Why is it strictly prohibited to intake a sugary treat after a Hiatal Hernial Surgery?
To understand this, let’s first profoundly dive into what Hernia and Hiatal Hernial are!
What is Hernia?
Hernia is not an illness but a condition that arises due to a profound fascial defect and causes peritoneal sac protrusion via a musculoaponeurotic barrier.
Simply, it is an aberration in muscle action. It generally manifests when the layer of smooth muscles that protects and supports your organs and alimentary canal weakens, causing that specific organ or your gut to pop out.
Moreover, hernias can occur in practically any area of the human gastrointestinal anatomy since we have a tubular digestive system. It is initially less harmful but becomes painful when the muscular tissue near the hernia loses blood flow, is ripped, strained or gets strangulated.
Too, a small hernia is more dangerous than a large hernia because it has a higher percentage of muscle strangulation, leading to obstruction and necrosis. If any muscle loses blood supply, its cells die (necrosis). Such a condition is a medical emergency and requires urgent surgery.
Hiatal Hernia: Such a type of hernia develops through your esophageal hiatus. It is a hernia which develops between your oesophagus and your stomach.
Moreover, there are 2 types of Hiatal Hernias. The first type is associated with Sliding Esophageal Hiatal Hernia, and the second type is associated with Paraoesophageal Hiatal Hernia.
Sliding Esophageal Hiatal Hernia (Type I) :
The Sliding Esophageal Hiatal Hernias develop when the stomach and GE junction herniate into the thorax through the oesophagal hiatus, resulting in a type I hiatal hernia.
Furthermore, Sliding Esophageal Hiatal Hernia has a high incidence rate of over 90%. Further, it is diagnosed through Upper Gastrointestinal series, manometry and esophagogastroduodenoscopy (EGD) with biopsy for esophagitis.
Symptoms:
Most patients are asymptomatic, i.e., they do not show any symptoms, but the condition can cause acid reflux, dysphagia (from inflammatory oedema), esophagitis, and pulmonary problems secondary to aspiration.
Complications:
Its complications are Reflux esophagitis, Barrett’s oesophagus, cancer and stricture formation, and aspiration pneumonia; it can also result in Upper gastrointestinal bleeding from oesophagal ulcerations.
Treatment:
85% of cases are medically treated with antacids, H2 blockers/PPIs, head elevation before meals, light meals, and no eating before bedtime. Despite effective medical care, 15% of patients require surgery due to chronic symptoms.
Furthermore, its surgical treatment involves Laparoscopic Nissen fundoplication (LAP NISSEN) involve wrapping the fundus around the Lower oesophagal sphincter and suturing it in place.
Paraoesophageal Hiatal Hernia (TYPE II):
The herniation of all or part of the stomach through the oesophagal hiatus into the thorax without displacement of the gastroesophageal junction is known as para oesophagal hiatal hernia; it is also known as type II hiatal hernia.
Also, the incidence rate of Paraoesophageal Hiatal Hernia (Type II) is less than 5% compared to the Type I hernia.
Symptoms:
Its symptoms are derived from mechanical obstruction, dysphagia, stasis, gastric ulcer, and strangulation; many cases are asymptomatic and not associated with Reflux because of a relatively normal position of the GE junction.
Complications:
The complications of Paraoesophageal Hiatal Hernia are haemorrhage, incarceration, obstruction, and strangulation.
Treatment:
Unfortunately, its treatment is always surgical because of the frequency and severity of potential complications.
Now Let’s look at why we can’t eat Chocolates after a Hiatal Hernial Surgery!
Lactose Intolerance:
Chocolates are dairy products and contain Lactose sugar. Many people around us are lactose intolerant, which means they cannot digest any product with lactose.
Moreover, when a dairy product is consumed by a person who is a victim of lactose intolerance, their digestive system gets upset, characterized by pain in the lower abdomen and diarrhoea. Such things can upset the stomach and cause pain in and around your hernial surgery.
