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Hiatal hernia most often affects the elderly and obese people, especially smokers, as well as people living under constant stress. The hernia results from a malfunction of the diaphragm - the septum that separates the chest from the abdominal cavity. The hernia is accompanied by heartburn, vomiting, chest pain. What are the symptoms of a hiatal hernia?
A hiatal herniais formed when the stomach moves upward and part of it from the abdomen to the chest. How does a hiatal hernia develop? The diaphragm is a partition that separates the chest from the abdominal cavity. It is a broad, but thin muscle, stretched between the lower ribs, and tightly wrapped around the lower esophagus. The place where the esophagus passes through the diaphragm is called the hiatus. If the esophageal hiatus weakens, relaxes, stretches and no longer adheres tightly to the esophagus, it ceases to fulfill its function - the diaphragm cannot hold the stomach in its place.
Although doctors distinguish as many as five types of hiatal hernia, the most common - in 90 percent. cases - this is the so-calledherniasliding. In its course,esophagusmoves freely in the esophageal development, and the gastric cardia moves above the diaphragm. As the name suggests, it is like "sliding" of a part of the stomach into the esophageal zone through the esophageal opening in the diaphragm.
Hiatal hernia: symptoms
Patients suffer from heartburn, vomiting, chest pains, and also have trouble swallowing. The symptoms of a hiatal hernia are similar to those of many other diseases. In this case, the reflux of stomach acid into the esophagus causes irritation and, consequently, inflammation of the mucosa that lines the inside of the esophagus. There is pressure and a burning sensation behind the breastbone, in the heart area, shortness of breath, sweating. The symptoms usually appear about an hour after a meal. This symptom is often attributed to ischemic heart disease or even a heart attack. However, a hernia may be evidenced by bitter belching accompanying pressure and burning, a feeling of food retention in the esophagus, vomiting.
Hiatus Hernia:reasons
Doctors have yet to establish the causes of a hiatal hernia, so they have not found a way to prevent it. The disease is associated with congenital weakening of the muscular ring surrounding the end of the esophagus, but not only. A hernia can be caused by severe abdominal injuries, chronic constipation and the associated constant stretching of the diaphragm while passing stools, pregnancy, obesity, lifting heavy loads and contracting abdominal muscles. Age over 50 and smoking are also conducive to hernia formation. Women suffer from it much more often.
Hiatal Hernia: Diagnosis and Treatment
A doctor is able to pre-diagnose a hiatal hernia after talking and examining the patient. However, since many symptoms are similar to those associated with diseases of the heart muscle, endoscopic examination of the upper gastrointestinal tract should be performed, with particular focus on the end of the esophagus and its opening to the stomach, X-rays, manometry (esophageal pressure test), computed tomography and ECG with exercise test.
You must do it- Eat your meals calmly, without haste. They may not be plentiful, you need to eat little, but often, have dinner at least two hours before bedtime.
- Sleep with your head on a high pillow (at least 10-15 cm above bed level).
- Prevent constipation.
- Avoid putting heavy pressure on the diaphragm (pushing it) when passing urine and faeces.
- You must lose weight.
- Quit smoking.
Treatment is primarily aimed at relieving symptoms and preventing complications such as ulceration and even cancer of the esophagus. Pharmacological treatment consisting in taking antacids or inhibiting the secretion of gastric acid, accelerating the transfer of food from the stomach to the duodenum and preventing constipation, is accompanied by recommendations to change the lifestyle.
Rarely, only if the treatment does not bring the expected results, and the development of the disease causes a risk of complications, surgical treatment is applied. The procedure, performed using the traditional or laparoscopic method, consists in strengthening the ring surrounding the esophagus in the diaphragm or in fixing the stomach in the abdominal cavity, which will prevent its content from moving to the esophagus.
If you suffer from hiatal hernia, give up:
- wearing tight clothing
- lifting heavy objects
- lie down and bend over immediately after a meal
- alcohol and caffeinated beverages (coffee, tea, coca-cola)
- light bread
- sweets and cakes
- hard-to-digest and flatulent products (cabbage, peas, beans)
- fried foods.