Hiatus hernia

Finally be aware of the fact that diseases in the upper part of the gastrointestinal tract are common in the elderly and can cause severe complications and even be fatal. Drugs that are often used in the elderly due to chronic diseases with inflammation and pain are often the cause of gastritis, peptic ulcers and hiatus hernia. The risks of medication side effects as a reason for the problem must be taken into account when treating elderly for peptic ulcers and stomach pain. 

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Prior to this work, dietary fiber, of which ceUulose is oae of the more important constituents, was considered important primarily as a means of preventing or overcoming constipation. Otherwise, dietary fiber was considered to be a metaboHcally iaert substance. A large variety of diseases such as appendicitis, hiatus hernia, gallstones, ischemic heart disease, diabetes, obesity, dental caries, and duodenal ulcers are now suspected to be associated with the consumption of a highly refined diet (42). 

Gastric ulcers, chronic gastritis and hiatus hernia are increasingly common conditions in old age. Both morbidity and mortality from bleeding stomach ulcers have increased in persons over 75 and this is in contrast to the lowered incidence in other... 

Hiatus hernia refers to the protrusion of a portion of the stomach into the thorax through the oesophageal hiatus of the diaphragm. Hiatus hernia is common in obese patients and during pregnancy. Very often the condition is asymptomatic. 

Simple dietary advice about bulk foods can mitigate minor bowel disturbances. More serious complications that can arise include paralytic ileus, which can be life-threatening, especially in the elderly (78). A less well-known adverse effect is the potential for aggravating or even possibly inducing a hiatus hernia, presumably due to an anticholinergic effect on the cardiac sphincter (79). 

Tyber MA. The relationship between hiatus hernia and tricyclic antidepressants a report of five cases. Am J Psychiatry 1975 132(6) 652-3. 

Hernias likewise do not constitute a general contraindication. (228) In numerous cases, we have observed no complications. (253) Large hiatus hernias are, however, an accepted contraindication. 

A 72-year-old woman with a symptomatic hiatus hernia, osteoarthritis, and Alzheimer s disease was taking fluoxetine 20mg/day, donepezil hydrochloride 10 mg/ day, nimesulide 12.5mg/day, and omeprazole 20 mg/ day (288). There still was no twitch response to peripheral nerve stimulation 20 minutes after rapid-sequence induction of anesthesia with propofol 2.5mg/kg and suxamethonium 1 mg/kg. She then gradually developed a weak twitch response, and 50 minutes after induction of anesthesia four twitches with a fade were elicited by train-of-four stimulation. No additional medication was given and after the end of the procedure 10 minutes later she was extubated uneventfully. She refused further blood testing and so her plasma cholinesterase activity at that time is not known. However, her anesthetic notes from a previous operation did not reveal any problems with prolonged paralysis after suxamethonium. 

Regurgitation of acid and enzymes into the oesophagus from the stomach due to, for example, hiatus hernia or weakness... 

Active substance against diarrhoea, gastritis, ulcers and hiatus hernia (Section 3.4.5)... 

M2. Moncrieff, A., and Wilkinson, R. H., Sucrosuria with mental defect and hiatus hernia. Acta Paediat. 43, Suppl. 100, 495-516 (1954). 

Hiatus hernia Protrusion of the stomach through a tear in the diaphragm wall. 

A 77-year-old woman with hiatus hernia, who had been taking cimetidine 400 mg four times daily for 3 years, experienced a severe frontal headache and hypertension, which appeared to be related to the ingestion of a cup of Bovril and some English cheddar cheese, both of which can contain substantial amounts of tyramine. Although the authors point out the similarity between this reaction and that seen in patients on MAOIs who eat tyramine-rich foods (see MAOIs or RIMAs + Tyramine-rich foods , p. 1153), there is no satisfactory explanation for what occurred. They note that she was also taking salbutamol (another sympathomimetic) but rule out any contribution from this drug. 

Chacko I, Ford WDA, Furness ME (1998) Antenatal detection of hiatus hernia. Pediatr Surg Int 13 163-164... 

Chana 1, Crabbe DC, Spitz L (1996) Familial hiatus hernia and gastro-oesophageal reflux. Eur I Pediatr Surg 6 175-176... 

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