vomiting, hernia strangulation may have occurred, and you need to go to the hospital immediately!8

The most common way to diagnose a hiatal hernia is by x-ray. Other ways to diagnose a hiatal hernia are by upper GI or endoscopy. 9

Hiatal Hernia Protocol

  • Follow strengthen LES protocol10
  • Magnesium glycinate – 600 mg before bed
  • Visit a chiropractor; they might be able to manipulate down the hiatal hernia into the correct position.11
  • Lose weight if you are overweight.
  • Possibly try Nu Nefarious homeopathic supplement

GERD Protocol 13 – The Joys of Squatting to Relieve Constipation!

Proper defecation posture is important to develop so that you can lower intra-abdominal pressure.12 So what is proper defecation posture, you might ask? Well if you guessed that the proper posture is sitting straight up on the toilet when you defecate, try again. You can always watch any toddler or domesticated animal for a long enough period of time if you need any help answering this question. And even though they can not tell you how to use the bathroom properly, they still defecate the way humans were designed to defecate—squatting.13

The problems with sitting on the toilet while defecating instead of squatting are numerous. When you sit on the toilet to defecate, it creates a narrow anorectal angle. This narrow angle can be obstructive and can cause you to not completely empty your bowels when you use the bathroom. This improper evacuation might cause some stool to be pushed back up into the colon.14 It has been theorized that this undelivered stool can eventually lead to appendicitis. Appendicitis may develop from this constant irritation of toxins and opportunistic bacteria that were originally posed for proper elimination.

Sitting on the toilet seat to defecate also causes, you to repeatedly perform the Valsalva maneuver (hold one’s breath and bear down) to pass a bowel movement. The repeated Valsalva maneuver creates unneeded stress on both the vagus nerve and the cardiovascular system. Finally, sitting on the toilet can increase the risk of diverticulosis and hemorrhoids from the straining that is required to pass a bowel movement.15 The extreme pressure buildup if the patient is constipated can be up to three times greater than if they had squatted to relieve themselves.16

There are two benefits to sitting on the toilet to defecate, though. There is more added privacy when you sit on the toilet to defecate, as well as less splash back that could get on your clothes from sitting down on the toilet. Sadly, these two mentioned benefits of sitting on the toilet are the only negatives for squatting over the toilet to relieve oneself.

To squat on the toilet, one has to stand with their knees and hips sharply bent, and their butt should hover over the toilet opening. Some people who squat have seen complete relief from their constipation. The main reason that is theorized that squatting is easier to defecate is because of the correction of the anorectal angle. You also do not have to rely on a constant Valsalva maneuver to defecate, which is easier on your vagus nerve and your cardiovascular system.17 To make things even simpler, you could purchase a Squatty Potty®, which is a platform built for one to easily stand on and successfully squat over the toilet without having to have perfect balance.