The chest cavity is separated from the abdominal cavity by a strong muscular organ called the diaphragm. Its central part consists of natural holes. Large vessels pass through them, as well as the esophagus.
It is in this place that many hernial protrusions are found. Almost 90% of cases are the formation of a sliding cardiac hernia with corresponding symptoms.
Features of the formation of pathology
One of the most common diseases is a hernia of the POD (esophageal opening of the diaphragm). The older a person gets, the higher the likelihood of its occurrence.
The specificity of the disease is that it can develop in the body for years, while the patient takes medications for concomitant disorders that have similar symptoms. In other words, a hernial protrusion often remains asymptomatic for a long period.
A POD hernia is formed as a result of the fact that the following move into the chest cavity:
- upper parts of the stomach;
- the lower part of the esophagus;
- intestines.
Distinguish protrusion:
- Sliding (axial). Penetration of the abdominal part of the esophagus and gastric fundus into the chest is noted. It is diagnosed most often, and almost never occurs infringement.
- Paraesophageal. The movement of the bottom of the stomach and other organs is characteristic, and the esophagus retains its location. Due to the high probability of infringement, urgent surgery is indicated.
- Mixed.
A sliding formation is otherwise called non-fixed, since it can change its localization. In a fixed protrusion, the position is always stable.
Any form is provoked by various factors:
- age-related changes;
- abnormal development of the ligamentous apparatus;
- diseases of the gastrointestinal tract of an inflammatory nature;
- abdominal trauma;
- prolonged increased pressure in the abdominal cavity;
- diseases of the esophagus.
Stages and characteristics
Patients who have been diagnosed with an axial cardiac hernia will be wondering what it is. In medicine, it is customary to distinguish between several degrees of protrusion, depending on how large a hernia has formed. Therefore, treatment is prescribed only after an accurate determination of the stage of the disease.
Usually, with a pathological formation at the initial stage, the patient almost does not feel discomfort. This explains why complications arise, for the elimination of which it is necessary to resort to surgical intervention.
Sliding hernia happens:
- esophageal (1 degree);
- cardiac (grade 2);
- cardiofundal (grade 3);
- giant (4 degree).
The esophageal form is characterized by the location of the abdominal segment under the diaphragm. The patient complains about:
- heartburn;
- discomfort in the epigastric region after a long stay in a bent form.
Feeling worse when the diet is disturbed.
Axial, that is, sliding, cardiac hernia of the POD develops as a result of the location of the lower food sphincter above the anatomical septum, while the gastric mucosa is partially present in the esophageal opening.
Because of a sliding cardiac hernia, a person feels heartburn regardless of whether he has been eating or not. Also the state is supplemented:
- severe painful discomfort in the abdomen;
- constant belching;
- nausea;
- pain in the chest, which are similar to manifestations of angina pectoris;
- problematic swallowing;
- increased pain in the supine position or when bending over.
If the stomach partially bulges into the chest cavity, a cardiofundal hernia is diagnosed. Pathology is quite rare and is accompanied by:
- acute pain in the abdomen after eating;
- shortness of breath;
- cyanosis;
- rapid heartbeat.
The most difficult degree is the fourth. In this case, the patient is urgently prepared for surgery.
Possible Complications
When a patient does not turn to a doctor for help in a timely manner, a sliding cardiac hernia of the POD can result in serious consequences:
- hemorrhages in the esophagus;
- gastroesophageal reflux disease;
- infringement;
- cicatricial narrowing;
- peptic ulcer;
- perforation of the esophagus.
After the operation, complications are also not excluded in the form of:
- pathological expansion of the esophagus;
- re-education of the protrusion;
- enlargement of a certain gastric area.
Treatment Methods
In the absence of these complications, non-fixed cardiac hernia is eliminated with the help of:
- antacids that help normalize acidity and eliminate pain;
- antispasmodics;
- agents that enhance the protective function of the gastric mucosa;
- medicines that help to cope with belching and heartburn.
For the treatment to be effective, you will need:
- Follow a diet.
- Review your daily routine.
