Hernia means the protrusion of a body part into another part of the body through a gap or opening. Hernias are commonly seen in the abdomen where there is muscle weakness. A Hiatus Hernia forms at the level of the diaphragm where the esophagus joins with the stomach. A part of the stomach herniates through the esophageal opening leading to Hiatus Hernia. Although Hiatal Hernias have been reported at all ages, they are most frequent between the age of 40 and 70 years.

Causes of Hiatus Hernia

The esophageal opening in the diaphragm is surrounded by muscles which prevent regurgitation of stomach content into the esophagus. Weakness of these muscles leads to herniation of the stomach through the hiatus. Such weakness is congenital, or may be acquired as a result of general laxity of muscle tone due to sedentary habits and increasing age.

Raised intra-abdominal pressure secondary to pregnancy, obesity, fluid retention or abdominal tumor is frequently responsible for Hiatus Hernia.

Types of Hiatus Hernia

The following varieties of Eesophageal Hiatal Hernias have been recognized:

• Sliding Variety: This is the type most commonly seen. The esophago-gastric junction is drawn into the thorax above the opening of the diaphragm and can slide back into the abdomen. There is free gastro-esophageal reflux, which causes symptoms of inflammation of the esophagus .

• Rolling Variety: The esophago-gastric junction is not drawn up in such cases. Only the stomach herniates into the thorax. This kind of hernia does not produce any symptoms. 

• Mixed type: Here, the features of both sliding and rolling varieties are seen together. 

• Hiatus Hernia with a short esophagus : This is very rare. Some cases are due to a congenital short esophagus , while others are secondary to inflammation of the esophagus, where it contracts and is pulled up into the thorax.

Large hernias can lead to several complications like bleeding in the stomach, reduced blood supply to the stomach or gastro-esophageal reflux disorder. Therefore, treatment should be sought as early as possible. Allopathic treatments for Hiatus Hernia include Famotidine (Pepcid) and Cimetidine (Tagamet). However, these conventional drugs only provide temporary relief from the symptoms and fail to address the root cause of the problem.

Tips to Help Hernia Patients

• Sleeping with the head end of the bed elevated on 20cm blocks is advised
• Regular use of antacids is recommended
• Meals should be small frequent and bland
• The patient should not sleep for at least 2 hours after a meal

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Prana' stands for life force, and as the name suggests, it is instrumental in keeping us alive. 'Pranayama' is the process that helps us control 'Prana', and thus in a way, control our life. On careful observation, it is clear that there exists an intimate connection between the breath and energy-currents. Proper coordination of the breathing process leads to the control of vital inner-currents and energies. It ultimately results in the control of the body, mind and soul continuum. Over the millenia yogis have understood how each pranayama affects the energy meridians of the body and therefore these yogis recommend particular pranayamas for particular conditions and constitutions.

1.Tandem Breathing ('Sahita Kumbhaka') 

It has 2 types, based on whether or not there is any concomitant chanting of Mantras with the Pranayama exercise. 

Steps:

1. Comfortable aasana like Padma-asana or Swastika-asana.
2. Slow inhalation; with concomitant chants of the mantra 'OM AARAH', if possible.
3. Hold the breath for a short period of time. 
4. Slow Exhalation.

Significance:

It's a daily and constant process, which we seldom appreciate.

Benefits:

It encourages concentration with closed eyes while we inhale and exhale.

2. Awakening breath ('Surya Bheda')

Steps:

1. Upright position in a comfortable asana like Padma-asana / Swastika asana / Siddhasana. Concentrate with eyes closed.

2. Rest the right thumb on the right nostril (Avoid applying any pressure or blocking the nostril). At the same time, rest the right index finger on the space between 2 eyebrows and close the left nostril with the right ring and little finger.

3. Slow inhalation through the right nostril is pursued, till comfortable.

4. With the thumb applied to the right nostril, retain the breath firmly pressing the chin against the chest. There is no specific limit to this and it can be pursued till there is discomfort.

5. Slow and silent exhalation through the left nostril. It is followed by a short gap wherein inhalation is avoided. This same procedure is to be repeated again. 

Time limit: 

Hold your breath till you perspire. This point cannot be reached at the very outset. The period of retention of breath needs to be gradually increased. 

