Throughout life, a person is forced to encounter certain ailments and, as a rule, the situation only worsens with age. Esophageal hernia, the symptoms and treatment of which are not known to many, can be a serious problem.
Despite the fact that this pathology is not considered dangerous, at its first manifestations it is necessary to immediately seek help. Esophageal hernia, or as doctors call it, diaphragmatic hernia is a disease that is mainly encountered by people over the age of 60 years. This is due to the fact that during this period of life, most have a decrease in muscle tone, which leads to unpleasant consequences. It is worth considering in more detail the development of a hernia of the esophagus, the symptoms and treatment of this ailment.
What is a
Esophageal hernia according to ICD-10 has the code K44. A disease of this type is a pathological extension of the diaphragmatic opening located in the esophagus. Through it, a periodic or constant displacement of the lower esophagus, stomach, and in some cases a loop of the intestine occurs.
Considering the symptoms and treatment of esophageal hernia, it is worth saying that, according to studies, this pathology is recorded in every fourth person. However, not everyone can independently diagnose the development of this disease. This is because the symptoms of pathology are not always pronounced.
As a rule, esophageal hernia is caused by a stomach ulcer, chronic gastroduodenitis or pancreatitis. However, it all depends on the specific case.
Causes of hernia
Describing the symptoms and treatment of esophageal hernia, it is worth clarifying that this pathology mainly occurs in women of advanced age. At the same time, the ailment can be both acquired and congenital, but manifest only after many years.
As a rule, the appearance of this pathology is associated with such deviations:
- Shortened esophagus. This is an abnormal condition in which the stomach and diaphragm are too close together. Such a cause of esophageal hernia is congenital.
- Weakened ligamentous apparatus. Occurs due to age-related changes.
- Reducing the size of the liver or its improper functioning.
- Sudden weight loss or too fast the process of resorption of the fatty layers located under the diaphragm.
- Operations performed on the esophagus.
- The accumulation of a large volume of fluid in the peritoneum.
- Bearing two or more fruits. In the case of such a pregnancy, women have a change in the location of the abdominal organs.
- Chronic constipation.
- Heavy physical exertion, especially if most of the stress falls on the hands.
- Violation of the motor functions of the esophagus.
- Chemical injury to the walls of the esophagus. In this case, damage can occur even if the person was eating too hot food.
- Chronic diseases associated with impaired motor activity of the digestive system.
- Mechanical trauma to the abdomen (at the same time, manifestations will not necessarily be visible on the skin).
Increased pressure inside the abdominal cavity can also provoke this disease. Esophageal hernia is the result of severe exertion and overweight.
Varieties of pathologies
In medicine, several categories of esophageal hernias are distinguished:
- Axial or sliding. This is the most common variety that occurs in 90% of patients seeking help. In this case, the cardia is located just above the desired point.
- Shortened esophagus. This category includes congenital malformations. In some situations, this type of hernia can be combined with a sliding hernia. As a rule, it occurs against the background of injuries in the esophagus.
- Paraesophageal. This is the rarest kind of pathology, which is diagnosed only in 5% of cases. In this case, the cardia remains in the right place. Violations affect only the esophagus, which becomes much wider. Through it begins to pass the stomach.
Symptomatology
This pathology can manifest itself in different ways depending on the specific situation. If the hernia is relatively small, then this does not always affect the well-being of the person. In some situations, patients until the last are unaware of the presence of this ailment.
However, it is worth highlighting the most common symptoms:
- Heartburn. It can be barely noticeable or torment the patient for a long time. It usually manifests itself at night or after eating.
- Pain syndrome. Pain in a hernia of the esophagus appears only in 50% of cases. As a rule, discomfort appears in the area behind the sternum. The pain may be burning or stitching. Usually, the most vivid discomfort is observed after performing heavy physical exercises or exertion.
- Dysphagia. This means that food is much harder to pass through the esophagus. As a rule, this symptom manifests itself in the same way, regardless of the type of food. However, the most pronounced sensations appear when eating too hot or cold food.
- Burping. This symptom also manifests itself far from in all patients. If the patient suffers from frequent burping, then it occurs suddenly, for example, during a conversation.
- Hiccups. Similar symptoms appear in rare cases. But if a person suffers from hiccups against a hernia of the esophagus, then this condition can last up to several weeks.
Features of symptoms with infringement of a hernia
This condition is considered quite dangerous. Hurt hernia occurs not only in the case of an advanced stage of the disease, but sometimes with the manifestation of the primary signs of pathology.
If a person has an infringement of a hernia, then this condition manifests itself in the form:
- sudden, sharp or shooting pain in the lower sternum;
- pain syndrome that spreads to the clavicle or scapula. As a rule, pain increases with an increase in intestinal motility. In some cases, the pain can be so severe that there is a risk that the patient will fall into a state of shock;
- prolonged vomiting;
- strong bloating of the abdominal cavity and too much gas.
