Esophageal hernia (Hiatal Hernia, Diaphragmatic Hernia, Paraesophageal Hernia). Esophageal hernia symptoms and treatment diet Esophageal hernia symptoms and treatment diet

Refers to chronic diseases. Pathological changes in the narrow muscular tube and the ligamentous apparatus of the diaphragm lead to serious disruptions in the functioning of all organs of the gastrointestinal tract.

Any deviations negatively affect a person’s quality of life and can cause a lot of unpleasant symptoms and complications. A timely diagnosis will save you from unnecessary problems. The disease cannot be neglected; it is treatable and increases the chances of recovery for those patients who seek medical help at the first signs of the disease.

Causes

An analysis of morbidity in relation to age-related susceptibility to hiatal hernia determines that this condition is observed in people under 50 years of age - in 0.7% of cases, in people aged 51-60 - in 1.2%, in 4.7% - in people over 60 years of age. Regarding gender, it is noted that the diagnosis of the disease occurs more often in women than in men.

The causes of esophageal hernias are divided into acquired and congenital.

The only congenital cause is a short esophagus, due to which part of the stomach is initially located in the chest cavity.
Acquired causes usually occur in people over 60 years of age, but can develop earlier.

Acquired causes of hiatal hernia include:

weakening of the esophageal ligaments due to age;
decrease in liver volume, weight and function (atrophy);
sudden weight loss, during which fatty tissue under the diaphragm is absorbed;
operations on the esophagus;
ascites (accumulation of free fluid in the abdominal cavity);
multiple pregnancy, in which the relative position of the abdominal organs changes;
chronic constipation;
some physical activity (weight lifting, squats);
esophageal motility disorder;
burns of the esophagus by hot food or chemicals (when swallowing acids and alkalis);
excess weight;
chronic diseases in which the normal motor activity of the stomach, initial parts of the small intestine, and gall bladder is disrupted;
abdominal injuries without damaging the integrity of the skin.

Types of disease

In medical practice, there are three types of hiatal hernia. Let's look at their specific features:

Axial (sliding hernia)– occurs in more than 90% of cases. With this pathology, the cardia is located above its rightful place, which leads to a change in the normal ratio of the stomach and esophagus.
Short esophagus- an anatomical anomaly, most often found in combination with a sliding hernia. Occurs due to inflammation or damage to the walls of the esophagus.
Paraesophageal– occurs in 5% of patients with hiatal hernia. The cardia does not change its primary localization. The disorder is characterized by enlargement of the esophageal opening, through which the stomach organs exit and enter the esophagus.

Symptoms of a hiatal hernia

A small esophageal hernia usually does not manifest itself in any way at the initial stage, so a person does not feel any suspicious symptoms.

The most common signs and symptoms of a hiatal hernia are:

Painful sensations. This is the most characteristic sign of the disease. The pain can occur suddenly and very strongly. Places of occurrence: behind the sternum, “under the stomach”, in the hypochondrium on the left side. They can intensify significantly with physical activity and movement.
Difficulty swallowing, feeling of a lump in the throat. When you try to “swallow” it, the pain may increase, creating unpleasant sensations behind the sternum.
Hoarseness of voice- occurs due to the reflux of stomach contents into the larynx and oral cavity, resulting in a peptic burn.
Regurgitation, belching of bitter air;
Heartburn that occurs on an empty stomach or after eating, while lying down. Leaning your body forward can make heartburn worse;
Feeling short of breath;
Hiccups can be persistent 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.
Increased saliva production at night, coughing attacks are accompanied by a feeling of suffocation.

Pain after eating (especially when overeating), bloating and changes in body position with a hiatal hernia occur most often. Also characteristic of this disease, but much less common:

prolonged dull pain under the shoulder blade and in the upper abdomen;
sudden cutting pain in the chest;
severe pain in the solar plexus area, aggravated by pressure;
aching pain in the lower sternum and when tapping.

The presence of these symptoms indicates a complication or an advanced form of the underlying disease and the possibility of the appearance of concomitant ones.

