The stomach is one of the key organs on the health of which the comfort and full human life directly depend. The appearance of a sliding hernia can have a noticeable negative effect on this organ. It is impossible to ignore such a problem, so it is important to familiarize yourself with the symptoms of pathology and treatment methods.
Hiatal hernia
This disease can be defined as a pathology, the essence of which is reduced to the displacement of one or more organs located in the peritoneum. The movement itself is carried out through the opening of the esophagus in the diaphragm in the direction of the chest cavity. As a result, the organs that should be in the abdominal cavity appear in the chest area and noticeably bulge.
Esophageal hernia (the second name of the disease) can even lead to partial slippage of the stomach, which ultimately ends up in the chest area.
This condition sometimes provokes the development of acid reflux in the patient, that is, the outflow of gastric acid into the esophagus. Most of these diagnoses are made to patients older than 50 years. It is worth noting that women suffer from such a problem as axial hernia, much more often than the stronger sex.
Causes of occurrence
The displacement of the internal organs may be the result of several factors that should be given attention. Here are the reasons for the appearance of this pathology:
- too strong loads leading to overstrain of the peritoneum;
- prolonged cough;
- excess weight;
- pathology of the development of the diaphragm of the esophageal opening, which has an inborn nature;
- changes associated with the aging process;
- constant constipation;
- a noticeable increase in pressure inside the peritoneum;
- operations and various injuries;
- In some cases, a hiatal hernia may be due to pregnancy or difficult childbirth.
It is easy to notice that excessive tension in the peritoneal region, which appears under the influence of various reasons, leads to such a difficult state.
Types and degrees of disease
Modern medical practice allows us to identify several key types of this problem:
- Paraesophagenic. We are talking about the displacement of only part of the stomach without participating in the process of other organs.
- A sliding hernia, it’s axial. In this case, the cardiac part also shifts into the chest cavity.
- Mixed. We are talking about the signs of the first two species, which appear simultaneously.
- Congenital. Such a diagnosis is made when a hernia is detected, the formation of which occurs against the background of a small esophagus located in the form of a "chest ventricle". This situation is abnormal.
It is important to note the fact that a sliding hernia is a pathology that can have several degrees, each of them has its own characteristics and deserves attention:
1. The stomach is under the diaphragm, the cardia is at the level with it, and the abdominal segment of the esophagus is higher than the diaphragm.
2. A hiatal hernia of the 2nd degree is characterized in that the esophagus is compressed evenly, and the cardinal part of the stomach protrudes into the mediastinum.
3. A pronounced contraction of the esophagus is observed, and the entire stomach or its component appears in the mediastinum.
How is the diagnosis
There are several methods by which an axial hernia or other type of this pathology can be detected.
First of all, it is worth resorting to an X-ray examination, which will be based on barium contrast. If the procedure is carried out correctly, then in the end you can see a noticeable protrusion in the picture.
Attention should be paid to such a technique as pH-metry. With its help determine the acidity of the stomach. These data are very important for the appointment of effective therapy.
Fibrogastroscopy plays a role in identifying the patient's condition. Using this technique makes it possible to assess the condition in which the esophagus and stomach as a whole are.
Without such diagnostic measures, such a pathology is almost undetectable in the early stages. Therefore, it is worth familiarizing yourself with the symptoms in order to be able to recognize the effects of such a serious illness in time.
Manifestations of the disease
As key symptoms, you can identify pain that appears with varying frequency and intensity. At the same time, they can be both stupid and burning.
Sometimes painful sensations radiate to the area of the heart, as a result of which patients begin to suspect heart failure. In some cases, a hiatal hernia can cause pain in the interscapular area.
If the disease is caused by such a congenital problem as an insufficiently wide esophagus, then the symptoms may resemble the manifestations of an axial hernia. We are talking about heartburn that occurs after eating, pain behind the sternum, aggravated in a horizontal position, and pain in other parts of the body.
In general, the pathology is manifested as follows:
- difficulties in the process of swallowing food;
- heartburn after exercise or eating;
- pain in the chest area;
- signs of hiatal hernia can take the form of belching with air or stomach contents.
The indicated symptoms are sometimes incorrectly evaluated by patients. According to reviews, people think that these are signs of other diseases, they are self-medicating. However, for any suspicion of a hernia of this type, you should immediately go to the doctor. This will allow you to start timely treatment and prevent complications.
Therapies
If you had to deal with such a problem as a hiatal hernia, then there can be two ways out of the situation: surgical or conservative treatment.
As the main task of classical methods, it is possible to determine not the elimination of hernia itself, but the reduction in the symptoms of reflux esophagitis and the neutralization of gastroesophageal reflux. That is, doctors seek to remove pain and prevent possible complications. These goals are achieved through the appointment of a diet based on fractional and frequent meals. For the duration of such treatment, you will have to abandon some products. We are talking about chocolate, carbonated drinks, coffee, animal fats, fresh bread and other flour products. Also, doctors do not advise with this treatment to rest in a supine position for the next 3 hours after eating.
Bad habits can complicate the process of combating the disease, so they will have to be abandoned. The effect of pharmacological preparations is also possible. These can be proton pump inhibitors, prokinetics, antacids, etc.
As for surgical intervention, it is relevant only if conservative treatment has not given the desired effect. The most commonly used laparoscopic technique.
Possible complications
If a hiatal hernia was diagnosed, then without timely and qualified treatment for the patient can become even worse.
The fact of complications can be expressed through several processes:
- infringement of a hernia;
- esophageal bleeding;
- peptic stricture of the esophagus ;
- reflux esophagitis;
- perforation of the esophagus;
- prolapse of the gastric mucosa into the esophagus ;
- peptic ulcers.
If the operation was performed, then there is a risk of dilatation of the stomach, megaesophagus and gastroesophageal reflux. Do not exclude the possibility of a hernia recurrence. A complication may be aspiration pneumonia. Parenteral administration of antibiotics is used to neutralize it.
Summary
It is a big mistake to be dismissive of the occurrence of a hiatal hernia. If such a diagnosis was made, then the treatment process should be taken as seriously as possible. Otherwise, the condition may deteriorate significantly.