esophageal hernia ( hiatal ) symptoms
Hernia esophagus (passage leading from throat to the stomach) or hiatal hernia diaphragm is a condition in which the gastroesophageal junction (the place of transition), or part of the stomach moves through the esophageal opening of the diaphragm into the chest cavity,It leads to the critical state of the patient, requiring rapid diagnosis and treatment.The esophagus may be broken when severe vomiting, contact chemicals, injury, or other diseases of the esophagus, such as esophageal cancer.Pain in the chest by a large gap in the esophagus may resemble symptoms of heart attack.
a healthy person hiatal its edge tightly covers the esophagus, reliably separating the chest and abdominal cavity.Relaxation of the diaphragm muscles contributes to the appearance of free space between the outer wall of the esophagus and esophageal aperture edge.At the heart of this process may underlie congenital weakness of the muscles of the diaphragm, its inflammatory diseases, disorders of the nervous regulation of musc
most common hiatal hernia occurs in the elderly;aging is accompanied by a gradual relaxation of the tone of the tissues.Often this condition is seen in patients with prolapse of internal organs (visceroptosia);people for a long time to do hard physical work;patients with a sharp and considerable emaciation, and muscular dystrophy.Leakage
esophageal contents, such as saliva, vomit or food into the surrounding tissue, can lead to bacterial infection and abscess.Treatment usually comprises the step of recovery and disposal gap esophageal contents from the surrounding tissues;during surgery using antibiotics to prevent bacterial infection or to fight it.If the esophagus was heavily damaged, it may be necessary surgical removal of part or all of the esophagus.
In practice, physicians often have to deal with the pain, which are usually diagnosed with a hiatal hernia.The upper part of the stomach is displaced into the thoracic cavity through the esophageal aperture.This situation is unnatural for the stomach, as this process of digestion becomes painful.Also contained in the stomach acid enters the esophagus and in contact with its wall, causes severe heartburn.
If the stomach is normally acid does not have access to the esophagus: firstly, intestinal peristalsis directed towards the rectum, and secondly, the person has a valve 2, which block access digestible food back into the esophagus.The first of these valves is inside, between the stomach and esophagus, and the second - on the outside, in the diaphragm in the place where the stomach connects with the esophagus.Described valves simultaneously relax in the moment pass them food passes into the stomach, and in the rest of the time they are tightly closed, which prevents the regurgitation of food (its movement in the direction opposite to the physiological).
Gastrointestinal tract can be schematically represented in the form of a long hollow tube that begins in the mouth and ending with the opening of the rectum.Various bodies of this complex system have unique functional characteristics that makes the digestion of food and waste disposal in a well-established physiological process.This process is controlled by the so-called local hormones that are distributed at each stage of digestion, separation necessary enzymes and so on. D.
At the initial stage of digestion of food allocated gastric juice containing acid and active enzymes that promotes the breakdown of proteins and other indigestible food.Thereafter, the liquid, but quite active stomach contents into the upper intestine.There is so-called the pyloric valve, which regulates the interaction of the two ends of the gastrointestinal tract.
pancreas that produce insulin, also highlights the intestine several types of enzymes, but its most important function is the allocation of a special alkali neutralizing stomach acid.For the production of alkali pancreas need a lot of water, which it extracts from the bloodstream.In chronic shortage of water, this process is not very effective, so the pyloric valve, not getting on the nervous system of clear signals, disclosed only partially, since its main function - to prevent the penetration of the intestine active gastric environment.Described condition causes the characteristic pain, the cause of which is experienced by the body chronic thirst.
Depending on the amount you drink in our body produces a corresponding amount of a particular substance called motilin.The more water we drink, the more motilin enters the gastrointestinal tract.The effect of this substance is to stimulate motility, causing timely closing or opening the valves throughout the gastrointestinal tract.
