Hernia of the esophageal opening of the diaphragm (HH) and reflux esophagitis is a disease of the esophagus and diaphragm, which is caused by the expansion of the esophageal opening of the diaphragm due to stretching of the ligaments that fix the esophagus and stomach. As a result of these phenomena, the upper part of the stomach goes into the chest cavity and the work of the esophageal sphincter is disrupted.
Disruption of the lower esophageal sphincter leads to the throwing of gastric contents into the esophagus with the development of chronic inflammation of its mucous membrane. This inflammatory process of the esophagus is called reflux esophagitis. Sometimes this long-term ongoing process leads to the development of esophageal cancer. According to the European and American Gastroenterological Associations, if HHT exists for 5-12 years without treatment, then the risk of developing esophageal cancer increases by 270% after 5 years and by 350-490% - depending on age - after 12 years.
PREVALENCE OF THE DISEASE
At present, HHH is one of the most common diseases of the gastrointestinal tract and in terms of its frequency it ranks 2-3 among gastroenterological diseases.
The most common symptoms of hiatal hernia are:
• Pain is the most common symptom of pathology. They are burning, occur in the epigastric, retrosternal region, sometimes in the left hypochondrium, significantly increase with movement, physical exertion, bending.
• Painful, prolonged heartburn - occurs both after eating and on an empty stomach, aggravated when lying down and when bending forward.
• Belching sour, bitter, air, as well as regurgitation, often against the background of pain.
• Difficulty swallowing, a feeling of a lump stuck in the throat, pain during the swallowing process is very characteristic. Attempts to swallow food can be accompanied by an increase in pain syndrome, the appearance of feelings of discomfort behind the sternum, developing into pain of a bursting nature, often radiating to the left shoulder, scapula (as with angina pectoris).
Therapeutic treatment of HHH is aimed at relieving symptoms: while the patient is taking medications, adheres to a strict diet, strictly follows all the doctor's prescriptions, then his condition is relatively comfortable. When treatment is stopped, all symptoms of HHH (constant belching, excruciating heartburn) return. Patients with small hernia of the esophageal opening of the diaphragm, without a pronounced clinical picture and only if the patient is ready to take medications for life that prevent the occurrence of reflux esophagitis or reduce the symptoms of the disease, are subject to conservative treatment by a gastroenterologist. It was found that when using drugs that reduce the acidity of gastric juice within 5 years, the risk of developing stomach cancer increases by 350%, and after 12 years - increases by 560% compared to persons without HH of the same age. Also, a decrease in the level of acid in the stomach disrupts the digestion of food and its undigested residues enter the large intestine, where they cause putrefactive processes and lead to the development of severe intestinal dysbiosis.
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