GVPD - what is it? Symptoms and treatment of HBPA

Let's start with the fact that not all are familiar with the acronym GVPD. What it is?

The hernia of the esophageal opening of the diaphragm (still the same HPVC in abbreviated form), or simply the hernia of the esophagus, is nothing more than a disease characterized by the displacement of an organ (located in the abdominal cavity) through the food hole in the diaphragm to the thoracic cavity. This organ is almost always the stomach.

Hernia of the esophagus can be congenital or acquired and has pronounced clinical manifestations. Congenital hernia is less common than acquired. There are many reasons for the appearance of the HVAC.

In the article, we will consider what is GVPD, the symptoms, treatment and postoperative period of this ailment.

General characteristics of the disease

The diaphragm (to which the GPOD directly relates) has the form of a dome-shaped septum, which consists of two types of tissue: the muscular and the connective. This very septum separates the abdominal cavity from the thoracic cavity. Bunches of muscles in the diaphragm form a small hole through which the esophagus passes. And you probably already understood why this hole is called the esophagus.

Let's return to the hernia of the esophageal aperture of the diaphragm (GAPD). What it is? It is formed as a result of the displacement of some organ from the abdominal cavity to the thoracic cavity through that very esophageal opening of the diaphragm. And it happens because of its weakening.

Hernia of the esophageal opening of the diaphragm is such a common disease that it can successfully compete with cholecystitis, pancreatitis or duodenal ulcers. However, in its seriousness, it will also compete with them.

Regarding the age of patients, it can be said that most often the disease develops in people older than 60 years. With regard to gender - women are more likely to suffer from this ailment than men.

Classification

Hernias of the esophagus are classified according to their characteristics. There are such types:

• Non-fixed or fixed hernias (only for axial hernias and para-esophageal ones). In particular, the parasophageal hernia is when the part of the stomach that forms it is located right next to the esophagus, above the diaphragm. And the cardia of the stomach is concentrated under the diaphragm. Axial GVPD is esophageal, cardiac, subtotal or total gastric. There are still sliding hernia, the peculiarities of which are that with this form a hernial sac lined with the peritoneum is formed. It differs from axial in that the latter bag does not. Axial hernia can freely move while moving the body.
• Paraesophageal hernia (fundal or antral).
• Congenital hernia, the cause of which is a short esophagus with an anomaly in development.
• Hernias of another type (small intestine, glandular, etc.).

This disease can also be classified in degrees:

- Esophageal hernia of the first degree. Characterized by the fact that the cardia of the stomach is at the level of the diaphragm, the stomach is slightly elevated and densely attached to the diaphragm. The abdominal esophagus is located in the chest cavity, directly above the diaphragm.

- Esophageal hernia of the second degree. The clinical picture is as follows: abdominal esophagus in the thoracic cavity, and in the esophagus a part of the stomach is already located.

- Esophageal hernia of the third degree. The most severe degree is characterized by the presence of the esophagus, cardia, and sometimes even the body and bottom of the stomach above the diaphragm.

Causes of hiatal hernia

Earlier it was mentioned that there are a lot of reasons for hernia of the esophageal aperture of the diaphragm. However, most often identify the following factors:

• Thinning of connective tissue ligaments, caused by changes in the age-related character or provoked by some other processes.
• Systematic or simultaneous, chronic increase in pressure in the abdominal cavity. The causes of increased pressure can be chronic constipation, heavy physical exertion (for example, lifting heavy objects), blunt abdominal injuries and much more.
• Chronic diseases that directly affect the digestive system and in which the motor skills of the gallbladder, stomach or duodenum may be impaired.
• Disorders of the endocrine glands (endocrinopathy).
• Harmful habits (smoking, drinking alcohol), the elderly person.

GVFD: symptoms

Depending on the clinical manifestations of the disease, the following forms of hernia of the esophageal opening of the diaphragm are distinguished:

- asymptomatic HFRS;

- HHP, the course of the pathology during which is caused by a syndrome of cardia deficiency;

- GVDD, not characterized by the presence of cardia deficiency syndrome;

- GVPD, which appear as a complication of other types of GIT diseases (or simply develop against their background);

- para-esophageal HVAC;

- congenital GHPD, characterized by a short esophagus.

It is worthwhile to consider each type of GVPD (symptoms of each type) separately:

• Asymptomatic hernia. As you have already understood by the name of this form of the disease, there are no signs of GPAP in these cases. This mainly applies to cardiac hernia or esophagus, that is, to small formations. Detect this form of hernia absolutely accidentally, most often - during a complete examination, and sometimes a person does not even guess that he has GVPD - symptoms (treatment will be discussed below), there are no hernias after all.
• GVPD with a syndrome of cardia deficiency. The most common signs of cardiac GVLD are heartburn and pain that occur after eating, as well as with sudden changes in the position of the patient's body. It should also be noted that these symptoms are most often manifested at night, which can be explained by the peculiarity of the increase in the tone of the vagus nerve, and also by relaxation of the lower esophageal sphincter.