- Reduce the number of loads.
- Give up smoking.
- Set aside time for gymnastic exercises.
It is important to always remember that successful recovery depends on early diagnosis. Do not choose drugs on your own. Any drugs should be taken only for medical purposes.
Denial of responsibility
The information in the articles is for general information purposes only and should not be used for self-diagnosis of health problems or for medicinal purposes. This article is not a substitute for medical advice from a doctor (neurologist, internist). Please consult your doctor first to know the exact cause of your health problem.
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A hiatal hernia is essentially a defect in the septum between the abdominal cavity and the sternum. This partition consists of muscles that tend to lose their elasticity and flexibility with age. Therefore, the protrusion of the esophagus into the sternum through the apertures of the diaphragm is often referred to as age-related diseases. It is older people who are most vulnerable to such ailments.
An important factor is also that the pressure in the chest cavity is much lower than in the peritoneum. From this, often after heavy physical exertion, with prolonged coughing and other similar phenomena that increase internal pressure, it can provoke the occurrence of a hiatal hernia.
Depending on the place of origin of education, there are:
- axial fall out;
- cardiac hernia.
In modern medicine, hiatal hernia is divided into several types:
- shortened esophagus (congenital hernia of the esophagus);
- paraesophageal hernia;
- sliding hernia.
Sliding hernia is quite common, but has a number of difficulties. Including, with this form of ailment of the esophagus, it is more difficult to establish a diagnosis, since the symptoms do not manifest themselves properly, and the protrusion itself is visible only under certain conditions.
Such a hernia of the esophageal opening of the diaphragm differs in that the displacement into the sternum occurs not near the esophagus, but along its axis.
When diagnosing a sliding hernia of the esophagus, the location of the hernia will be slightly different than in the case of other subtypes of hernias of the esophagus. Sliding protrusion means that the upper part of the stomach is located above the level of the diaphragm. It turns out that the stomach, as it were, takes part in the formation of the hernial sac.
A sliding hernia may or may not be fixed. With a fixed formation of the esophageal opening of the diaphragm, the location of the hernia does not change depending on the position of the patient's body. This means that when the patient assumes a vertical position, the sliding fixed hernia will remain in the sternum. This occurs because the hernial phenomenon is held by adhesions in the hernial sac.
Also, modern medicine distinguishes between sliding hernias with congenital or acquired shortened esophagus.
Since there is a large difference in pressure between the sternum and the abdominal cavity, this contributes to the penetration of the contents of the stomach into the esophagus. As you know, the esophagus is sensitive to such things. This can cause erosions and ulcers, thereby causing patients not only inconvenience and discomfort, but also causing severe pain. If this inflammatory process occurs constantly, then the mucous membrane is easily injured and bleeds. This in turn can cause tissue anemia.
Reasons for the formation of a sliding hernia
The reason for the formation of a sliding formation of the esophageal opening of the diaphragm is the pathology of the ligament that holds the gastroesophageal canal inside the esophageal opening of the diaphragm.
As the upper part of the stomach moves upward in a sliding hernia, this muscular ligament is exhausted and stretched. The esophageal opening becomes larger in diameter. Therefore, depending on the amount of contents in the stomach and the position of the human body, the hernial phenomenon (including part of the gastroesophageal canal) may first move into the sternum from the abdominal cavity, and then return back.
In this case, the hernial formation of the esophagus can be both large in size and small in size. As a rule, a large hernial prolapse is observed in patients who have long suffered from such a disease.
If the protrusion is fixed and narrowed by scars in the hernial sac, an acquired shortening of the esophagus may occur. In this case, the esophago-gastric canal, or fistula, as it is called, will always be above the diaphragm.
The advantage of a sliding hernia is that it cannot be pinched. But with advanced options, fibrous stenosis may occur. Also, a concomitant disease of a sliding hiatal hernia is reflux esophagitis.
Infringement of a sliding hernia
As already mentioned, the sliding fall out cannot be infringed. Even if the opening narrows and the cardia that has entered the sternum is compressed, this does not threaten circulatory disorders. Because the contents are emptied through the esophagus, and the outflow of blood occurs through the veins of the esophagus.
