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Axial esophageal hernia diaphragm 1 degree: symptoms and treatment

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Axial hernia - pathologic process in the digestive system, accompanied by protrusion of the esophagus and displacement of the stomach into the chest cavity through the aperture in the diaphragm, the

is intended for the esophagus. With such a process, it is not the whole esophagus, but only its lower part;not the entire stomach is displaced, but only a certain part of it( guard, bottom, etc.).Given the etiology( cause) of such a hernia and the organs in which the pathology occurs, the full name of the disease will sound like an "axial hernia of the esophagus of the diaphragm."

In addition, such a hernia is called "slippery hernia".She received this name for the fact that one of the walls of the hernial sac is formed by an organ that is covered with a peritoneum( a thin serous membrane that covers the walls of the abdominal cavity and some organs in it), and a protrusion through the slippage of the organ from its usual location is formed.


  • 1 Statistics and Etiology
  • 2 Symptomatic manifestations of
  • 3

treatment methods 1 Statistics and etiology

For a better understanding of the nature of the pathology, it is not superfluous to know what is the diaphragm and how it is related to the digestive organs. The diaphragm is an odd transverse( elastic, elastic tissue, capable of contraction under the influence of impulses from the nervous system) muscle. Due to this muscle, the lungs are able to expand, and the human body is divided into the chest and abdominal cavity. For the symbols of the diaphragm, use the lower edge of the edges.

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Axial esophageal hernia diaphragm 1 degree: symptoms and treatment

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aplastic hernia In essence, the axial hernia of the esophagus is a defect that occurs in the diaphragm that affects the esophagus and stomach. Since the diaphragm is a muscle and consists of fibers, the main factor that provides the normal functioning of this organ is the elasticity and flexibility of muscle fibers. Unfortunately, over time, muscle fibers become less flexible and elastic. Because of this, the axial hernia of the esophagus belongs to a group of age-related diseases. Accordingly, this pathology occurs in the vast majority of adults.

Statistics show that the axial hernia of the diaphragm occurs in about 5% of adults around the world. Women suffer from such a hernia more often than men, and in children it is usually congenital. If we consider the frequency of this pathology in all cases of diaphragmatic hernias, it occurs in 90% of cases, that is, more often than diaphragmatic hernia of the bladder, small intestine or large intestine, etc. However, among the pathologies of the digestive system, the axial hernia takes the third place, sometimesahead of even peptic ulcer and cholecystitis.

There are 3 apertures in the diaphragm that allow the bodies between the chest and abdomen to connect with each other. Thus, in the diaphragm, there are openings for the esophagus, aorta and hollow vein. Pathology occurs when, due to the lost flexibility and elasticity of the diaphragmatic muscles, the esophageal hole expands and becomes in diameter much more than the diameter of the esophagus. The elasticity and flexibility of diaphragmatic muscles can be disturbed not only with age but also for a number of other reasons. These include:

  • The hereditary factor. In rare cases, the defect of the esophagus is transmitted from the parents to the child.
  • GERD( gastroesophageal reflux disease).This quite common pathology leads to shortening the esophagus through the inflammatory process and the formation of scarring in the esophagus wall.
  • Diseases of the pancreas and liver for a long time, their chronic forms.
  • High intra-abdominal pressure. Such a phenomenon can be the result of constant flatulence( excessive gas formation and bloating), constipation, overeating, weight lifting.
  • Dysfunction of the stomach and duodenal motility.
  • Respiratory diseases, the manifestation of which is a constant painful cough.
  • Pregnant women. During pregnancy increased in size, the uterus makes excessive pressure on the diaphragm. Sometimes the pathology develops only after severe labor, and not during pregnancy.
  • Obesity is also accompanied by excessive strain on the diaphragm. In addition, in people with obesity, the stomach has a size many times more than a set of excess weight.
  • Mechanical damage to the diaphragm: fracture of ribs, etc.
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    2 Symptomatic manifestations of


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    About half of patients for a long time do not suspect the presence of axial hernia. This is due to the fact that the typical hernia manifestation( protrusion) is not visible, since the hernia is localized within the body. Pathological manifestations of axial hernia are similar to the symptoms of pathologies of the organs of the gastrointestinal tract. This is due to the fact that in the first case, and in the second there is a functional violation of the gastrointestinal tract. Symptoms are:

  • The emergence of gastro-oesophageal catarrhal reflux is the neglect of the contents of the stomach in the esophagus cavity. Gastric juice has a sour environment due to hydrochloric acid. For the walls of the esophagus, this environment is aggressive and causes their irritation and inflammation. This phenomenon man feels the appearance of heartburn( a sense of burning in the chest) after eating. Heartburn is aggravated in time by physical activity, when the patient takes a lying position. The patient may feel a tangle in the throat.
  • Pain syndrome occurs after eating. It can be felt in the area of ​​the sternum, neck, shoulder blade, lower jaw, heart. The pain from such a localization also occurs in diseases of the cardiovascular system - angina pectoris. Therefore, proper diagnosis is important. Sometimes pain syndrome occurs only after a horizontal or other position. The patient may feel the presence of an alien body in the upper abdomen and swelling.
  • Hiccup, which manifests itself by involuntary convulsive reductions in the diaphragm. It causes irritation of the nerve of the diaphragm, which occurs due to the formed hernial sac. Often, the hiccups last for a long time, arise after eating.
  • A blister resulting from the ingestion of air into the stomach during meals. In people without hernia and other pathologies of the digestive tract, gradual air flow through the mouth is observed. In the axial hernia, the stomach pressure is elevated, this is manifested by the dislocation in the region of the substrate and leads to an increased and rapid release of air from the stomach, accompanied by a characteristic sound.
  • Dysphagia is a process of disturbing swallowing. In dysphagia, it is harder to swallow liquid food, especially if it is cold or hot, or the patient eats too quickly.
  • Bleeding is a complication of hernia. Violation of the integrity of the esophagus vessels and bleeding occurs. It turns out not at once, which is dangerous for human health. Determining the presence of bleeding allows progressive anemia.
  • Perforation of the esophagus is a serious complication that manifests itself as a violation of the integrity of the esophagus wall. As a rule, such a complication is possible when the hernia is pierced by the walls of the esophagus.
  • Ulcerative mucosal lesions of the esophagus.
  • Axial esophageal hernia diaphragm 1 degree: symptoms and treatment

    3 Methods of treatment


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    Combination therapy is used to treat axial hernia of the esophagus. To begin, prescribe medications that facilitate the manifestation of the disease( heartburn, bloating, flatulence).Positive effect are drugs that reduce the pH of the stomach, in order to less damage to the walls of the esophagus.

    Facilitates the symptoms of a particular diet. It is important not to use products that do not cause the secretion of gastric juice: spicy and fatty foods, chocolate, coffee, alcohol, etc. You need to eat a bit and often. Helps to avoid complications and reduce the severity of symptoms without excessive physical activity and lifting heavy objects.

    It is important to understand and to know that medication and dietary management provide temporary relief without eliminating the cause of the disease. Because of this almost always with an axial hernia surgical operation is assigned. Currently, two methods of surgical intervention are used in surgical practice: open access - fundoscopic treatment according to Nissen, less used due to a large number of complications, and toothpaste that is often used, as it may have fewer complications;laparoscopic access - surgery with less injury to healthy tissues and rapid rehabilitation process.