A hernia of the esophageal opening of the diaphragm (diaphragmatic hernia) occurs if through the esophageal opening of the diaphragm - the opening through which the esophagus from the thoracic cavity enters the abdominal - the abdominal part of the esophagus, part of the stomach or the abdominal part of the esophagus, together with part of the stomach, is displaced into the chest cavity.
Causes of the disease The cause of a diaphragmatic hernia is the increased elasticity of the tissues limiting the esophageal opening of the diaphragm. This elasticity can be innate. Sometimes there is a developmental anomaly - the so-called "short esophagus with a pectoral stomach."
Symptoms of the disease One of the most common complaints is heartburn (caused by reflux of gastric contents into the esophagus). With a hernia of the diaphragm, heartburn often occurs at night or after eating. Heartburn can also occur after exercise, and is often accompanied by pain.
Pain with a hiatal hernia occurs in 40-50% of patients. The pain is quite intense, felt retrosternal, has a burning character and, therefore, is often confused by patients with pain with angina pectoris.
The next common symptom of a hiatal hernia is belching. Belching - involuntary sudden release of gas through the mouth from the stomach or esophagus, sometimes with an admixture of stomach contents, occurs in 30 - 73% of patients.
Diagnosis The diagnosis of a hiatal hernia is made by X-ray examination. Routine fluoroscopy of the esophagus and stomach with barium contrast is often sufficient. To clarify the diagnosis, esophagogasroscopy is performed.
Treatment Prescribed a diet with fractional meals in small portions, treatment of constipation. Physiotherapy is mandatory. Doing certain exercises can help prevent stomach displacement. Drugs are used to reduce gastric secretion and reduce acid aggressiveness of gastric contents, normalize dyskinesias of the gastrointestinal tract.
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