Hernia of the esophagus refers to chronic diseases.
Pathological changes in the narrow muscular tube and ligamentous
diaphragm apparatus leads to serious disruption to all
organs of the gastrointestinal tract.
Any deviations negatively affect the quality of a person’s life and
can cause a lot of unpleasant symptoms and complications. From unnecessary
problems will save the timely diagnosis. Run
the disease is impossible, it is treatable and increases the chances of
recovery of those patients who seek medical attention
help at the first sign of illness.
Analysis of incidence relative to age
hernia of the esophagus determines that this condition is noted in persons under 50
years – in 0.7% of cases, at the age of 51-60 – in 1.2%, in 4.7% – in
age after 60 years. Regarding sex
It is noted that the diagnosis of the disease occurs more often in
women than men.
Causes of command of hernia of the esophagus are divided into acquired and
- The only congenital cause is the short esophagus, due to
which part of the stomach is initially located in the chest cavity.
- Acquired causes usually occur in people over 60,
but may develop earlier.
The acquired causes of hernia of the esophagus include:
- weakening of the ligaments of the esophagus due to age;
- decrease in volume, weight, and liver function (atrophy);
- dramatic weight loss in which fatty tissue is absorbed
under the diaphragm;
- operations on the esophagus;
- ascites (accumulation of free fluid in the abdominal cavity);
- multiple pregnancy in which changes
interposition of the abdominal organs;
- chronic constipation;
- some physical activities (weight lifting,
- violation of esophageal motility;
- burns the esophagus with hot food or chemicals (with
ingestion of acids and alkalis);
- excess weight;
- chronic diseases that disrupt normal
locomotor activity of the stomach, the initial sections of the small intestine,
- injuries of the abdomen without damaging the integrity of the skin.
In medical practice, there are three types of hernia of the esophagus.
Consider their specific features:
- Axial (sliding hernia) – found in over 90%
cases. With this pathology, cardia is located above its
legitimate place that leads to a change in the normal ratio
stomach and esophagus.
- Short esophagus – anatomical anomaly, most often
occurring in combination with a sliding hernia. Arises
due to inflammation or damage to the walls of the esophagus.
- Paraesophageal – occurs in 5% of patients with HH. Cardia
does not change its primary localization. Violation is characterized by
expansion of the esophageal opening through which the organs go
stomach and enter the esophagus.
Symptoms of hernia of the esophagus
Hernia of the esophagus, which has a small size, usually does not
manifests itself in the initial stage, so the person does not feel
no suspicious symptoms.
The most common signs of hernia
- Pain sensations. This is the most characteristic sign of the disease.
The pain can occur suddenly, very much. Locations –
behind the sternum, “under the spoon”, in the hypochondrium on the left side. Can
significantly increase with physical exertion, movement.
- Difficult swallowing, feeling of a lump in the throat. Upon attempt
�“Swallow” his painful sensations can increase, creating
discomfort behind the sternum.
- Hoarseness – arises in connection with the cast of content
stomach to the region of the larynx and the oral cavity, resulting in
a peptic burn occurs.
- Regurgitation, burping with bitter air;
- Heartburn that occurs on an empty stomach or after eating, while in
supine position. Strengthen heartburn can tilt the body forward;
- Feeling short of breath;
- Hiccups – can differ persistent course and cause considerable
discomfort to the patient. The main cause of prolonged hiccups is
irritation of the branches of the vagus nerve and, as a result, convulsive
contraction of the diaphragm.
- At night, there is increased saliva secretion, coughing
accompanied by a feeling of choking.
Pain after eating (especially when overeating), abdominal distension
and a change in body position occurs most frequently. Also characteristic
for this disease, but are much less common:
- prolonged dull pain under the shoulder blade and at the top
- sudden cutting chest pain;
- severe pain in the solar plexus, aggravated by
- aching pains at the bottom of the sternum and when tapping.
The presence of these symptoms indicates a complication or
neglected form of the underlying disease and the possibility of
In the presence of a hernia of the esophagus, not all cases arise.
the above symptoms. The probability of their occurrence is significant
degree depends on the type of hernia, its size and a number of other
Signs of hernia injury
One of the most dangerous complications of diaphragmatic hernia is her
infringement. It may occur as after a long currents
disease, so be the first manifestation of the disease. To timely
to identify the infringement, the patient should be assessed for the following
- Sudden pain of a sharp or shooting character at the bottom
half breast / upper third of the abdomen.
- Часто, боль распространяется в лопатку или надключичную
hole Increased pain provokes increased intestinal motility
(due to food intake, fluids, certain medications, etc.).
The intensity of the pain is extremely high, in rare cases it can
lead to shock;
- Vomiting that does not stop for a long time
(from several hours to days). As a rule, increases at height
- Severe bloating with increased pain.