If the body receives required for the process of digestion of water, the pancreas secretes sufficient alkali solution to prepare the upper intestine to the adoption of acidic gastric contents.Under normal circumstances, the time was called the pyloric valve to the intestines could take digested food in the stomach and in the right quantity produced motilin clearly coordinating these actions.
Digestive problems arise if the body is chronically short of water to digest food.In this case, the system does not allow to get the acidic stomach contents to the intestines, and acid neutralization mechanism operates inefficiently.And the first thing that happens as a result, - a change in the intensity of reduction valves located near the stomach.In particular, the pyloric valve begins to shrink, and the outer and inner valve located between the stomach and the intestines, on the contrary, relax.In this case, part of stomach acid into the esophagus and cause pain, we call heartburn.
In some cases, the phrenic lethargy valve is so significant that the upper part of the stomach can pass through it in the chest, which is called hiatal hernia.In addition, food can not remain permanently in the stomach, and if you can not get into the bowels she remains the only way - through the mouth.As a result, changes in the direction of peristalsis occurs unpleasant phenomenon - vomiting.
symptoms at small sizes hernial opening may be missing for a long time (stage asymptomatic hiatal hernia).As the hernia hole and penetrate through it into the chest cavity all large-volume tissue wall of the gastroesophageal junction and stomach wall progressively developed signs of disease.The most typical complaints - pain in the chest or upper abdomen (the stomach).The cause of pain is mechanical factors are: stretching of the esophagus, the tension of tissues in the body wall retractions result in the hernial opening, the pressure on the hernia sac surrounding tissue.
Pain may spread (to give, radiate) up, down, or in the back.Very often pain resemble (pretend to) chest pain of angina pectoris.As a rule, the occurrence of pain in patients with hiatal hernia associated with food and comes after a heavy meal, especially if followed by the patient rests lying.
most severe, excruciating pain appear if the hiatal hernia is accompanied by inflammation of the mucous membrane of the esophagus (esophagitis).This occurs as a result of frequent or continuous casting of acidic gastric content into the lower esophagus and its chemical irritation mucosa hydrochloric acid.Esophagitis contributes to patients with heartburn, belching, regurgitation of food, burning or impede the passage of food during swallowing.
Long and unbearable pain during hiatal hernia may indicate the most frequent complications of the disease - the infringement, in the compression of the hernia hernial ring.Infringement of blood circulation in the tissues of the disadvantaged as a result of compression can lead to serious consequences necrosis (necrosis) of the wall of the stomach or esophagus.
should be examined by a gastroenterologist (or therapist) and surgeon.Reliable diagnostic methods hiatal hernia are X-rays of the stomach and fibrogastroscopy.
• X-ray of the breast.You may be required that you take an X-ray contrast agent before, so that esophageal rupture site could be clearly identified.
Treatment is usually conservative, but in severe cases of the disease, surgical intervention.In carrying out the doctor's recommendation, it must be remembered that observance of diet, physical activity and avoiding harmful habits, you can pretty much achieve the prevention of the progression of the disease, substantially ease the course of the pathological process.In this regard, we recommend frequent small feedings in small portions of food.In the case of a combination of hiatal hernia and esophagitis should stick to a diet number 1. In the remaining patients from the diet is necessary to eliminate the sharp, sour, salty foods, fizzy drinks, foods that cause flatulence (beans, rye bread, cabbage, etc.)
By limiting caloric intake should try to reduce the weight, which will help to significantly reduce existing symptoms associated with a hernia of the diaphragm aperture of the food and esophagitis.Drinking alcohol and smoking is contraindicated.It should refrain from the use of black coffee and strong tea.After the meal you can not go to work or engage in heavy, physical activity associated with the torso forward.In addition, it is desirable that during sleep the patient's head was 10-15 cm above the trunk that will prevent wicking and threw the acid gastric contents into the esophagus, to prevent the occurrence of symptoms of hiatal hernia.Patients who had undergone surgical treatment of this disorder, after surgery should comply with all the recommendations listed above.