Diseases of internal organs. Hernia of the esophageal opening of the diaphragm

According to the anatomical structure of man, the abdominal and thoracic areas are separated by a diaphragm. It has an anatomical vascular opening made by a fibrous ring. In order to ensure the protection of blood vessels, it has a constant diameter. The second aperture - esophageal - is formed capable of constriction and expansion (depending on the lump of food) muscles.

With violations in the work of the spine, the work of internal organs is disrupted. For example, the curvature of the spine (scoliosis), to some extent present in most of the population, leads to a violation of the innervation of organs. As a result, visceroptosis (displacement, omission of organs) and violation of their functions and tone occurs.

With a decrease in the tone of the diaphragm, the esophagus is enlarged. Due to intra-abdominal pressure or in the horizontal position of the body through it, the stomach passes partly or completely out of the abdominal cavity into the thoracic cavity. Thus, a hernia of the esophageal opening of the diaphragm arises.

The stomach part, being in the chest area, pushes the heart, bronchial tree and nerve trunks. This, in turn, can provoke sharp violations in the heart rhythm (tachycardia), bouts of bronchospasm (asthma). In patients with angina pectoris, a hernia of the esophageal opening of the diaphragm can cause an attack of atrial fibrillation, and in special cases - myocardial infarction.

It is necessary to mention the physical suffering of the patient. The situation is further aggravated by the fact that in many cases, many years of efforts aimed at healing have proved ineffective. In such situations, the hernia of the esophageal opening of the diaphragm often refers to a secondary disease, while in the first place is the "obsessive-compulsive disorder". The effect of the gastric part on the mediastinum, heart and lungs is carried by the patients very painfully.

The main symptoms of a hernia of the esophageal opening of the diaphragm:

- Heartburn (both after and before eating), very painful, especially when taking a horizontal position;

- belching with sour, bitter air;

- regurgitation of food, accompanied by pain;

- burning pain in the left hypochondrium, behind the breastbone, in the epigastric region (may increase with tilt or load);

- pain in the process of swallowing food, feeling in the throat of a lump ;

- Discomfort, developing to severe pain, extending into the left shoulder blade and shoulder;

- Burning sensation;

- A sense of lack of air or dissatisfaction with inhalation.

Very often a hernia of the esophageal opening of the diaphragm causes neurotic patients who are able to seriously change the psyche, and in some cases, the social behavior of the patient.

In a number of cases, a spontaneous increase in pressure is observed. At night, salivation is increased, attacks of suffocation and coughing are amplified, in the morning hoarseness appears in the voice.

Treatment of a hernia of the esophageal aperture of the diaphragm is prescribed radical (by operation). It should be noted that surgical intervention is used only according to indications. As practice shows, there is a certain percentage of cases in which surgical intervention can eliminate the disease.

Conservative methods of therapy are directed somewhat differently. The effectiveness of treatment in general, as well as its nature, depend more on how accurately the features of the disease course are taken into account. In other words, everything depends on the primary disease, its symptoms, complications and effects on the body.

Given the fact that the clinical picture of the disease in most episodes is determined by the manifestation of gastroesophageal reflux, then the main therapeutic measures are directed at its elimination.