The presence of one of these signs requires the urgent provision of
medical care to the patient.
The following complications are possible:
- development of erosive, catarrhal or ulcerative
- pinching of the hiatus hernia;
- the development of peptic ulcers of the esophagus;
- cicatricial stenosis (narrowing) of the esophagus;
- gastric or esophageal bleeding;
- reflex angina;
- perforation of food.
- At infringement it is necessary to immediately receive medical assistance.
You must immediately go to the hospital or call an ambulance if
there is a suspicion of pinching hernia hiatus
- If a person knows that he has a similar disease, then
discuss with your doctor the possible options to avoid pinching. Let be
The specialist will talk about the possible risks and possible behavior in
- You should not wait until the disease leads to such a complication.
It is worth thinking seriously about removing the disease until it
particularly disturbing and does not pose a threat to human life.
If there was an attack of pain during a hernia of the esophagus, you can try
use the following methods:
- lie back and relax. Put your hand under the sternum and
gently massage down a few centimeters.
Repeat twice a day;
- drink a glass of water and stand on an elevation, for example, on the lower
step. Slightly damping, jump down. Water adds weight
stomach and this will help the stomach to slide down into place.
In most cases, the disease is first detected when
radiography of the chest organs from the patient,
esophagus and stomach, as well as during endoscopic examination
(gastroscopy, esophagoscopy). X-ray signs of hernia
- Absence of subphrenic esophagus
- High position of the food sphincter
- Expansion of the diameter of the esophageal opening
- Finding the cardia over the diaphragm, etc.
Endoscopy is determined by the offset of the esophageal-gastric line.
above the diaphragm, signs of erosion and ulcers of the mucous membrane, gastritis and
esophagitis. To exclude tumors, endoscopic examination is performed.
biopsy and morphological study of the biopsy.
How to treat a hernia of the esophagus
Begin testing and start treatment as soon as possible.
earlier. It is not necessary to bring hernial education to serious
conditions when the body begins to irreversible processes and
treatment will be delayed. Guaranteed positive outcome and complete
recovery is possible only with a responsible attitude to
own health. In the treatment of hernia formations of the esophagus
use conservative and surgical treatment methods.
The main treatment takes place at home and includes four
- Exercise therapy,
- folk remedies.
Drug treatment takes up most of
treatment, pills and solutions can be symptomatic
complex, which prevents the patient from living normally. To achieve
remission allows drugs, the action of which
aimed at reducing gastric secretion and protecting the mucous
esophagus from the aggressive effects of gastric juice.
Gymnastics and exercises
For hernia of the esophagus prescribed drugs in the following groups:
- N-2 blockers of histamine receptors, reducing secretion
of hydrochloric acid. Representatives: Nizatidin, Ranitidine, Roxidine,
- Antacid drugs that bind hydrochloric acid, which
constantly irritating to mucous membrane
stomach sheath. Representatives: Renny, Gastal, Almagel;
- Proton pump inhibitors that inhibit salt production
acid. Representatives: Omeprazole, Esomeprazole;
- Prokinetic drugs for the normalization of esophageal motility
to eliminate reflux. Representatives: Tsisaprid,
When hernia of the esophagus is recommended to perform exercises two
- breathing exercises;
- physical exercises aimed at training abdominal muscles
Respiratory exercises should be performed on an empty stomach. Examples
- Starting position (PI): lying on the right side, head and shoulders –
on the pillow. Inhale – stick out the belly, exhale – relax it. Through
week of such training suck on the exhale.
- IP – kneeling. On the inhale, lean to the sides. AT
initial position – exhale.
- Lying on your back, we rotate the body to the side, making
Purpose surgical intervention is recovery
natural anatomical relationships in the esophagus,
diaphragmatic orifice, stomach.
The main indications for the operation to remove a hernia
- the ineffectiveness of conservative therapy;
- the presence of a large hernia;
- fixation of protrusion in the hernial ring;
- развитие осложнений (кровоcurrents, анемии, эзофагита, эрозии
or esophageal ulcers;
- episophageal (paraesophageal) hernia of sliding type –
with its presence, the probability of infringement increases significantly;
- incorrect development (dysplasia) of the esophageal mucosa, in
the result of which it acquires the structure of a thin mucous membrane
For the treatment of hernia in patients, the following may be used.
types of operations:
- Fundoplication according to Nissen (envelops the upper part of the esophagus,
so that the contents of the stomach are not thrown there).
- Belci operation (fix the lower esophagus to the diaphragm and
sphincter, hem the bottom of the stomach to the esophagus).