Advantages:

• It cures the diseases caused by excess of Vata & Kapha
• Improves digestion
• Awakens 'Kundalini Shakti'

Indications:

• Intestinal worms
• Arthritis
• Sinusitis

3. Hissing breath ('Ujjayi')

Steps: 

1. Sit comfortably in Padma-asana / Swastika asana / Siddhasana. Close the mouth. 
2. Fold the tip of the tongue and rest it on the palate. The tongue will appear to be 'twisted'. 
3. Inhale air slowly through both the nostrils in a uniform manner till the breath fills the chest. This results in a peculiar sound uniform in pitch and continuous in nature.
4. Retain the breath as long as you can, till there is any discomfort.
5. Close the right nostril with the right thumb.
6. Exhale slowly through the left nostril.

Time limit:

3 min to hr

Advantages:

• Strengthens the nervous system
• Improves the tone of voice
• Relieves stress
• Increases lung capacity

Indications:

• Indigestion
• Koch's
• Bronchitis
• Pharyngitis
• Spleen disorders
• Tonsillitis
• Cough
• Ascites

• Purifies the blood
• Quenches thirst and appeases hunger

• Spleen disorders
• Chronic dyspepsia
• Indigestion
• Bilious disorders

5. Cooling Breath (Shitkari) 

Steps: 

1. Upright position in a comfortable asana like Padma-asana. 
2. Fold the tongue so that its tip is brought to rest over the upper palate. Inhale air through the mouth accompanied by a hissing sound 'Si'/ 'C'. 
3. Retain the breath as long as you can, till there is any discomfort.
4. Slowly exhale through both the nostrils.

Time limit: 

Gradually increase by 1 minute every week, till 5 minutes.

Advantages:

• Helps to keep the body cool in summer
• Improves vigor & beauty
• Helps quench thirst when thirsty

Indications:

• Dental carries
• Bleeding and inflammation of gums
• Ulcers
• Colitis
• Throat infection
• Hypertension patients can practice this type of Pranayama to decrease blood pressure.

6. Bellow Breath (Bhastrika)

It draws similarity with the bellows of a blacksmith. It involves rapid expulsion of breath and is a powerful exercise. It can be termed as a combination of Kapalabhati and Ujjayi. 

Steps: 

1. Upright position (with a straight neck) in a comfortable asana like Padma-asana. 
2. Body, head and neck in erect posture. Close the mouth. 
3. Inhale air (chest expands and abdominal muscles are pulled in) and quickly exhale 10 times (1 set). While doing so a hissing sound is produced. 
4. When 1 set is on the verge of completion the final expulsion should be followed by a deepest possible inhalation. 
5. Retain breath as long as you can till there is some any discomfort. 
6. Follow it with a complete slow exhalation. This marks the end of one round. 
7. After a short rest (with normal breathing pattern) begin the next round. 

Time limit: 

Practice three rounds daily in the morning and evening. 

Advantages:

• Decreases anxiety and depression
• Stimulates appetite
• Improves resistance power
• Gives warmth to the body
• Purifies 'Nadi' and awakens the 'Kundalini' quickly

Indications:

• Abdominal disorders
• Throat and chest infection

Note:

• In case you encounter any giddiness, stop the practice and take a few normal breaths. Continue after the giddiness has subsided.
• In summer, practice it in the morning only during cool hours.
• Those wishing to practice it in the long-term and in an intense manner, should live on 'Khichdi', and take an Enema ('Bhasti') in the morning before starting the practice.
• People suffering from heart or lung disorders should do it slowly.

7. Humming Breath (Bhramari)

 Its name is derived from the fact that a sound like that of 'humming of bees' is produced when it is practiced.

Steps: 

1. Upright position in a comfortable asana like Padma-asana or Swastika-asana. Keep the neck and back erect.
2. Place your thumbs on the ears, index fingers just above the eyebrows (near the sinuses) and the remaining three fingers on the eyes. The finger-tips should slightly press the ridge of the nose on each side.
3. Inhale and exhale air rapidly through both the nostrils, making a humming sound resembling that of a Bee ('Bhramara'). Concomitantly chant 'Om'.
4. The process can be continued till you perspire profusely. 
5. Next inhale through both the nostrils and retain the breath as long as you can, till there is some discomfort. 
6. Exhale slowly through both the nostrils. 

Time limit: 

Beginners may practice it 3 times, and advanced practitioners 11-21 times.