In the presence of a hiatal hernia, the above symptoms do not occur in all cases. The likelihood of their occurrence largely depends on the type of hernia, its size and a number of other factors.

Signs of a strangulated hernia

Why is a hiatus hernia dangerous? One of the most dangerous complications of diaphragmatic hernia is strangulation. It can occur either after a long course of the disease or be the first manifestation of the disease. In order to promptly identify infringement, the patient should be assessed for the following symptoms:

Sudden sharp or shooting pain in the lower half of the chest/upper third of the abdomen.
Often, the pain spreads to the scapula or supraclavicular fossa. Increased pain is provoked by increased intestinal motility (due to food intake, liquids, 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, it intensifies at a height of pain;
Severe abdominal bloating with increased pain.

The presence of one of these signs requires urgent medical care for the patient.

Complications

The following complications are possible:

development of erosive, catarrhal or ulcerative reflux esophagitis;
infringement;
development of peptic ulcer of the esophagus;
cicatricial stenosis (narrowing) of the esophagus;
stomach or esophageal bleeding;
reflex angina;
perforation of food.

If you are injured, you must immediately get medical help. You should immediately go to the hospital or call an ambulance if you suspect a strangulated hiatal hernia.
If a person knows that he has such a disease, he should discuss with his doctor possible options for avoiding pinching. Let the specialist talk about possible risks and possible behavior in a particular case.
You should not wait until the disease leads to such a complication. It is worth seriously thinking about removing the disease while it is not particularly alarming and does not pose a threat to human life.

If you experience an attack of pain due to a hiatal hernia, you can try using the following methods:

lie on your back and relax. Place your hand under the sternum and lightly massage downwards a few centimeters. Repeat twice a day;
drink a glass of water and stand on an elevated platform, for example, on the bottom step. Lightly cushioning and jumping down. Water adds weight to the stomach and this will help the stomach slide down into place.

Diagnostics

In most cases, this disease is first detected when the patient undergoes an X-ray of the chest, esophagus and stomach, as well as during an endoscopic examination (gastroscopy, esophagoscopy). X-ray signs of a hernia are:

Absence of the subphrenic esophagus
High position of the alimentary sphincter
Expansion of the diameter of the esophageal opening
Location of the cardia above the diaphragm, etc.

Endoscopy reveals a displacement of the esophageal-gastric line above the diaphragm, signs of erosion and ulcers of the mucous membrane, and esophagitis. To exclude tumors, endoscopic biopsy and morphological examination of the biopsy specimen are performed.

How to treat a hiatal hernia

It is advisable to begin examination and begin treatment as early as possible. You should not bring the hernia to a serious condition, when irreversible processes begin in the body and treatment will be delayed. A guaranteed positive outcome and complete recovery is possible only with a responsible attitude towards your own health. In the treatment of hernial formations of the esophagus, conservative and surgical treatment methods are used.

The main treatment takes place at home and includes four methods:

taking medications,
diet,
folk remedies.

Medicines

Treatment with drugs takes up the majority of therapy; tablets and solutions can relieve the symptomatic complex that prevents the patient from living a normal life. Remission can be achieved with medications whose action is aimed at reducing gastric secretion and protecting the esophageal mucosa from the aggressive effects of gastric juice.

Gymnastics and exercises

For esophageal hernia, the following groups of drugs are prescribed:

H-2 blockers of histamine receptors, reducing the secretion of hydrochloric acid. Representatives: Nizatidine, Ranitidine, Roxtidine, Famotidine;
Antacid medications that bind hydrochloric acid, which constantly has an irritating effect on the gastric mucosa. Representatives: Rennie, Gastal, Almagel;
Proton pump inhibitors, which inhibit the production of hydrochloric acid. Representatives: Omeprazole, Esomeprazole;
Prokinetic drugs to normalize esophageal motility to eliminate. Representatives: Cisapride, Metoclopramide.

breathing exercises;
physical exercises aimed at training the abdominal muscles.