Symptoms
As a rule, a sliding formation proceeds without pronounced symptoms. Serious symptoms appear when comorbidities join the sliding fallout or complications begin.
Then, the patient may complain about:
- heartburn;
- regurgitation;
- belching
- pain;
- burning effect behind the sternum;
- lump in the throat;
- increased salivation;
- sometimes increased blood pressure.
Symptoms may vary depending on the position of the patient's body. Burning occurs in almost every patient with a sliding hernia of the esophagus.
The pain is not like what a person with an ulcer might feel. With hernia formation, pain occurs after eating and is proportional to the amount of food taken. When taking drugs that reduce acidity, the pain disappears almost instantly.
Diagnostics
You can diagnose a sliding formation in the following ways:
- gastroscopy;
- fluoroscopy of the stomach, including analysis of functionality;
- change in daily pH in the esophagus.
Treatment
Sliding hernias are initially treated with the traditional method, which involves a special diet, physical exercises and medication. If this does not help, and the patient begins to develop complications, there may be a question of surgical intervention. Surgery is also indicated for bleeding.
Hello! Please tell me. I started having a very strong heartbeat. First a push, then as if the heart turned over, and then a strong heartbeat. I have addressed to the cardiologist. They did a Holter test. Nothing bad was found. I told him that I had a sliding hernia. The doctor said that most likely it makes itself felt sliding hernia. Please tell me. Can a sliding hernia act like this And what morning exercises can be done with a sliding hernia (I mean morning exercises), as well as what medications a sliding hernia is treated with. Sincerely, Allah.
With age, the septum of muscles loses its elasticity and flexibility. The esophagus protrudes into the sternum through a hole in the diaphragm. alimentary esophageal opening of the diaphragm most often occurs in adulthood.
A hernia of the esophagus most often occurs in adulthood.
Depending on the location of the defect, there are:
- axial hernia;
- cardiac rupture.
There are several types of pathology:
- shortened (detected in people with a birth defect);
- paraesophageal hernia;
- sliding hernia.
A feature of a sliding hernia is the difficulty of diagnosis. The reason is that the symptoms of this disease are quite mild. Falling out itself can only be determined under certain conditions.
A distinctive feature of this defect is that the displacement into the sternum occurs along the axis of the esophagus. The location of the hernia affects the position of the top. In this case, the falling out leads to the fact that the upper part of the patient's stomach is above the level of the diaphragm.
The stomach takes part in the formation of a hernial formation. There are 2 types of sliding hernia: fixed and non-fixed. The position of the patient does not affect the location of the hernial sac. If a person assumes a vertical position, then a fixed hernia will remain in the sternum. The formation is held by adhesions that form in the area of the hernia.
Specialists distinguish between sliding hernias with congenital and acquired defects. There is a difference in pressure between the sternum and. Due to this difference, the contents of the stomach enter the esophagus.
The mucous membrane of the esophagus is quite sensitive to such substances. This causes the appearance of erosions and ulcers. The patient experiences inconvenience, discomfort and severe pain. The inflammatory process in the esophagus develops gradually. In this case, the mucous membrane bleeds and is constantly injured.
The patient begins anemia associated with iron deficiency due to tissue manifestation.
What is a hiatal hernia, the video will tell:
Reasons for the formation of a sliding hernia
Increased salivation is a sign of a sliding hernia.
The condition of the ligaments affects the formation of the esophageal opening of the diaphragm.
The upper part of the stomach with this disease is shifted upward. This leads to the fact that the muscle ligament becomes much thinner.
The stretching of the ligament provokes an increase in the diameter of the esophageal opening. The patient develops a complication with regular overeating. If such a defect is detected, the doctors refer the patient for surgery.
There are several methods for removing hernias. Thanks to the fundoplication around the esophagus, the surgeon creates a special cuff. It prevents reflux of stomach contents into the esophagus. During the operation, a laparoscopic method is used. With its help, doctors manage to reduce trauma to a minimum. This shortens the length of the patient's recovery period.