Advantages:

• Improves speech and voice-quality
• Helps in the achievement of ultimate peace ('Samadhi')

Indications:

• Sinusitis
• Hypertension
• Depression
• Stress

Contraindications

• Epilepsy
• Head injury
• Brain tumor
• Migraine
• Severe or persistent headaches

8. Supreme Breath ('Murcha Pranayama') 

Steps: 

1. Upright position in a comfortable asana like Padma-asana. 
2. Close the eyes and concentrate on the space between the 2 eyebrows ('Trikuti'). 
3. Inhale slowly through the mouth and retain the breath till you feel faint. 
4. Sever off your connection with the surroundings and focus on the center-point between the 2 eyebrows.
5. Apply the chin on the chest and then exhale slowly. 

Advantages:

• Practice without distraction endows divine happiness
• Makes you feel pleasant and relaxed

Indications:

• Anxiety
• Depression
• Mental disorders

9. Unconditioned Breath ('Kevala Kumbhaka') 

Perfection in Tandem breathing (mentioned earlier) paves the way for Kevala Kumbhaka. Thus, an existence devoid of inhalation and exhalation and unconditioned by space, time and number is unconditioned breath.

Steps: 

1. Upright position in a comfortable asana like Padma-asana.
2. It involves the sudden stopping of the breath without resorting to inhalation or exhalation.

Advantages:

• Attainment of Raja Yoga and perfection in Hath Yoga
• Arousal of Kundalini Shakti
• Cures diseases and promotes longevity

10. Alternate Breath

A simple, yet scientific exercise that can be practiced virtually anywhere. It is based on the fact that we alternate between the two nostrils when we breathe. 

Steps: 

1. Upright position in a comfortable asana like Padma-asana. Tilt your head slightly forward.

2. First half round:

• Fold the index and middle fingers of the right hand into its palm. The other fingers should be extended.
• Close the right nostril with your right thumb.
• Inhale through the left nostril for a definite period of time – say 5 seconds.
• Close the left nostril with the right ring-finger and little-finger.
• Concurrently remove your thumb from the right nostril, and exhale.
• This is to be done for twice the inhalation period, i.e. for 10 seconds.
• This completes the first half of one round. 3. Second half round
• Inhale through the right nostril for a definite period say 5 seconds.
• Close the right nostril with the right thumb.
• Exhale through the left nostril for a period that is twice that of inhalation i.e. 10 seconds.
• This completes the other half of one round.

3. Second half round:

• Inhale through the right nostril for a definite period – say 5 seconds.
• Close the right nostril with your right thumb.
• Exhale through the left nostril for a period that is twice that of inhalation i.e. 10 seconds.
• This completes the other half of one round.

Time limit: 

If there is no discomfort of any kind after practicing as instructed above, increase the inhalation period gradually second-by-second. Correspondingly change the exhalation period.

Number of Rounds: 

Begin with 3 rounds. If there is no discomfort, 1 round can be added every week, until you are doing 7 rounds.

This exercise can be practiced as often as you wish, but do remember to do it at least once a day.

Advantages:

• Cleanses/detoxifies the Pranic channels
• Regulates Prana
• Imparts relaxation
• Improves mental functioning and alertness
• Imparts optimum creativity and optimum logical, verbal activity of the brain
• Improves sleep

Indications:

• Stress and related disorders
• Physical and mental fatigue
• Tension headaches

Contraindications

Cold/ Nasal block (Stuffed nose). Forced breathing is not advocated and can lead to complications.

The mind is a tool developed for our survival. You are not the mind, nor the body but rather one that can perceive the mind and the body. However, one is now constantly wagged around by the mind and its fears and desires. Often we find ourselves trampled in a parade of thoughts and washed around in a flood of emotions. Meditation is simply the process of returning Home to our true nature as the witnessing consciousness in which arise all thoughts and emotions. It is merely the fragrance of Being Human.

Meditation cannot be done, it will happen once we stop doing everything and anything. Now is all that exists, all else is merely grasping at the wind hoping to change things that are generally way beyond our control.

Talking about meditation and whether you believe you can do it or not, is pointless. When we rise above our mind, emotions and body, meditation will happen. Simply listening and following is enough. Meditation is in our very nature, and it happens for us all. Behind all those thoughts is a Witness. You are that Witness.

So please, let it happen.

 

• Guided Healing Meditation with Patrick from Samarpan foundation-Goa,India

• Guided Qi Gong energy healing meditation with our founder Apoorv

Advaita self discovering meditation with Apoorv"I AM THAT I AM"meditation with Dr Stephen Wollinsky

• Meditation 1

• Meditation 2

• Meditation 3

• Meditation 4

• Meditation 5