It has been said many times in this forum that hiatus hernia may be the cause of some arrhythmias - some MDs accept it, while some don't. My intention is to try to discuss the mechanism of developing hiatus hernia, despite I am not with medical background. It does not matter since, no matter whether I am right or not, nobody will pay any attention to my idea, lol.
Well, being with technical background, I cannot avoid to look at the things that way... If we have an elastic membrane, like the diaphragm is, with the elastic balloon beneath it, like the stomach is, of course with the opening on the diaphragm and the elastic pipe lead through it (like the esophagus is), then any attempt to push the stomach through the opening on the diaphragm, acting with the force from below, would bring no result. Here is why. The stomach would be deformed under the pressure from below in such a way, that it would be flattened and enlarged in diameter. It would be utterly impossible to press such a structure through a small opening, through which the esophagus goes. So, the mechanism must be different...
And here is how I see it - if, by chance, the esophagus receives the wrong electric signals and starts pulling the stomach through the diaphragm, then the known effect of "threading in" will appear and the diameter of the stomach, in the vicinity of the esophagus connection with the stomach, will reduce, so, little by little, the stomach will be pulled through the diaphragm into the chest cavity. From technical standpoint, it is the only way it can happen.
The question remines, why would the esophagus get the wrong signals?! It is a million Dollar question, but the fault originates in Autonomous Nervous System, which, with the ageing, is inclined to make a mess, not only in the form of cardiac arrhythmias.
The complexity of human body requires an interdisciplinary approach, which is rarely present. We know well that even the cooperation between the EPs and cardiologists is sometimes hard to achieve, despite dealing with the same pump ...
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As an engineer I understand your reasoning but wonder if there is actually a strong enough "pull" within the oesophagus to do this. The muscle is designed to push food towards the stomach not away so it would be as if a hydraulic jack was able to -pull a car downwards as well as push it up!
Normal movements of esophagus are in "wavy" form, transporting portions of food or liquid towards the stomach. If the signals are irregular, prolonged, cramp like pull is developed, leading to "shortening" of the esophagus, what is well known to MDs. Obviously, there is enough force to do the job... There is no other suspect connected with the stomach, so the esophagus is to blame, lol.
That's interesting. I have a sliding hernia, and was told that the neck of the stomach is shaped smoothly and becomes much narrower as it forms into becoming the oesophagus. I am a tall chap and was told my food pipe is extra long. The hernia itself, I have been told, is not responsible for the acidity that I get, which is, instead, caused by a weakness in the cardiac sphincter; this is there, I gather, to stop acid flowing out into the food pipe. Mine is not good at doing this.
The link between a HH and AF is far from easy to prove, and I have read only one study that showed it, and that was with large hernias. But, as you say, certainly there seems to be a link, and the symptoms, for me, are similar, with chest discomfort in the left rib area.
Hello, Steve! Thanks for taking the time to reply! As I said before, being with a mechanical background, I can not avoid to look at the things that way. Sliding hernia is the consequence of alternating action of esophagus - it pulls the stomach in the chest, then it relaxes and lets it slide down, where it belongs. And so on, and so on...
Often mentioned manipulation, in the form of drinking a glass of water, and then jumping from the first staircase is quite good as the instant cure. The stomach goes up because it is pulled up, then the force of inertia pulls it back down when a person jumps down.
In your case, the esophagus is elongated, and lets, from time to time, the stomach go down. Decades ago, this was called "lowered stomach" and was cured from old women, who knew the techniques to correct this condition (at least in my country). Are there, in UK, still the people who know how to treat this condition, or is it left for underdeveloped countries only...?
That was a fine reply - thanks for your time, too! I have tried the drinking water trick in the past when my HH has "played up" and it never worked at all. This led me to the view that my symptoms are sphincter related rather than HH per se (indeed, online, there's little said at all about HH symptoms). Possibly I get a kind of gastritis or something on oaccsion. Whatever it is, the symptoms include nausea, and that is one of the worst of all common symptoms for me. I do take daily esomeprazole and this has worked well for many years to stop acid-related pain and troubles but every so often, this breaks through and lasts for weeks, even months, before going away. I've concluded that gastric and intestinal troubles (I have IBS and diverticular, too) can take an age to settle for some reason.
I enjoyed the story of the "lowered stomach" (which country are you from, by the way)? I have read that the last witch was burned at the stake in England in 1727, and with her passed all that esoteric knowledge that might have cured me!
Well 50% of my stomach managed to make it's way through ,flip over & weld itself to chest .I had hiatus hernia 10 years before AFib .It arrived after stents & clobidogrel for 12 months.If you can work out the technicalities please do.
I do think hiatus hernia should be treated more seriously & would welcome that.
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