Do not ignore this condition of a hernia of the esophagus. What to do in this case? Call an ambulance immediately, as a person needs urgent hospitalization. Do not self-medicate in such a situation in any case.
Possible adverse effects of esophageal hernia
If you do not timely diagnose such an ailment and do not pay attention to alarming symptoms, then there is a risk of complications. A person can develop:
- Erosive, catarrhal or ulcerative reflux esophagitis.
- Peptic ulcerative lesion of the esophagus.
- Cicatricial change and narrowing of the organ.
- Gastric or esophageal bleeding.
- Reflex angina pectoris.
- Perforation on the walls of the esophagus.
Therefore, do not ignore pain and other unpleasant sensations.
First aid for hernia
There are several recommendations of doctors who are recommended to follow in order to avoid serious complications:
- Call a doctor immediately if you suspect a pinched hernia.
- After diagnosis, check with your doctor all possible options for the development of pathology. The specialist should tell you what to do with this or that type of exacerbation of the disease.
If a person has an attack, and he expects the arrival of a doctor, then his condition can be slightly improved if the patient:
- lie on your back and try to relax;
- put one hand under the chest and will produce light massaging movements downward;
- drink a mug of water, rise to a small height and jump, a little cushioning.
Diagnostics
There are many diagnostic measures that help determine the presence of a hernia. The most common of these is sternum fluoroscopy. An endoscopic examination may be required to confirm the diagnosis.
To identify a hernia, doctors pay attention to several radiological signs:
- Lack of the necessary site located in the esophagus under the diaphragm.
- The increased location of the sphincter.
- Esophageal opening too large.
- The location of the cardia above the diaphragm.
In the process of endoscopy, a slight shift in the line of the esophagus and stomach will be noticeable. Erosion or ulcer of the mucous membranes, gastritis or esophagitis can also be detected.
Treatment
Only a qualified specialist can determine exactly what therapeutic measures a patient needs.
If the disease is at the initial stage of development, then the doctor most often recommends treatment at home, which may include:
- taking medications;
- medical gymnastics;
- diet
- alternative methods of treating a hernia of the esophagus (only in conjunction with another type of treatment and on the recommendation of a specialist).
Drug treatment
As a rule, at the initial stages of the development of pathology, the patient is prescribed various drugs that will help get rid of unpleasant symptoms. However, in order to achieve remission, you need to take medications that can reduce the secretion of gastric juice and protect the intestinal mucosa from the negative effects of hydrochloric acid.
Based on these requirements, specialists usually prescribe to patients:
- H-2 blockers that affect histamine receptors. These drugs include Nizatidine.
- Antacids. These drugs neutralize hydrochloric acid. Typically, agents of this type can be found in liquid form or in the form of chewable tablets. For example, "Rennie" and "Gastal."
- Proton pump inhibitors. They prevent the production of hydrochloric acid. Omeprazole refers to this type of drug.
- Prokinetics. Means of this type are necessary to restore the functioning of the digestive system and to eliminate reflux.
Physical exercise
Therapeutic gymnastics is also an effective way to get rid of unpleasant pathology. It must be performed only on an empty stomach.
In order to get rid of pathology faster, it is necessary to learn several effective exercises:
- Take a lying position on the right side. Place your head and shoulders on a small pillow. Take a deep breath and inflate your stomach. Relax as you exhale.
- Get up straight. Taking a deep breath, alternately lean to the right and left.
- Take a horizontal position. Inhale and turn to the sides.
Such exercises are recommended to be done several times in the morning and before bedtime. A positive result will be noticeable after 3-4 weeks. With complex therapy and dieting with a hernia of the esophagus, good results can be achieved.
Power Features
If such a pathology occurs, you must include in your diet:
- Dried fruits.
- Dairy products.
- Low-fat meat and fish.
- Various cereals and crackers.
- Boiled eggs.
- Green tea and natural juices.
Also, a diet with a hernia of the esophagus implies that from the diet it is necessary to completely exclude:
- Smoked meats.
- Spices.
- Marinades and pickles.
- Fried and fatty dishes.
- Sour fruit.
- Alcoholic, carbonated drinks and coffee.
- Any products with a peel or a film (for example, sunflower seeds).
You need to eat in small portions, but often.
Surgical intervention
A planned operation, which involves the correction of the esophagus, is performed if the patient is diagnosed with severe reflux esophagitis, which cannot be treated with conservative treatment methods. Esophageal hernia is removed if the risk of pinching is too high.
Also, surgery may be required for congenital anomalies, for example, with a shortened esophagus. As a rule, specialists restore the correct structure of the esophagus. There are many ways to perform surgery. This or that method is selected depending on the specific situation.
Prevention
In order not to suffer from serious consequences, it is recommended not to start the pathology. If a person is at an advanced age, then he is at risk, so you should begin to undergo a routine examination. Also, experts recommend giving up bad habits (smoking and drinking). In addition, it is worth starting to engage in physical exercises aimed at strengthening the muscles of the peritoneum.