A hernia of the esophagus: causes, symptoms, diagnosis, diet and treatment

The term “hernia of the esophagus” refers to illness of a chronic nature, characterized by the displacement of some internal organs from the abdominal cavity into the chest through an enlarged opening of the diaphragm. According to statistics, suffer 22 % of the Russian population, the most frequently it is diagnosed in persons with abnormalities of the gastrointestinal tract. Timely treatment for the qualified medical assistance will help to avoid negative consequences, and surgical intervention.

General information

The Esophagus is a muscular tube that is hollow inside. It connects the throat and stomach. Its length is 23.5-25 cm of the Esophagus is necessary in order to swallowed food can enter the stomach.

A Muscular tube provided with two valves (sphincters). Through their work, the food moves only in one direction. Even if the person will long to stand on my head, the food will not fall back into the throat.

The Esophagus passes from the chest into the abdominal cavity through a hole in the diaphragm. This kind of partition, consisting of muscle tissue and tendons. The main task of the diaphragm - implementation of the respiratory process. It also divides the chest and abdominal cavity. Under the influence of various adverse factors violation occurs in the operation of the diaphragm. When this occurs, the shift up of the stomach, and part of the muscular tube can move in its hole along with the gastric contents. In this case, the diagnosis is “hernia of the esophagus”.

Cause of disease

In most cases, the pathology occurs in the background of age-related changes. Is the weakening of muscles and ligaments, lose their elasticity and they begin to function worse.

In addition, the causes of hernia of the esophagus may be the following factors:

• Genetic predisposition;
• Frequent episodes of flatulence;
• The period of carrying a child;
• Complicated deliveries;
• Abnormal accumulation of fluid in the abdominal cavity;
• Diseases of the respiratory system, accompanied by a prolonged cough;
• High intensity physical activity;
• Vomiting
• Congenital disorder of the stomach or esophagus;
• Obesity;
• Constipation is of a chronic nature;
• Constant overeating;
• Pathology of the digestive system;
• Scars resulting from burns (thermal or chemical);
• Injuries (both open and closed);
• Uncontrolled taking of some medicines;
• Smoking;
• Excessive coffee drinking.
  

Classification

Depending on the mechanism of development and anatomical features, hernia of the esophagus can be:

1. Moving.
2. Paraesophageal.
3. Mixed.

Currently the most frequently diagnosed sliding hernia of the esophagus. It is characterized by penetration into thoracic cavity kardiya, a small part of the bottom of the stomach and of the muscular tube. If you change the person the position of the body organs are returned to their normal position. But it happens so that they can't cope on their own. In such situations it is accepted to speak about the pathology of a fixed nature.

Paraesophageal hernia is characterized by the fact that a large part of the stomach lies in the chest cavity. The esophagus and the lower sphincter remains stationary. Such a hernia often trapped. This process is accompanied by the appearance of distinct symptoms.

A Disease of mixed character combines features and moving, and paraesophageal hernias. This disease usually classified depending on how much the internal organs have shifted from the abdominal cavity into the chest.

There are 3 degrees of hernia of the esophagus mixed character:

• I. the Stomach is slightly lifted and comes into contact with the diaphragm. Kardiya remains in the normal position. In the thoracic cavity is the lower part of the esophagus.
• II. To the diaphragm is tight and stomach, and kardiya. In the chest cavity is still only the lower part of the muscular tube.
• III. Significantly shifted the esophagus, kardiya and a large part of the stomach. Often the chest cavity is also penetrating loops of the small bowel.

On the Basis of the bodies that form the hernia, they are divided into the following types:

1. Sliding. They may be esophageal, or gastric cardiophorinae.
2. Okolovodnye. They are divided into fundalini and the antrum.

Each of them has a different severity of symptoms.

Symptoms

A hernia of the esophagus at the initial stage of development does not manifest itself. As growth begins to feel the first worrying signs.

The Main symptoms of hernia of the esophagus are as follows:

• Heartburn. It may be different intensity. Most often heartburn occurs after meals and when the patient takes a horizontal position.
• Pain. Their character can be cutting, blunt, piercing or burning. Most often pain occurs in the chest, rarely in the epigastrium or hypochondrium. When hernia incarceration she is a sharp character.
• Dysphagia. This condition is characterized by obstruction of passage of food through the muscular tube to the stomach. Patients note a feeling ofdiscomfort associated with stuck food in the esophagus.
• Burp. Its predecessor is the sense of fullness in the upper abdomen.
• Hoarseness in voice, pain in the language. The States result from the reflux of gastric juice into the mouth, which occurs peptic burn.
• Hiccups. It is long lasting.
• Cough.
• Asthma.
• Failure of cardiac rhythm.

Patients rarely exhibit all the symptoms at once. The set of features also depends on the type of pathology.

Diagnostics

Information about what to do in case of hernia of the esophagus, must provide a doctor. At the first disturbing symptoms you must consult a gastroenterologist.

In the course of primary reception, the doctor interviews the patient. Students must provide information about all the available symptoms. Based on the results of the survey, the doctor prepares the direction of the survey.