However, the possibility of slippage of the cuff cannot be ruled out. This increases the risk of complications after surgery. Surgical intervention in most cases helps to achieve positive results. Success largely depends on the passage of physiotherapy procedures during rehabilitation.
Sometimes hernial prolapse is fixed in one position. This is due to the narrowing of the scars in the hernial sac. In this case, the patient is diagnosed with an acquired shortening of the esophagus. The esophageal canal is located above the diaphragm.
In severe cases, a person may develop fibrous stenosis. A complication of a sliding hernia is also reflux esophagitis. The sliding fallout cannot be impaired. If there is a narrowing of the hole, then the cardia is compressed, which enters the sternum. This condition does not lead to circulatory disorders.
What are the signs of the disease
Heartburn is a symptom of a sliding hernia.
Sliding hernia of the esophagus does not have clear manifestations. Symptoms in a patient appear only when various complications of the disease occur.
There are several characteristic signs of a sliding hernia of the esophagus:
- the patient begins to complain about;
- he suffers from bouts of belching;
- there is pain in the esophagus;
- regurgitation occurs after eating;
- people experience a burning sensation behind the sternum;
- a lump appears in the throat;
- there is an increased secretion of saliva;
- some patients have high blood pressure.
Symptoms of the disease depend on the position of the patient's body. Burning occurs in almost every person with this pathology. Severe pain is experienced by a person with a stomach ulcer. A large amount of food can provoke the appearance in the esophagus.
By taking acid-reducing agents, you can get rid of discomfort.
How is the diagnosis carried out
To identify a sliding formation, experts use several methods:
- in the process of gastroscopy, doctors use endoscopic equipment to determine inflamed areas, the presence of ulcers and erosions;
- fluoroscopy of the stomach is designed to assess the state of hernial formations;
- a study of changes in daily pH in the esophagus is designed to determine which leads to the appearance of pain.
Features of treatment
Maalox will help reduce the acidity of the esophagus.
To eliminate the defect, doctors use traditional methods. The complex of therapeutic measures includes a special diet, therapeutic exercises, medication.
To reduce acidity, doctors prescribe antacids to patients (Phosphalugel,). To help patients suffering from attacks of belching, you can use Motilium. The dosage is indicated by the doctor, taking into account the patient's condition.
However, with serious complications, these methods do not allow to achieve positive results. In this case, the patient is sent for surgery.
Sometimes patients experience slippage of the cuff, and the disease occurs again. Reoperation can help such patients.
Patients must adhere to At the time of illness, you will have to abandon the use of fatty and spicy foods. Eliminate smoked meats and marinades from the diet. Eat small meals to speed up the digestion process.
After the operation, patients should not engage in intensive physical labor. It is forbidden to do exercises that provoke an increase in pressure in the abdominal cavity.
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Classification, treatment and symptoms of hernia of the esophagus. Details about…
Sliding hernia of the esophagus is one of the most common pathologies of the esophageal opening of the diaphragm and is characterized by certain features, unlike other hernias. In some cases, it occurs without any symptoms and is diagnosed only after the study.
Sometimes the problem can be accompanied by unpleasant symptoms that worsen the quality of life of the patient and lead to serious consequences.
This article will discuss why the disease occurs and what methods are used to treat it.
What is pathology
A sliding hernia of the esophagus is a pathological condition in a chronic form, in which the abdominal part of the organ (stomach and lower part of the esophagus) is displaced through the diaphragmatic opening into the sternum cavity, and are not located in the abdominal cavity.
In some cases, there is no hernial sac. The cardial part of the stomach or loops of the small intestine can also be displaced.
Reasons for the appearance
Experts say that congenital and acquired factors influence the occurrence of a hernia.
Congenital causes of hernia development include:
- the formation of a hernial sac as a result of improper closure of the diaphragm;
- slow lowering of the stomach during fetal development;
- underdeveloped diaphragmatic crura.