Breathing exercises should be performed on an empty stomach. Examples of exercises:

Starting position (IP): lying on your right side, head and shoulders on a pillow. Inhale - stick out your stomach, exhale - relax it. After a week of such training, we draw in our stomach as we exhale.
IP - kneeling. As you inhale, bend to the sides. In the starting position – exhale.
Lying on your back, twist your body to the sides while inhaling.

Surgical treatment

The purpose of surgical intervention is to restore the natural anatomical relationships in the area of the esophagus, diaphragmatic opening, and stomach.

The main indications for surgery to remove a hernia are:

ineffectiveness of conservative therapy;
presence of a large hernia;
fixation of protrusion in the hernial orifice;
development of complications (bleeding, esophagitis, erosion or ulcer of the esophagus;
peri-esophageal (paraesophageal) sliding type hernia – if present, the likelihood of strangulation increases significantly;
incorrect development (dysplasia) of the esophageal mucosa, as a result of which it acquires the structure of the mucous membrane of the small intestine.

The following types of operations can be used to treat hernia in patients:

Nissen fundoplication (they envelop the upper part of the esophagus so that the contents of the stomach do not flow there).
Belsi operation (the lower part of the esophagus and sphincter are attached to the diaphragm, the fundus of the stomach is sutured to the esophagus).
Laparoscopy (restores the natural anatomy of the upper abdominal cavity, reduces the size of the esophageal opening).

Diet

The main task pursued by nutritionists, prescribing adherence to strict instructions for organizing the daily diet of patients with hiatal hernia, is to minimize and stop the spontaneous release of vomit, which can cause clogging of the respiratory tract and suffocation due to lack of oxygen.

A patient with a hiatal hernia must follow a diet and eat 5-6 times a day. Eating occurs much more frequently than in a healthy person, but the portions are smaller. A significant portion of the diet is consumed in the first half of the day.

To the approved list of products, from which you can compose and develop recipes for medicinal dishes, include:

Dried fruits (the main emphasis is on the consumption of prunes, which helps to narrow the diaphragm and strengthen the ligaments);
Fermented milk products with a reduced fat content (low-fat kefir product, cottage cheese, yogurt, unsweetened yogurt);
Low-fat varieties of sea/river fish and poultry/beef (it is recommended to consume meat products in the form of meatballs, soufflé, aspic or cutlets);
Vegetable soups (preference should be given to potato or carrot soups, which are rubbed through a sieve before use);
Ripe fruits (you can make salads from sweet fruits or prepare cottage cheese casseroles with their addition);
Sweet crackers, previously soaked in warm milk or hot tea;
Chicken/quail eggs, cooked soft-boiled;
Porridges and grouts with added cereals and sugar, prepared with milk;
Sweet juices, green tea with added milk.

Without an adequate diet, drawn up with a doctor, the hernia will progress and carry more and more negative consequences every day, which accumulate over time and can be life-threatening.

When following a diet during a hiatal hernia, it is imperative exclude harmful foods from the menu:

First of all, you need to give up spicy foods - onions, garlic, peppers, spicy seasonings, sauces. You should not eat fried, smoked, excessively fatty and salty foods.
It is strictly forbidden to drink alcoholic beverages, sweet carbonated water, coffee, energy drinks, sour concentrated juices and milk.
It is also necessary to limit the patient’s choice of fruits. Despite the fact that they are all very healthy, in this situation you should not eat sour fruits: cranberries, grapes, pomegranates, kiwis, lemons, oranges (all citrus fruits), green apples, cherries and others.
Most fruits should be peeled and washed thoroughly. Grated fruits and vegetables are better absorbed.

When following the diet most carefully, you must also remember that after eating you should not lie down under any circumstances; it is best to walk around a little. This will help the esophagus cope with its task. In addition, you should not overeat at night. Even a glass of kefir before bed can provoke an exacerbation. Eating strictly 3 hours before you go to bed.

Treatment of hiatal hernia with folk remedies

Folk remedies for the treatment of hiatal hernia are primarily aimed at relieving symptoms and preventing complications such as ulcers and even esophageal cancer. Traditional medicine inhibits the secretion of gastric juice, accelerates the movement of food from the stomach to the duodenum and prevents constipation.