Heartburn:
Eating chocolates or other dairy products triggers heartburn. Heartburn is also known as GERD (Gastroesophageal reflux disease), acid reflux or acid indigestion.
If you have had a Hiatal hernial surgery, your lower oesophagal sphincter’s function must be disrupted. The lower Esophageal sphincter (LES) functions as a valve or a one-way gate. It inhibits stomach fluids from flowing back to the oesophagus unless the brain initiates a peristaltic movement.
Further, when you consume food which requires a higher proportion of acids in your stomach to be broken down, those acids can flow back up. They can potentially burn the cells present in the epidermal lining of your oesophagus. Furthermore, it can trigger severe pain and cause complications during hiatal hernial surgery.
Chocolates contain fats, caffeine, sugar and an active ingredient termed Theobromine.
Fats:
Fats are also known as lipids or fatty acids. They are of two types, saturated and unsaturated. Saturated fats are solids at room temperature, and unsaturated fats are oils at room temperature, for example, olive oil.
Furthermore, fats have a complex structure with a carbon backbone, and the simplest is triglyceride, a three-carbon fat.
Also, saturated fatty acids are derived from animals, and unsaturated fatty acids are derived from animals.
Moreover, saturated fats are more dangerous as compared to unsaturated fats because they have the potential to clog your blood vessels. Stopping in blood vessels leads to blood flow blockage and can potentially cause myocardial Infarction (MI), heart failure, or Myocardial failure.
Further, fats are known to cause the release of several enzymes in your stomach to be digested. When these enzymes touch your surgical area, the cells near Hiatal hernial surgery cause a stimulus sent to the brain through neurons. In this response, the brain activates severe pain and pressure due to muscle contractions in your stomach.
Hence, it is recommended not to eat a fatty meal after the Hiatal Hernial Surgery.
Sugar:
Sugar is a type of carbohydrate. As the name suggests, carbohydrates mean “hydrated carbons”. They have a higher proportion of Carbon and Hydrogen bonds, yielding high energy on hydrolysis. There are 3 categories of Sugars based on their sweetness and their solubility.
Further, the simplest form of sugar is known as Monosaccharide. They are lovely in taste and are highly soluble in water. In nature, monosaccharides ranging from 3 carbon to 7 carbon are found. Additionally, the simplest example of a monosaccharide is Glucose, the main energy-providing compound in living things.
Furthermore, the second form of sugar is known as disaccharide or oligosaccharide. They are polymers and yield two monosaccharide molecules on hydrolysis. They are comparatively less sweet and soluble than monosaccharides and are widely found in nature. The disaccharide which is mainly found in nature is Cellulose.
The third type of sugar is known as Polysaccharide. Polysaccharides are neither sweet nor soluble in water.
Moreover, the breakage of Carbon-Hydrogen bonds requires a high amount of energy to be broken down. That is why stomach acids are released, as they are highly unstable and contain enough power to break the Carbon-Hydrogen bonds in a sugar molecule.
Furthermore, sugar can also irritate and cause inflammation and severe pain in your oesophagal lining because it causes gastroesophageal reflux disease and reduces lower oesophagal sphincter pressure, which causes the lower oesophagal sphincter to lose its functioning and cause stomach fluids, particularly acids, to flow back up and cause irritation in your oesophagal lining.
Likewise, sugar is also known to cause gas and bloating in the stomach, which increases pressure on your lower oesophagal sphincter, leading to gastrointestinal reflux disease.
Moreover, products containing sugar also cause stomach distention. Distention occurs when the muscles of the muscular layer of your GUT wall. Due to stomach distention, your oesophagus is prone to acid reflux.
This is precisely why doctors highly recommend rejecting a diet with higher proportions of Glucose or other forms of sugar in it.
