Axial hernia of the esophageal opening of the diaphragm - treatment

Axial hernia of the esophageal opening of the diaphragm is observed when the muscles of the diaphragm relax around the esophageal opening. As a result, part of the stomach during exercise, after eating and other effects slips into the chest cavity, and after a while comes back.

Types of axial hernia of the esophageal opening of the diaphragm

Axial is called non-fixed hernia of the esophageal aperture of the diaphragm, which is not always present, but depending on the fullness of the stomach, intra-abdominal pressure, body position and other factors. With such a hernia, the lower part of the esophagus and part of the stomach slide freely into the chest cavity and back, by weakening the muscles around the diaphragmatic opening.

Axial hernia of the esophageal foramen is divided into:

• cardial - when only the cardia is above the diaphragm (the section that is transitional between the esophagus and the stomach);
• cardiofundal - penetration into the opening of the diaphragm of the upper part of the stomach;
• subtotal and total gastric - above the diaphragm is the greater part or the entire body of the stomach.

Cardial hernia constitute the largest percentage of all axial hernia of the esophageal opening of the diaphragm. Other types of hernia account for less than 5% of cases.

Stages of axial hernia of the esophageal opening of the diaphragm

1. Axial hernia of the esophageal aperture of the 1st degree. Virtually not diagnosed, above the diaphragm is only the abdominal part of the esophagus, and the cardia penetrates into the lumen of the diaphragm.
2. At the second degree of axial hernia, the cardia is placed above the diaphragm, and the upper part of the stomach is at the level of the diaphragmatic opening.
3. In the third and fourth stages, a part or whole of the stomach extends directly into the thoracic cavity.

Treatment of axial hernia of the esophageal opening of the diaphragm

Conservative therapy for this disease is used in the early stages and more to avoid the development of complications. Treatment includes:

1. Fractional food , with a plentiful drink. Exclusion of acute, cholesterol-rich and gas-promoting products. All food must be thoroughly chewed.
2. Compliance with special treatment. You can not take a horizontal position immediately after eating, avoid sudden changes in body position, loads that can trigger excessive strain of the diaphragm and peritoneum.
3. Reception antatsidnyh drugs , drugs affecting the production of stomach hydrochloric acid, and drugs that regulate gastric motility.
4. Special respiratory gymnastics.

In the case of deterioration and in the later stages of the disease, surgery is performed to regulate the hernia and restore the elasticity of the muscular apparatus.