Among the factors in the development of a hernia, experts distinguish those in which pressure in the abdominal cavity increases: 
- excessive body weight;
- strong physical activity;
- hereditary factor;
- malnutrition;
- stressful situations;
- bad habits;
- chronic constipation;
- the period of bearing a child;
- strong and prolonged cough.
Cholecystitis, reflux esophagitis and stomach ulcers are also common causes of this pathological condition, since reflex contractions of the esophagus occur in these diseases.
The risk group includes the elderly, as well as women, in particular pregnant women.
Symptoms of the disease
Most often, the pathology has no clinical signs and is asymptomatic, therefore, it is detected only with certain diagnostic methods.
It is difficult to visually determine the problem, since the protrusion is not formed under the skin, but is directed towards the chest cavity.
However, experts determine the following symptoms of pathology with a large hernia: 
- burning sensation in the pit of the stomach and behind the chest;
- heartburn, manifested after eating and in a supine position;
- reflux of stomach contents into the esophagus and pharynx;
- belching
- shortness of breath
- increased salivation;
- soreness in the epigastric zone;
- feeling of a lump in the throat;
- impaired swallowing function (so-called dysphagia).
In addition, due to belching and penetration of the contents of the stomach into the respiratory system, the patient often suffers from tracheitis and bronchitis.
In some cases, the disease is accompanied by an increase in blood pressure.
Disease classification
Sliding hernia of the esophageal opening of the diaphragm is of two types:
- fixed (its location does not change when the patient's postures change);
- non-fixed (the localization of the hernia changes when the position of the body changes).
Experts define such types of hernia with a shortened esophageal opening, depending on the cause of development:
- acquired;
- congenital.
Given the localization of the hernia, the following types are distinguished:
- cardiac;
There are several degrees of hernia:
- At grade 1, only the lower esophagus penetrates the chest cavity. Usually such a deviation is asymptomatic and is treated with medication and diet.
- At 2 degrees, not only the esophagus, but also parts of the stomach are localized in the sternum. Various signs of the disease begin to appear.
- Grade 3 is characterized by the location in the sternum of the esophageal tube and the upper part of the stomach. The symptoms are pronounced.
The third degree of pathology requires surgical intervention.
Diagnostic methods
When the patient complains, the specialist necessarily collects an anamnesis and examines the patient.
After that, laboratory diagnostic methods are prescribed: 
- blood test (general);
- urine test.
A hernia can be detected using fluoroscopy. A gastroscopic examination is also carried out.
In some cases, additional diagnostic methods and consultation of several specialists may be prescribed.
Treatment of pathology
Treatment of the disease should be comprehensive.
The main methods of therapy for a small hernia without complications are:
- the use of medicines;
- diet;
- alternative therapies;
- establishing a healthy lifestyle.
With a large hernia and the occurrence of complications against the background of pathology, surgical intervention may be required.
Medical treatment
Usually, the pathology responds well to medical treatment.
Therapy includes the use of the following groups of drugs: 
- Hydrochloric acid synthesis inhibitors. Most often use Omez or Omeprazole.
- Antacids to reduce acidity. Maalox, Phosphalugel, Gastal are prescribed.
- Medicines for relieving spasms and soreness: Drotaverine, Papaverine, No-shpa.
To restore the protective functions of the mucosa of the organ, the drug De-nol is used. You can eliminate belching and heartburn with Motilium.
Only a qualified specialist should prescribe medications, their dosage and duration of use.
Folk remedies
As an auxiliary method, alternative methods of treatment can be used.
These include internal use: 
- decoction of gooseberries (three times a day before meals);
- potato juice;
- chamomile tea;
- mint decoction;
- carrot juice;
- infusion of flaxseeds;
- decoction from the collection of mint, coltsfoot, marshmallow rhizomes with the addition of propolis;
- kefir with olive oil.
Most often, folk remedies are used to get rid of certain symptoms: elimination of heartburn, soreness and spasms, belching.
Surgery
Indications for surgery are the following factors: 
- large size of the protrusion;
- the presence of complications;
- the occurrence of bleeding;
- failure of conservative therapy.