Traditional recipes:

To get rid of bloating and bloating, use an infusion of valerian root, fennel fruit and peppermint. Take these ingredients in equal quantities and pour boiling water. Leave in a dark place until the infusion has cooled completely. Drink in the mornings and evenings.
aspen bark - removes bile, has a general strengthening and anti-inflammatory effect: pour a spoonful of crushed bark into a glass of boiling water and boil a little. After cooling the drink, strain. You should drink a tablespoon three times a day before meals;
Goose cinquefoil (2 tablespoons) is poured with 300 ml of boiling water and left for 12 hours. Take 1 tsp. 10-15 times a day.
Carrot juice. Relieves inflammation, reduces acidity, eliminates heartburn. Consume before meals three times a day. You should avoid this drink if you have diabetes, diarrhea, and gastritis.
A hiatal hernia is very often accompanied by heartburn. In this case, the well-known baking soda and water will help. Add 1 tsp to 1 glass of water. soda, the composition must be stirred before drinking. Pregnant women should not use this product because it contains a large amount of mineral salts.
Pour three tablespoons of cold water over a spoonful of seeds and leave overnight. The next day, warm the mixture a little and, chewing thoroughly, eat. You can also simply pour boiling water over the seeds, let it brew, and then drink the resulting liquid half a glass before bed. Flax seeds should not be used for pancreatitis, cholecystitis and gallstones.
Ginger helps to get rid of not only heartburn due to a hiatal hernia, but also pain. To relieve symptoms, simply chew a small amount of ginger or make tea from it.

Prevention

It is impossible to avoid all possible causes of a hiatal hernia, but you can significantly reduce the risk of its occurrence: lead a healthy lifestyle, treat diseases of the digestive system in a timely manner, and avoid injury. There are many factors that provoke the problem, and most of them are congenital. It is extremely important to monitor your own health and the health of your child so that if symptoms of the disease are detected, you can get medical help in a timely manner.

This is all about hiatal hernia: causes, symptoms and treatment methods. Don't get sick!

A hiatal hernia (HHH, hiatal hernia) is an anatomical defect, the essence of which is the displacement of part of the esophagus or stomach into the chest cavity. When the ligamentous apparatus of the esophageal opening (cardia) is in normal condition, movement of organs is impossible. The risk of pathology appears if the ligaments and subdiaphragmatic fatty tissue are weakened.

Classification of hiatal hernia

In medical practice, there are three types of hiatal hernia. Let's look at their specific features:

Axial (sliding hernia) - occurs in more than 90% of cases. With this pathology, the cardia is located above its rightful place, which leads to a change in the normal ratio of the stomach and esophagus.
A short esophagus is an anatomical anomaly, most often found in combination with a sliding hernia. Occurs due to inflammation or damage to the walls of the esophagus.
Paraesophageal – occurs in 5% of patients with hiatal hernia. The cardia does not change its primary localization. The disorder is characterized by enlargement of the esophageal opening, through which the stomach organs exit and enter the esophagus.

Causes of the disease

One of the key causes of hiatal hernia is weakening of the ligamentous apparatus of the esophagus and stomach. According to statistics, this risk factor is present in 5% of people aged 20 to 40 years and in more than 50% of people over 50 years of age. Let us note that in medicine, hiatal hernia is more common in those who avoid sports. Predisposing causes also include a thin physique and poor diet.

Another circumstance that can lead to a hiatal hernia is an increase in intra-abdominal pressure, which can be caused by the following reasons:

Flatulence.
Pregnancy with complications.
Frequently recurring bouts of vomiting.
Hurting cough.
Abdominal tumors.
Disorders of esophageal peristalsis caused by chronic inflammatory diseases.
Disorders of intrauterine development of the fetus.

Clinical picture of the disease

In the initial stages, symptoms of a hiatal hernia usually do not appear. If it is small in size, then to make a diagnosis it is necessary to carry out a set of diagnostic procedures that will reveal weakening of the muscles of the esophageal opening. In this regard, it is possible to detect pathology at first only if there are other diseases of the stomach or intestines that manifest themselves in a similar way.