Regarding the intensity of heartburn, it can be said that it can be easy (in this case it can be treated with antacids), and rather painful (so much that even deprives a person of working capacity). Its intensity is determined by a whole complex of various factors, and, first of all, to them is the acid-peptic, which is peculiar to gastric juice. Also, this can be affected by stretching the esophagus and throwing into it duodenal contents (primarily bile).

The most prominent sign of hernia of the esophageal aperture of the diaphragm, of course, is pain. It is worth noting that it directly depends on the causes of heartburn. Basically, it appears for identical reasons. Localized pain is mainly in the area behind the sternum, and it intensifies when the patient assumes a supine position. In addition to this position, pain also causes the torso to tilt back and forth. The nature of it may be different, more often it's stitching, cutting or burning sensations.

Regurgitation of gastric contents is also a fairly frequent sign of GHP. What it is? This is the process of casting the contents of the stomach into the mouth. Very unpleasant phenomenon, and thus the contents of the stomach can get into the trachea or bronchi.

And again a few words about the pain. Only half of patients experience real pain, and in 25% of cases this is pseudo-coronary pain, which is localized in the heart area. It can be easily disposed of with nitroglycerin. In addition to such pain, patients can feel unpleasant sensations in the interblade, hepatopancreatoduodenal areas, as well as in the Shoffar-Minkowski area, etc.

Also, about 70% of patients with a hernia of the esophagus of the diaphragm (especially if it is a cardiac GAPD) face such a symptom as eructation. Most often, it occurs in the contents of the stomach, and its predecessor is an unpleasant sensation of characteristic distension in the epigastric region, which indicates aerophagia. Brings an unpleasant bitter aftertaste. And antispasmodics, and analgesics in this case to remove these feelings can not.

Also, 40% of patients have difficulty in passing food along the esophagus, even when taking liquid food. Although it is worth noting that hard food passes easily enough. In people suffering from this symptom, most often it is manifested from very hot or vice versa, very cold food. Therefore, when a hernia is recommended to eat only food that has a body temperature.

About 4% of patients with GAPD suffer from hiccups against the background of the axial form of a hernia. Only this is not a very ordinary hiccup. Its main distinguishing feature can be considered a considerable duration (weeks, or even months, can last). It is not so easy to get rid of it, and only a qualified specialist can help.

Some patients also experience glossalgia (pain in the tongue) and hoarseness, which is a consequence of a peptic burn from the contents of the stomach emitted during regurgitation.

In addition to all of the above, it can be added that the symptoms of the hernia directly depend on its size.

• GVAP without symptom of cardia failure. In such cases, the symptoms of concomitant diseases are more evident, not the hernia itself. Symptoms of this form of hernia are pericardial, epigastric or retrosternal pain that appear immediately after a meal or after lifting weights.

Such pain can last for several days. Neutralize them with non-narcotic analgesics (with the exception of Validol, because it has no effect) or nitroglycerin. Also, the pain stops when eating food or liquids.

• GVPD, which appear as a complication or simply develop against the background of other types of gastrointestinal diseases. Such diseases are most often a stomach ulcer or duodenal ulcer. With this form of GAP, the symptoms of the main ailment appear, not the hernia itself.
• Parasophageal HVAC. This form of hernia is characterized by the absence of any symptoms and manifestations. Most often, the diagnosis of paresisophageal hernia occurs randomly, during general examinations. But when the hernia increases in size, esophageal compression appears (in other words, the narrowing of the esophagus). In isolated cases, esophagospasm develops (a disease in which the peristalsis of the esophagus is disturbed).

When infringement of parasefagial hernia, pain occurs in the sternum or epigastrium.

• Congenital tuberculosis characterized by a short esophagus. With this form of hernia, there may be two variants of development. In the first of them, a phenomenon such as a "chest stomach" can develop, for which the following forms are characteristic:

- location in the chest;

Intrathoracic localization of the stomach.

In the latter case, it is very difficult to make a diagnosis, it usually happens during surgery or even at autopsy.

Possible complications

Hernias of the esophageal opening of the diaphragm can provoke a number of complications. The most common manifestations are:

- gastritis or ulcer of the part of the stomach in which the hernia is located (appears in about 8% of cases);

- bleeding, anemia (occur in 20% of cases);

- the introduction of the lower part of the esophagus into the hernial sac;

- shortening of the esophagus (usually occurs only with cardioesophageal forms);

- prolapse of the gastric mucosa into the esophagus (that is, retrograde prolapse);

- infringement of a hernia (is the most difficult complication of all listed).