- Laparoscopy (restore the natural anatomy of the upper
parts of the abdominal cavity, reduce the size of the esophageal
The main task that nutritionists pursue is by assigning
Compliance with strict regulations for the organization of the daily diet
sick hernia of the esophagus, is to minimize and stop
spontaneous ejection of vomit that may become
cause airway clogging and choking
due to lack of oxygen.
Больной с грыжой пищевода должен обязательно соблюдать
diet and eat 5-6 times a day. Eating food passes
much more often than a healthy person, but the portions are smaller.
Much of the diet is consumed in the morning.
To the allowed list of products from which you can make
and develop recipes for medicinal dishes include:
- Dried fruits (the main emphasis is on the use of prunes,
which contributes to the narrowing of the diaphragm and strengthening of the ligaments);
- Dairy products with reduced fat content
(nonfat kefir product, cottage cheese, yogurt, unsweetened
- Low-fat varieties of sea / river fish and poultry / beef
(It is recommended to consume meat products in the form of meatballs, souffle,
jellied or cutlets);
- Vegetable soups (preference should be given to potato or
carrot soups that are wiped before eating
- Ripe fruits (you can make sweet fruit salads or
cook casseroles of cottage cheese with their addition);
- Crackers are sweet, pre-soaked in warm milk or
- Chicken / quail eggs, cooked soft-boiled;
- Cereals and grout with the addition of cereals and sugar cooked on
- Sweet juices, green tea with added milk.
Without an adequate diet, compiled with a doctor, a hernia will
progress and bring more and more negative
effects that accumulate over time and may be
With a diet during a hernia of the esophagus should be
It is obligatory to exclude from the menu harmful products:
- AT первую очередь нужно отказаться от острых продуктов – лук,
garlic, pepper, spicy seasonings, sauces. You can not eat fried
smoked, over-fat and salty foods.
- Категорически запрещено пить алкогольные напитки, сладкую
soda, coffee, energy drinks, sour
concentrated juices and milk.
- It is also necessary to limit the patient in the selection of fruits. Not
despite the fact that they are all very useful, in this situation it is impossible
eat sour fruits: cranberries, grapes, pomegranate, kiwi, lemons,
oranges (all citrus), green apples, cherries and others.
- Most fruits should be peeled, washed thoroughly.
Grated fruits and vegetables are better absorbed.
With the most careful diet, we must also remember that
that after a meal you should never go to bed, the best thing is a little
be like This will help the esophagus to cope with its task. Besides
Moreover, you can not gorge on the night. Even a glass of kefir before bedtime can
provoke exacerbation. Meal is strictly 3 hours before
you will go to bed.
Treatment of hernia of the esophagus folk remedies
Folk remedies for the treatment of hernia of the esophagus, first of all,
aimed at relieving symptoms and preventing such
complications like ulcers and even esophageal cancer. Folk remedies
medicines inhibit the secretion of gastric juice, accelerate movement
food from the stomach to the duodenum and prevent
- To get rid of bloating and flatulence, apply
infusion of valerian root, fennel fruit and peppermint. ATзять
these ingredients in equal quantities and pour boiling water. ATыстаивать в
dark place until the infusion has completely cooled. Drink in the morning and
in the evenings.
- кора осины — выводит жёлчь, обладает общеукрепляющим
and anti-inflammatory effect: pour a spoon into a glass of boiling water
chopped bark and boil a little. After cool
drink, strain. Drink three times a day in a tablespoon.
- Goose cinquefoil (2 tablespoons) poured 300 ml boiling water
insists 12 hours. Take 1 tsp. 10-15 times a day.
- Carrot juice Reduces inflammation, reduces acidity, eliminates
heartburn. Употреблять до еды три раза в день. Should be abandoned
от этого напитка при сахарном диабете, диарее, язве желудка и
- Hernia of the esophagus is very often accompanied by heartburn. Will help in
In this case, all known baking soda and water. For 1 cup of water
1 tsp is added soda, the composition needs to be stirred before
drink up. Pregnant women can not use this tool,
because it contains a large amount of mineral
- Pour a spoonful of seeds with three tablespoons of cold water and leave on
night. The next day, warm the mixture a little and, carefully
chew, eat. Также можно просто залить семена
boiling water, let it brew, and then drink the resulting liquid before
sleep half a glass. Not следует применять семена льна при
pancreatitis, cholecystitis and stones in the gallbladder.
- Ginger helps to get rid not only of heartburn with hernia
esophagus, but also from painful sensations. For relief of symptoms
just chew a small amount of ginger or make
It is impossible to avoid all possible causes of hernia, but
can significantly reduce the risk of its occurrence: to lead a healthy
lifestyle, time to treat diseases of the digestive system,
avoid injury. There are many factors provoking the problem.
и большинство из них носит врождённый характер.
Чрезвычайно важно следить за собственным здоровьем и здоровьем
child, so that if symptoms are detected
It was time to get medical care.