HH - what is it? The symptoms and treatment of HH

Let's Start with the fact that not everyone is familiar with the abbreviation HH. What is it?

Hernia hiatal (all the same HH for short) or simply a hernia of the esophagus, – nothing more than a disease characterized by the displacement of any organ (located in the abdominal cavity) through the food hole in the diaphragm to the chest cavity. This organ is nearly always the stomach.

Hernia of the esophagus may be congenital or acquired in nature and has distinct clinical manifestations. Congenital hernia is less common than the acquired. GPML may appear for many reasons.

In this article we will look at what is HH, symptoms, treatment and postoperative period of this disease.

General characteristics of the disease

Aperture (which is relevant GPML) has the form of a dome-shaped septum, which consists of two types of tissue: muscle and connective. This is the partition that separates the abdominal cavity from the chest. Bundles of muscles in the iris form a small opening through which the esophagus passes. And you probably already understand why this hole is called the esophageal.

Back to the hernia hiatal (HH). What is it? It is the result of displacement of some organs from the abdominal cavity into the chest through the esophageal opening of the diaphragm. And it happens because of his weakness.

Hernia hiatal – are so common disease that can successfully compete with cholecystitis, pancreatitis or duodenal ulcers. However, according to its severity it will also compete with them.

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On the age of the patients, we can say that most often the disease develops in people older than 60 years. As for sex – women suffer more from this disease than men.

Classification

Hernia of the esophagus klassificeret in accordance with their features. There are the following types:

• Floating or fixed hernias (only for axial hernias and paraesophageal). In particular, paraesophageal hernia – forms when part of the stomach is right next to the esophagus above the diaphragm. And kardiya stomach concentrated under the diaphragm. Axial HH – esophageal, cardiac, Subtotal or totalsolution. Distinguish even a sliding hernia, particularly that in this type formed inguinal hernia treatment bag lined with peritoneum. It differs from the axial to the fact that last bag there. Axial hernia can move freely with body movements.
• Paraesophageal hernia (pontalina or antral).
• Congenital hernia, the cause of which is short esophagus with an anomaly in development.
• Hernia of other types (intestinal, omental, etc.).

This disease can also be classified by degree:

Esophageal hernia in the first degree. is Characterized by the fact that the kardiya of the stomach is at the level of the diaphragm, the stomach is slightly raised and firmly adherent to the diaphragm. Abdominal esophagus located in the thoracic cavity above the diaphragm.

Hiatal hernia in the second degree. Clinical picture: abdominal esophagus in the thoracic cavity and the esophageal opening is already part of the stomach.

Hiatal hernia third degree. the Most severe degree, is characterized by the presence of the esophagus, the cardia, and sometimes even of the body and fundus of the stomach above the diaphragm.

Causes of hernia of the esophagus

Previously it was mentioned that the causes of hernia hiatal much. However, most often are the following factors:

• Thinning of the connective tissue ligaments that is caused by changes in age-specific or triggered by some other processes.
• Systematic or simultaneous chronic pressure increase in most of the abdominal cavity. The reasons for the increase in pressure can be chronic constipation, heavy physical exertion (e.g. lifting heavy objects), blunt abdominal trauma, and more.
• Chronic diseases that directly affect the digestive system and can disrupt the motility of the gallbladder, stomach or duodenum.
• Disorders of the endocrine glands (endocrinopathies).
• Bad habits (Smoking, alcohol consumption), older age of the person.

HH: symptoms

Depending on the clinical manifestations of the disease distinguish the following forms of hernia hiatal:

- HH asymptomatic;

- GPML, for the pathology in which is caused by the syndrome of insufficiency of the cardia;

- HH that are not characterized by the presence of the syndrome of insufficiency of the cardia;

- HH, which appear as a complication of other gastrointestinal diseases (or just develop on their background);

- HH paraesophageal;

congenital HH is characterized by short esophagus.

It Is necessary to consider each type of HH (symptoms of each type) separately:

• Asymptomatic hernia. As you know the name of this form of the disease, any signs of HH in these cases do not exist. Basically, it refers to the cardiac or esophageal hernia that is smallthe size of formations. Detect this form of hernia is completely random, often – during a full examination, and sometimes people are not even aware of the fact that he has HH - symptoms (treatment discuss below) because hernias do not exist.
• HH syndrome of cardiac insufficiency. The Most common symptoms of HH cardiac – heartburn and pain after eating, and when abrupt changes of body position of the patient. It should also be noted that these symptoms often occur at night, which can be explained by peculiarity of the increase of vagal tone, and relaxation of the lower esophageal sphincter.