If the hernia has reached a larger size, but this has not yet led to disruption of the esophagus, then the disease can be diagnosed by the following symptoms:

Chest pain (may feel like heart pain).
Inflammation in the oral cavity, larynx, esophagus.
Pain when swallowing food.

As a rule, at this stage of development of the pathology, pain occurs immediately after eating food, during physical activity and in moments of stress. The duration of attacks can vary from 2-3 minutes to several days.

The last stage of the development of the disease is the depletion of the apparatus of the esophageal opening to such an extent that it is no longer able to perform its function. The main manifestation in this case is heartburn, which occurs after eating or with a sudden change in body position. As a rule, at night the symptoms intensify, causing the patient severe discomfort.

Advice! If you experience some of the above symptoms of a hiatal hernia, treatment and diet are essential to avoid complications. To achieve the most effective results, be sure to consult your doctor.

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Possible complications of pathology

The consequences of a hiatal hernia can be very dangerous. In particular, this pathology can cause the development of coronary disease, weakening of the cardiovascular system and even myocardial infarction. Another very unpleasant consequence of hiatal hernia is belching of gastric juice, which in the future can cause the development of aspiration pneumonia (inflammation of the lung tissue). And here is a list of complications that may arise if you do not start treating a hernia in a timely manner:

Reflux disease.
Peptic stricture and esophageal ulcer.
Acute and chronic bleeding in the esophagus.
Prolapse of mucous membrane into the esophagus.
Infringement of protrusion.

Conservative treatment options

There are several ways to get rid of hiatal hernia at home. But before we begin to consider how to cure hiatal hernia without surgery, it is worth emphasizing that these methods should be used only after a preliminary examination by a doctor. In addition, in no case should treatment be stopped prematurely, otherwise this may cause a relapse of the disease.

To eliminate the symptoms of a hiatal hernia and restore the functions of the esophageal apparatus, the following is used:

Drug treatment reduces the production of hydrochloric acid and normalizes the motor functions of the esophagus.
Therapeutic exercises - allows you to restore the tone of weakened cardia ligaments.
Diet - involves split meals, reducing the secretion of gastric juice and preventing excessive gas formation.
Folk remedies - relieve heartburn, constipation and flatulence; normalize acidity and prevent stomach contents from entering the esophagus.

Let's consider each of the described methods in more detail.

Note! Non-surgical treatment of hiatal hernia is used in 90% of cases. The operation is prescribed only in cases where conservative methods have not given the desired result.

Drug therapy

If the patient has been diagnosed with a hiatal hernia, treatment with medications is an integral requirement of conservative therapy. To normalize acidity and eliminate symptomatic manifestations of the disease, the following drugs are used:

Antacids (Gastal, Almagel, Maalox) - prevent gastric juice from entering the esophagus.
Omeprazole, pantoprozole - reduce the amount of hydrochloric acid produced.
Metoclopramide, domperidone, cisapride - normalize the motor functions of the esophagus, thereby preventing the ejection of stomach contents into it
Ranitidine, roxatidine - act on the centers of hydrochloric acid production, reducing its amount.

Therapeutic gymnastics

The following techniques help strengthen the ligaments. Exercises should be done on an empty stomach, half an hour to an hour before meals:

Lie on your back. Place a pillow under your head and shoulders. Place the middle and index fingers of both hands in the hypochondrium in the midline of the abdomen. Take a breath. As you exhale, press on the abdominal cavity. Repeat 5 times.
Roll over on your side. As you inhale, push your stomach out as much as possible. As you exhale, relax your muscles. Repeat 5 times on the left and right sides.
Get on your knees, keep your back straight. Take a deep breath and at the same time bend your whole body to the left. Return to the starting position and make the same movement in the other direction. Repeat 5 times in both directions.