Removal of a hernia in medicine is called a Nissen fundoplication. When it is carried out, a special cuff is installed around the organ, which will prevent the entry of gastric contents into the esophagus.
Surgery is performed laparoscopically.
Exercises
In case of illness, experts also advise performing the following exercises that help eliminate a hernia:
- In the supine position, make turns left and right.
- Lie on your back, bend your knees, and put your hands behind your head. Alternately touch the left elbow to the right knee and vice versa.
- Lie on your back, take a deep breath and hold your breath for a few seconds. Exhale slowly slowly.
- Get on your knees, put your palms on the floor. Gently lower the body down, sliding the palms along the floor.
- Sit down, tilt your body forward a little. Place your palms under your ribs. Inhale as you move your fingers deeper. When exhaling, strain your palms in the other direction.
- Lie on your side, raise your head, putting your hand under it. When inhaling, protrude the stomach, while exhaling, relax.
Health food
With pathology, proper nutrition is considered an obligatory component of treatment.
The following foods should be excluded from the diet: 
- spices and seasonings;
- pickles;
- marinades;
- canned food;
- smoked meats;
- semi-finished products;
- fast food;
- meat and fish of fatty varieties;
- fried foods.
Useful products for pathology are:
- lean meat;
- soups;
- weak broths;
- cereals from different cereals;
- milk;
- vegetables;
- milk;
- dairy products;
- greenery;
- fruits;
- fruit drinks, compotes;
- vegetable and fruit juices.
It is also important to adjust the diet. The patient is advised to eat small meals. However, the frequency of administration should be increased to six times a day. Do not eat before bed. After eating, at least two hours should pass.
Dishes should be boiled, baked in the oven or steamed. In case of impaired swallowing function, it is recommended to eat mashed food.
Complications of pathology and prognosis
If the disease progresses and is not treated, serious complications usually develop.
These severe consequences include: 
- esophagitis (inflammatory process of the mucous membrane of the esophagus);
- the formation of ulcers and erosions on the mucosa of the organ;
- fibrous stenosis;
- aspiration pneumonia;
- oncological processes;
- bleeding of the esophagus.
Due to frequent bleeding, the patient develops anemia.
If the treatment of pathology is timely, then the likelihood of complications is reduced several times.
Usually, with the treatment provided, the prognosis is favorable and does not affect the patient's life expectancy.
A sliding hernia is a pathology in which the stomach and lower esophagus begin to shift into the sternum. Usually, with an uncomplicated and uncomplicated form, the disease is amenable to drug treatment. However, in some cases, surgery may be used.
What is a sliding hernia of the esophagus, and how it appears, is up-to-date information for people who are faced with such a problem. The organs of a healthy person are held in position by ligaments. In the presence of anomalies in the structure of the muscles of the diaphragm, part of the esophagus extends into the abdominal cavity, due to which a hiatal hernia is formed. If the organ does not move along its axis, the protrusion is called sliding.
In medicine, this disease is called a wandering hernia. Its identification presents some difficulties, because the esophagus during the examination can be in a physiological position, and pathological changes occur only under certain conditions. The stomach often penetrates into the hernial sac, its upper sections remain above the level of the diaphragm.
There are several types of wandering hernias. A protrusion is called fixed, in which its contents are held by adhesions. A floating hernia occurs only when a certain position is adopted.
Causes of the disease
In the presence of a small sliding hernia, the patient's health practically does not worsen. Symptoms of the disease are mild. These include frequent hiccups, belching and that appear as a result of overeating. Symptoms of the disease with proper nutrition are practically absent. A large hernial sac can be infringed, which causes severe pain in the epigastric region, nausea and vomiting, which are rarely accompanied by the release of the contents of the stomach to the outside.
Sliding hernias are also classified on the basis of which organ entered the protrusion cavity. With gastric, not only the esophagus is displaced, but also the upper sections of the stomach. With the esophagus, only the esophagus enters the hernial orifice. Cardiofundal protrusions are prolapse of the cardia and gastric fundus. There are many factors that can lead to the development of a sliding hernia:
- Decreased muscle tone and ligaments of the diaphragm. Similar pathological changes often occur in the body of an elderly person and in persons with weak, untrained abdominal muscles.