Regarding the intensity of the heartburn, we can say that it can be easy (in this case, it can be treated with antacids), and quite painful (so much so that even deprives a person of health). Its intensity is determined by a range of different factors, and, first and foremost, these include acid peptic, which is peculiar to the gastric juice. Also it can affect the stretching of the esophagus and reflux of duodenal contents into it (primarily bile).

The Most eye-catching symptom hernia hiatal, of course, pain. It is worth noting that it depends on the causes of heartburn. Basically, it appears identical reasons. The pain is localized mainly in the region behind the sternum, and is enhanced when the patient takes a prone position. In addition to this situation the pain also cause the trunk bending forward and backward. Her character may be different, most often it is the pricking, cutting or burning sensations.

The Regurgitation of gastric contents – is also quite frequent symptom of HH. What is it? This process of reflux of stomach contents into the mouth. A very unpleasant phenomenon, and stomach contents can enter the trachea or bronchi.

Again, a few words about pain. The real pain is only half of the patients, and in 25% of cases it pseudoternary pain, which is localized in the region of the heart. It can be cured with nitroglycerine. In addition to this pain, patients may feel discomfort in the interscapular, hepatopancreatoduodenal regions and area's-Minkowski, etc.

Also, about 70% of patients with a hiatal hernia of the diaphragm (especially if it's cardiac GPML) faced with such symptoms as belching. Most often it occurs contents of the stomach, and its predecessor is an unpleasant sensation characteristic of fullness in the epigastric region, which means air swallowing. Brings an unpleasant bitter taste. And antispasmodics and analgesics in this case to remove these feelings I can't.

Also in 40% of patients have obstruction of passage of food along the esophagus, even when taking liquid food. Although it is worth noting that the solid food passes quite easily. People suffering from this symptom most often it manifests itself from very hot or very cold food. Therefore, when the hernia is recommended to only eat food that has a temperature of the body.

About 4% of HH patients suffer from hiccups on the background of the axial form of hernia. Only it's not quite the usual hiccups. Its main feature can be considered of significant duration (can last weeks or even months). To get rid of it is not so simple, and to help in the case only by a qualified specialist.

Some patients also experience glossalgia (sore tongue) and hoarseness, which is a consequence of peptic burn the contents of the stomach ejected during regurgitation.

In Addition to the foregoing we can add that the symptoms of the hernia is directly dependent on its size.

• HH without symptom of cardiac insufficiency. In such cases, more manifest symptoms of related illnesses and not the hernia. Signs of this form of hernia will be pericardial, or retrosternally epigastric pain appearing immediately after a meal or after lifting weights.

Such pain can Last for several days. To neutralize them you can use non-narcotic analgesics (with the exception of tincture of Valerian, because it has no effect), or nitroglycerin. Also the pain stops when food or liquid.

• HH, which appear as a complication or just develop on the background of other diseases of the gastrointestinal tract. Such diseases are most often the stomach ulcer or duodenal ulcer. In this form of HH symptoms of the main disease and not the hernia.
• Paraesophageal HH. This form of hernia is characterized by the absence of any symptoms and signs. Most often diagnosis paraesophageal hernia happens randomly during General surveys. But when the hernia increases in size, appears esophageal compression (in other words, narrowing of the esophagus). In a few cases develops ezofagospazm (a disease in which disturbed peristalsis of the esophagus).

When the infringement paraesophageal hernias there is pain in the sternum or in the epigastrium.

• Congenital HH is characterized by short esophagus. In this form of hernia of the esophagus may be two options. In the first of them may develop the phenomenon of “thoracic stomach", which is characterized by the following forms:

-location in the chest;

- the thoracic localization of the stomach.

In the latter case, diagnosis is very difficult, this happens usually when surgical intervention or even at autopsy.

Possible complications

Hernia hiatal can cause a number of complications. Most often manifest as the following:

- gastritis or ulcer, the part of the stomach where the hernia (there is about 8% of cases);

- bleeding, anemia (there are 20% of cases);

- the introduction of the lower esophagus in the hernial SAC;

- shortening of the esophagus (usually found only with cardioesophageal forms);

- prolapse of the gastric mucosa into the esophagus (ie, retrograde prolapse);

- the infringement of a hernia (is the most difficult complication of all these).