Diet

Improper eating behavior is one of the fundamental factors provoking the occurrence of pathology. In this regard, a dietary menu for hiatal hernia is one of the key ways to conservatively eliminate hiatal hernia. Adjusting nutrition in the treatment of this disease comes down to the following principles:

Eating schedule - since overeating contributes to acidity disorders, the first thing to do is to reduce the load on the stomach. You need to eat 5-6 times a day, and the volume of food consumed at one time should not exceed 300 ml. You need to eat at approximately equal intervals. For dinner, you can only eat foods that are easily digestible.
Normalization of acidity - food that promotes the production of gastric juice should be permanently excluded from the diet. Here we are talking about spicy dishes, smoked meats, spices, sweet desserts and confectionery products in general. If this restriction is not observed, the hiatal hernia can cause complications in the form of ulcers and erosions.
Prevention of constipation and flatulence - to reduce the load on the stomach, it is recommended to avoid foods such as corn, beans, yeast baked goods, cabbage, milk, and carbonated drinks.

Recipes from the people

Although doctors mostly insist that to eliminate the symptomatic manifestations of hiatal hernia it is necessary to take medications, it is possible to partially replace them with decoctions and tinctures. Let's look at the most common recipes for treating hiatal hernia using folk remedies:

To eliminate heartburn, a decoction of dried orange peel and licorice root is used. The drink is prepared as follows: take an equal amount of licorice root and orange zest. Pour in water so that it covers the mixture by a few centimeters. Boil until the water is reduced by half. Take 3 tablespoons before meals.
To get rid of bloating and flatulence, use an infusion of valerian root, fennel fruit and peppermint. Take these ingredients in equal quantities and pour boiling water. Leave in a dark place until the infusion has cooled completely. Drink in the mornings and evenings.
An infusion of cranberries, honey and aloe will help get rid of belching. Take these components in equal quantities and grind in a meat grinder, then add warm water and leave for 6 hours. Drink the composition 2-3 tablespoons after meals.

Advice! Before using any prescription, consult a gastroenterologist. This is necessary because only a competent specialist can determine how useful a particular composition will be in your particular case. Thoughtless self-medication can not only not bring positive results, but also cause serious damage to health.

Surgical intervention

If the above methods are unsuccessful, and the disease continues to develop, then the patient has no choice but to agree to surgical intervention. Let's consider the list of complications that may indicate the need for surgical treatment of the hiatal hernia:

Erosion of the esophagus.
Ulcerative lesions.
Internal bleeding.
Decreased hemoglobin and anemia.
Large size hernia (diameter more than 10 centimeters).
Dysplasia of the esophageal mucosa.

Depending on the type of complications, the operation may pursue the following goals:

Returning part of the stomach from the esophagus to its “native” place.
Repairing a hernial opening by suturing the breach to prevent stomach contents from entering the esophagus.
Fixation of the wall of the esophagus and stomach in the area of the anterior diaphragmatic wall.

There are two main ways to perform hiatal hernia surgery:

Laparoscopy.
Open cavity method.

The choice of one method or another is influenced by factors such as the age and condition of the patient, as well as the diameter of the hernial orifice. The recovery period depends on the type of surgery. Thus, with laparoscopy, the patient can get back on his feet by the evening and be discharged from the hospital in 3-5 days, whereas in the case of using the abdominal method, the patient needs to remain in bed for another 5 days, and complete rehabilitation occurs only after a month.

Note! Regardless of the type of operation, the patient must follow the prescribed diet for at least six months. If this is not done, the risk of relapse increases many times over.

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In conclusion of the article, we note its most important points:

To prevent hiatal hernia, you need to eat right and exercise.
Constant heartburn is one of the key signs of a hiatal hernia.
It is almost always possible to cure hiatal hernia without surgery.
The diet must be continued even when the symptoms have completely disappeared.
Folk remedies can partially replace medications, but the choice of prescriptions should always be discussed with your doctor.
The operation is performed in cases where conservative treatment has not yielded positive results.

Therapeutic measures must be carried out comprehensively. It is very important to diagnose diseases in a timely manner and select appropriate therapy. An esophageal hernia, the treatment of which will be discussed in detail below, is formed when the organs of the abdominal cavity are displaced into the thoracic cavity.

This happens when the esophageal ring is stretched and a difference in pressure is formed in the cavities. To prevent complications such as strangulation, timely treatment is necessary. Let's find out how a hiatal hernia is treated.