It is carried out using the following instrumental methods of diagnostics:

1. EGD. The essence of the method consists in introducing a flexible tube into the esophagus and stomach through the mouth. The duration usually does not exceed 5 minutes.
2. X-ray examination. The patient is positioned on a horizontal surface, after which the doctor makes the. After that, the person needs to accept suspension of barium. The technician then makes again a series of pictures with which to assess the nature of the motion of matter.
3. Daily pH-metry. On the patient's skin is set to the electrode, and in the nasal passage introduces the probe. After that, they connect to the unit, which registers a measure of the acidity of the stomach and esophagus. It the patient wears on the belt during the day.

Based On the results of the diagnosis, the doctor is the most effective treatment of hernia of the esophagus. Operation is assigned very rarely. As a rule, surgery is indicated for the ineffectiveness of drug therapy in advanced cases.

Medication

The Goal of therapy is the lessening of severity of symptoms and prevent complications.

Usually, the physician prescribes medicines of the following:

• Get rid of heartburn;
• Resolves the pain;
• Reduce the degree of gastric secretions;
• Lowering the acidity level;
• Protect the mucous membrane.

Currently, the pharmaceutical market there are many types of drugs with a similar action. Each of them has its contraindications, in connection with which only the doctor can prescribe certain medicines, taking into account individual peculiarities of the health of each patient.

Diet

Diet is important in disease, as in most cases it is accompanied by episodes of gastroesophageal reflux.

From the menu when the hernia of the esophagus is necessary to exclude:

• Products that increase the pH. These include: fatty, smoked, salted, fried, spicy food; coffee; black tea; citrus fruit; pastries; confectionery.
• Products contributing to the increase gas: beans, cabbage, radish, mushrooms, cereals, grapes, milk, pears.
• All kinds of herbs and spices.
• Fizzy drinks.
• Alcohol.

With regular diet the patient's condition significantly improved.

Physiotherapy

Gymnastics is important in the fight against disease. The purpose of its execution is to get rid of unpleasant symptoms and strengthen the musculo-ligamentous apparatus.

Exercises:

1. Lie on side, lift the head and hold her hand. On a deep breath bulging belly, exhale - relax.
2. Kneel down. On the inhale slowly do a forward bend, exhale return to the starting position.
3. Lie on your back. Keeping the normal rhythm of breathing, turn the torso to the right and left.
4. To Take a position standing, arms stretched along the body, the back should be smooth. Slowly rotate the torso left and right, but so that the lower part of the body remained motionless.
5. Stand on the knees, fixed in the floor with his hands. Sliding his hands across the floor, to go down slowly.

Each exercise should be performed 5 times. Contraindications to the gym are pronounced heartburn and pain in the sternum.

Surgical treatment

With the ineffectiveness of conservative therapy and the presence of hernia of large size, surgical intervention.

It is currently performed using one of the following methods:

• Laparoscopy. A hernia of the esophagus is removed after lowering of the upper part of the stomach back into the abdominal cavity. After that the aperture opening is sutured. Surgery less traumatic. In addition, after the operation the patient returns quite quickly to normal life.
• Method Belsi. Access to the hernia through the incision made to the left of the sternum. During the operation the doctor secures to the diaphragm the lower part of the esophagus and its anterior wall sutured the fundus of the stomach.
The
• Gastrocardialny. An incision is made in the middle of the abdomen just above the navel. During the operation the upper part of the stomach and the esophagus sutured to any subphrenic structure, for example, to predatelei fascia.
• Method of Allison. Its essence consists in the suturing of the legs of the diaphragm. Currently is rarely used.

Surgical intervention is contraindicated in pregnancy and in severe other existing pathologies.

Non-traditional methods

The popular treatment of hernia of the esophagus does not exclude the necessity of seeking medical attention. With its help it is possible to improve the General condition by loosening the degree of manifestation of symptoms.

The Most effective recipes:

• To make tea of chamomile. Drink it after each meal in small SIPS.
• To Prepare 1 tsp of carrot seeds and pour 200 ml of boiling water. Allow to cool and make the infusion in the morning after a meal.
• Take 1 tablespoon of flax seeds and pour 3 tbsp of cold water. Let stand 8-10 h. after the specified amount of time to warm up the resulting mass and eat it carefully chewing the seeds.

In severe heartburn can be added in a glass of water 1 tsp of baking soda and drink it. But this method should be resorted to very rarely. It also is contraindicated in pregnant women.

Consequences

Now, as to what threat a hernia of the esophagus. In the absence of timely treatment in the best case it leads to inflammation of the mucous membrane and the muscle pinched the tube or of the stomach. Hernia is also accompanied by the development of reflux esophagitis, which is often the pathology of malignant character.

Recommendations for patients

The Man diagnosed with the disease, you should regularly adhere to the following rules:

• Do not overeat;
• Sleep on a high pillow;
• To prevent the occurrence of constipation;
• Find time every day for physical therapy;
• Reduce body mass in obesity;
• Observe sparing diet.

Follow these guidelines in most cases, allows to avoid surgical intervention.

In conclusion

A hernia of the esophagus is a disease characterized by the displacement of some internal organs of the abdominal cavity in the breast. Its development is accompanied by severe pain, heartburn, belching, discomfort when swallowing food. If you experience first warning symptoms, you must consult a gastroenterologist. The doctor will prescribe the examination and its results will be the most effective treatment regimen.