Diagnosis

Experts Usually conduct several tests based on the results of which we can already diagnose "HH". What this tests:

• Fibrogastroscopy. it can help to understand the condition of the esophagus and stomach. Endoscopic signs of HH is determined by the doctor based on what he can diagnose and prescribe treatment.
• X-ray examination, which is conducted on the basis of barium contrast. Through this examination you can get an image of hernial protrusion, which is characteristic for each HH-level.
• PH-metry. This test is done to determine the level of acidity in the stomach. It is necessary in order to correctly assign the treatment of hernia.

Treatment of HH esophagus

Usually the treatment of hernia hiatal is using medicines, but in some cases (especially with complications) require surgical intervention.

As for drug treatments, it is to reduce stomach acid (with antacids), as well as decrease gastric secretion. It – the first task. Also when treatment is necessary to protect the mucous membrane of the stomach, which is also envisaged in the application of certain medications.

In the treatment assigned to a strict diet that you must adhere to unquestioningly. Basically, this diet is almost the same as for gastritis: nothing greasy, nothing spicy, sour, salty. Only healthy food such as vegetables, fruits, cereals, diet soups and broths, lean meats.

So, to eliminate heartburn and to reduce the gastric secretion can take the drug "Maalox". Which is very convenient, it is available not only in tablets but also in the form of gels, pills, suspensions. Each form of this tool a separate instructions for use, which can be found in any drugstore of your city.

It is Also possible to adopt such means as "Rennie" or "Gastal". To eliminate already appeared of heartburn is enough to take one tablet and prevention - 4 tablets a day (an hour after eating). However, remember that these drugs treat the symptoms.

As for surgery, it involves the removal of hernial education.

For a more accurate diagnosis and treatment you need to consult a doctor (surgeon or gastroenterologist).

Treatment of folk remedies

The GPML Treatment folk remedies will not give the desired results, since in most cases the sick person and need serious medications or even surgery.

That is, a hernia is any folk remedies to remove not able. The only thing you can apply them – to relieve the pain.

Some decoctions of herbs will help reduce pain. Here are some folk remedies that will help in the fight against hernia:

- a Decoction of marshmallow root. Pour about 20 g of crushed marshmallow root a Cup of boiling water and let it brew.

- Mix 30 drops of Alcohol tincture of propolis and 50 ml of milk. Take 2 times a day.

- flatulence helps A decoction of carrot seeds. Pour one gram seeds 2 cups hot water and let the mixture steep for about half an hour. Need to drink with the seed.

Remember, before taking anything (especially national resources) it is necessary to consult with your doctor.

Also use folk remedies to get rid of heartburn, hiccups and other symptoms of HH. But remember that this is only a temporary result, and treat the cause of the disease, not the symptoms.

Hernia of the esophagus after surgery

As mentioned above, in some cases, a hiatal hernia of the diaphragm requires surgical intervention. GPML-operation reviews, which is ambiguous, really can save a life in the most severe cases.

But what to do when the surgery is already done? How to comply with the postoperative regime? How soon you can return to your normal life?

GPML after surgery require care and comprehensive treatment and preventive measures.

On the first day after surgery, the patients need a checkup therapist and electrocardiography. On the second day is chest x-ray. On the third – General full blood count and biochemical research, the indications of which designate the sonography.

Twice a day to the patients to do simple exercises breathing exercises and medical gymnastics.

Asdrug therapy is the following. It involves the insertion of saline intravenously in a volume up to 1800 ml per day. All patients after surgery, take antibiotics.

Trocaria wounds are treated with alcohol and bind in a day.

Just a day after the surgery, patients can already drink water, and starting from the second day to take liquid food. The postoperative period lasts about 3 months.

How is she GPML-operation (reviews of which are different, depending on the severity of the disease) we have already mentioned above. It is to remove the hernia.

Conclusion

So, now you're not frightened, if will see somewhere the abbreviation HH. What it is and how it manifests itself, you already know.

It Remains only to sum up that the disease is very serious. Self-treatment, especially treatment of folk remedies, quite dangerous and can cause severe complications.

But, alas, from complications nobody is insured, as some forms of HH are asymptomatic. The only way out – to pass a full examination in the hospital at least once a year. So you will be able to detect this unpleasant disease.