Diagnosis of the disease

Usually, experts conduct several tests, based on the results of which it is already possible to diagnose "GPOD". What are these tests:

• Fibrogastroscopy. With its help you can understand the state of the esophagus and stomach. The endoscopic signs of the GPP are determined by the doctor himself, on the basis of which he can diagnose and prescribe the treatment.
• X-ray examination, which is carried out on the basis of barium contrast. Thanks to this examination, it is possible to obtain an image of a hernial protrusion, characteristic of each GVPD degree.
• PH-metry. This test is done to determine the level of acidity in the stomach. It is necessary in order to properly prescribe the treatment of a hernia.

Treatment of esophageal gavage

Usually, the treatment of hernia of the esophageal opening of the diaphragm is carried out with the help of medications, but in some cases (especially with complications) surgical intervention is required.

With regard to the treatment of medications, it consists in reducing the acidity of the stomach (with the help of antacids), as well as reducing gastric secretion. This is the first task. Also, during treatment, it is necessary to protect the gastric mucosa, which is also provided for the administration of certain medications.

A strict diet is prescribed for treatment, which must be adhered to unquestioningly. Basically, this diet is almost the same as with gastritis: nothing greasy, nothing acute, sour, salty. Only healthy food, for example, vegetables, fruits, cereals, dietary soups and broths, low-fat meat.

So, to eliminate heartburn and to reduce the secretion of the stomach can take the drug "Maalox." What is very convenient, it is produced not only in tablets, but also in the form of gels, dragees, suspensions. Each form of this product has a separate instruction for use, which can be specified in any pharmacy in your city.

You can also take such means as "Renny" or "Gastal". To eliminate the already occurring heartburn, it will be enough to take one tablet, and for prophylaxis - 4 tablets per day (one hour after a meal). However, remember that these drugs eliminate only the symptoms.

As for the surgical intervention, it consists in the removal of the hernial formation.

For more accurate diagnosis and appointment of treatment, you need to see a doctor (surgeon or gastroenterologist).

Treatment with folk remedies

Treating GHPD with folk remedies will not give the desired results, since in most cases a sick person needs serious medications or even a surgical intervention.

That is, the hernia itself is not capable of removing any folk remedies. The only thing they can be used for is pain relief.

Some decoctions of herbs will help reduce pain. Here are a few folk remedies that will help in the fight against hernia:

- Decoction from the roots of the althea. Pour about 20 g of crushed althea root mug of boiling water and let it brew.

- Mix 30 drops of alcohol tincture of propolis and 50 ml of milk . Take 2 times a day.

- With meteorism, a decoction of carrot seeds works well. Pour one gram of seeds with 2 cups of hot water and allow the mixture to infuse for about half an hour. You need to drink with the seeds.

Remember that before taking anything (especially folk remedies) you should always consult a doctor.

Also, with the help of folk remedies, you can get rid of heartburn, hiccups and other symptoms of GPOD. But remember that this is only a temporary result, and you need to treat the cause of the disease, not the symptoms.

Herniated hernia after surgery

As mentioned above, in some cases, hernia of the esophageal opening of the diaphragm requires surgical intervention. GPPO-operation, the comments about which are ambiguous, can really save a person's life in especially neglected cases.

But what to do when the operation is already done? How to follow the postoperative regimen? How long does it take to return to normal life?

GPPOD after surgery necessarily requires care and comprehensive medical and preventive measures.

On the first day after the operation, patients need an examination of the therapist and electrocardiography. On the second day, a chest X-ray is performed. On the third - the general or common developed analysis of a blood, and also biochemical research according to which indications a sonography is appointed.

Twice a day, patients should perform simple exercises of respiratory gymnastics and physiotherapy exercises.

As for drug therapy, we can say the following. It consists in the introduction of saline solutions intravenously in a volume of up to 1800 ml per day. All patients after the operation take antibiotics.

Trocar wounds are treated with alcohol and bandaged every other day.

Literally a day after the operation, patients can already drink water, and from the second day - take liquid food. The postoperative period lasts about 3 months.

How does the GPOD operation itself (reviews about which are different, depending on the severity of the disease) we have already mentioned above. It consists in the removal of the hernia itself.

Conclusion

So, now you will not be frightened if somewhere you will see the abbreviation of the GVPD. What it is and how it manifests itself, you already know.

It remains only to sum up that the disease is very serious. Self-medication, especially treatment with folk remedies, is dangerous enough and can cause serious complications.

But, alas, no one is insured against complications, as some forms of GVAP are asymptomatic. The only way out is to undergo a full examination in the hospital at least once a year. So you will be able to detect this unpleasant disease in time.