Caffeine:
Caffeine is a type of alkaloid, and it is a non-toxic drug which is often found in many chocolate products around us. When we consume caffeine, it gets digested in the stomach and intestines, mainly the small intestine. Furthermore, caffeine dissolves in our blood and reaches the brain, binding to the Adenosine A receptors. The blockage of Adenosine A receptors makes it difficult for Adenosine, a neurotransmitter in Central Nervous System (CNS), to bind to the Adenosine A receptors.
Adenosine is a depressant neurotransmitter that lets our Parasympathetic nervous system take over. The parasympathetic nervous system is associated with resting conditions. It suppresses the heartbeat and induces sleep.
Conversely, caffeine is a stimulant type of neurotransmitter that temporarily boosts your brain and nervous system. It increases awareness and alertness of the body and influences the sympathetic nervous system to take over. The sympathetic nervous system is associated with a fight-or-flight response.
Moreover, caffeine also requires a highly acidic environment in your stomach to be broken down. The release of acid through the gastric glands of your gut could lead to Gastroesophageal acid reflux, and it can irritate the lateral part of your oesophagus, exactly where you have had the surgery for Hiatus Hernia.
Additionally, this makes physicians advise against eating chocolate since it contains chemicals that might aggravate your symptoms.
Theobromine:
Theobromine is an alkaloid that is related to caffeine. Cocoa Beans are the primary component of chocolate. Theobromine levels in cocoa beans range from moderate to high.
Moreover, Theobromine also has a stimulatory function, and it works by stimulating the brain and central nervous system to be active and aware of the surroundings.
Further, Theobromine is a volatile compound that produces a lot of heat during its breakdown in the stomach. This heat can irritate your oesophagal lining and initiate severe pain in and around your Hiatal Hernia.
Furthermore, Theobromine can also trigger acid reflux. Acid reflux is a significant threat to Hiatal Hernial Surgery and causes complications.
This is why specialists advise against consuming chocolate since it contains Theobromine, which can harm your oesophagus wall and hinder your recovery from surgery.
Summary:
If you have Hiatal Hernia, it is advised not to consume chocolate as it can potentially harm your surgery and cause complications.
Chocolate ingredients such as sugars and Theobromine are known to cause conditions such as increased acid production and an increase or decrease in pressure of your Lower Esophageal Sphincter, which causes acid to flow backwards and cause burn and severe pain due to its low pH, all of which may prolong the recovery period of your surgery and lead to discomfort and awkwardness for people who just had a Hiatal Hernial Surgery.
For more information on Hiatal Hernia, its surgery, and post-operative dietary recommendations, refer to reputable sources like the Mayo Clinic, National Institute of Diabetes and Digestive and Kidney Diseases, WebMD, Harvard Health Publishing, and the Cleveland Clinic. These sources provide expert guidance and reliable information on the subject.
Frequently Asked Questions
What is a Hiatal Hernia?
A Hiatal Hernia is a condition where a portion of the stomach protrudes through the diaphragm into the chest cavity, specifically through the esophageal hiatus.
What are the types of Hiatal Hernias?
There are two types of Hiatal Hernias – Sliding Esophageal Hiatal Hernia (Type I) and Paraoesophageal Hiatal Hernia (Type II).
How are Sliding Esophageal Hiatal Hernias diagnosed?
Sliding Esophageal Hiatal Hernias are diagnosed using methods such as Upper Gastrointestinal series, manometry, and esophagogastroduodenoscopy (EGD) with biopsy for esophagitis.
What are the symptoms of Paraoesophageal Hiatal Hernias?
Paraoesophageal Hiatal Hernias can cause symptoms like dysphagia, gastric ulcer, and strangulation, though many cases may be asymptomatic.
Can I eat chocolates after Hiatal Hernia surgery?
It is not recommended to consume chocolates after Hiatal Hernia surgery due to potential complications. Chocolates contain ingredients like sugars and theobromine, which can increase acid production and disrupt the lower esophageal sphincter, leading to discomfort and hindering the recovery process after the surgery.