- Injuries of the chest and abdominal region. Various damage to the diaphragm can lead to the formation of a hiatal hernia.
- Increased intra-abdominal pressure. It can be both sudden (high physical activity, pregnancy, difficult childbirth and trauma) and gradual (increased gas formation, overeating, constipation).
- Congenital malformations of the structure of the digestive organs - the chest stomach.
- Prolonged course of peptic ulcer, accompanied by scarring of tissues.
Diseases that disrupt the motility of the esophagus and stomach (pancreatitis, cholecystitis, ulcers) can also contribute to the development of a hernia. Violations in the processes of formation of connective tissues is another reason for the occurrence of protrusion.
Clinical picture of the disease
Heartburn is the main symptom of an esophageal hernia. It is aggravated by taking a lying position or eating a large amount of food. The cause of heartburn is gastroesophageal reflux - the reflux of gastric juice and semi-digested food. The feeling of a lump in the throat when eating and pain behind the sternum are no less common symptoms of a sliding hernia. Dysphagia in the presence of a large protrusion occurs even when a person consumes semi-liquid food and water. The appearance of a symptom is associated with, in which the inflammatory process occurs or adhesions form.
The appearance of problems with swallowing can also be explained by the incorrect position of the organs. Belching with air and food regurgitation are caused by the reflux of stomach contents into the esophagus, especially if a person lies down immediately after eating. Similar symptoms may be associated with a decrease in the tone of the cardia. Often the patient feels a feeling of fullness in the epigastric region, which causes him to belch on his own, after which the condition improves.
The occurrence of hiccups contributes to the defeat of the vagus nerve. Seizures are rare and can last from a few hours to a month. Hiatal hernia also has unusual symptoms that significantly complicate diagnosis. A person is unsuccessfully treated for other diseases, not realizing the displacement of the digestive organs. The hernia enlarges, causing inflammation and other complications. Content infringement is considered the most dangerous. Symptoms of a complicated hernia are manifested in the form of acute pain in the epigastric region, nausea and vomiting. Semi-digested masses often contain impurities of blood and bile.
Diagnosis and treatment of the disease
Examination of the patient begins with an examination and a survey, during which the doctor analyzes the symptoms of the disease, determines their dependence on food intake. X-ray examination allows you to assess the position of the digestive organs. It is mandatory to conduct EGD - the introduction of an optical tube into the esophagus, with which its internal surfaces are examined. Special equipment registers changes in the acidity of gastric juice.
Elimination of a sliding hernia of the esophagus can be carried out in several ways. Conservative therapy is based on the use of drugs. Wandering hernia is an indication for a special diet and exercises aimed at strengthening the muscles of the abdominal cavity. With a small hiatal hernia, treatment is carried out according to the same scheme as for gastroesophageal reflux.
The operation is prescribed in the presence of a large protrusion and creating an obstacle to the normal movement of the food bolus, frequent reflux of the contents of the stomach into the esophagus, and cardiac insufficiency. Hernias that are prone to infringement and the formation of adhesions are treated surgically. An emergency operation is performed in the presence of inflammatory changes in the esophagus.
There are several types of surgery used to repair a sliding hernia. The operation can be performed open or laparoscopically. The Allison technique is used in conjunction with other therapeutic measures, since it is not able to completely eliminate gastroesophageal reflux. During the operation, an incision is made between the 7th and 8th ribs, through which the hernial orifice is sutured.
Gastrocardiopexy involves fixing the upper stomach to the diaphragmatic ligaments through an opening in the upper abdominal line. In a Nissen fundoplication, a cuff is wrapped around the upper part of the stomach to prevent the contents from being ejected into the esophagus. After installing this device, the stomach is given the correct position, the hernial ring is sutured. The Belsi method is used when the hernia reaches a critical size, while the bottom of the stomach is sutured to the wall of the esophagus, and the cardia is fixed to the diaphragm.