Treatment of hiatal hernia is complex. It consists of various directions. These include:

conservative therapy;
surgical intervention.

The first, in turn, consists of a diverse set of directions. The following treatment methods are of particular importance for hiatal hernia:

appointment of the appropriate diets;
physiotherapy;
complex therapeutic exercises.

This is the treatment for a diagnosis of hiatal hernia. The operation is recommended in case of huge hernias and lack of effect from conservative therapy. But it is important to understand that treatment with pills does not remove the hernia itself, but only eliminates the symptoms.

Conservative methods as a method of treatment

When a hiatal hernia is diagnosed, treatment is complex. Patients with this pathology should change their lifestyle. If we look at the factors that contribute to the occurrence of a hernia, the first thing that needs to be changed is the diet. It is important to understand that conservative methods are effective for small sizes and in cases of mild symptoms.

When diagnosing a hiatal hernia, the causes and methods of treating this disease are different, so we consider them further.

Diet and lifestyle

Treatment of hiatal hernia consists of using a gentle regimen. All products are thoroughly crushed, excluding coarse mechanical food. You should add foods high in fiber. These are all possible cereals, vegetables And fruits. Limit legumes and pasta. A prerequisite is to eat three hours before bedtime. It is recommended to sleep with the headrest raised 30 degrees. It is especially important for those who have GERD in combination with a hernia. It is advisable to limit your intake of coffee and carbonated drinks. Try to avoid bad habits.

We tell you in detail about the correct diet, healthy and harmful foods.

Your lifestyle should be replaced with a more active one. Excess body weight is an aggravating circumstance. Sports with a hiatal hernia are recommended to be limited in terms of performing exercises with high physical activity. You should adhere to exercise therapy.

Medication methods

How to treat a hiatal hernia? Treatment is similar to. Therefore, medications are prescribed to reduce the aggression of hydrochloric acid and improve digestion.

How to treat a hiatal hernia? The following medications are prescribed for hiatal hernia:

Taking certain medications directly depends on the severe symptoms of the hernia itself and concomitant diseases in the form of GERD. This is the most important thing in the matter of treating a hiatal hernia with medications.

Exercise therapy

Therapeutic gymnastics is aimed at strengthening the muscles of the anterior abdominal wall. The exercises are built on the same principle. All movements must be done while inhaling or exhaling. For example, the starting position is standing. Hands to the sides. The width of the legs is arbitrary. As you inhale, you should stick your stomach out. Don't overdo it. As you exhale, relax the front wall of the abdomen.

Another example. Lying position. As you inhale, turn your torso in one direction, and as you exhale, turn your body to the other. It is advisable to carry out such exercises every day. Respectively, with severe symptoms, exercise therapy alone will not have the desired effect. Therefore, it is important to seek specialized medical help.

Surgical intervention

When a hiatal hernia is diagnosed, treatment should include surgery. It is indicated for any type of hernia.

There are indications for surgery:

pronounced clinical picture in the form of pain;
in case of complications development;
if, in combination with a hernia, the patient has reflux that cannot be treated;
for hernias with complications on the pulmonary system and heart;
if the junction of the esophagus with the stomach, during biopsy takes on an uncharacteristic appearance of epithelium. That is, dysplasia develops, with subsequent metaplasia and cancer.

All operations are divided into 4 types.

Useful video

How to cure a hiatal hernia? You can learn more about this issue using this interesting video.

A hiatus hernia is a serious condition that occurs when reflux, a hole in the diaphragm, stretches and allows the stomach and lower esophagus to move into the chest cavity.

This common disease is more often observed in elderly patients, but can also occur due to the following reasons:

Congenital defect of esophageal length
Age-related decrease in the elasticity of the ligaments of the diaphragm and esophagus
Obesity or sudden weight loss
Atrophic changes in the liver
Thermal damage to the walls of the esophagus and abdominal trauma
High intra-abdominal pressure resulting from:

intense physical activity;
respiratory diseases accompanied by severe cough;
constipation;
pregnancy;
accumulation of fluid in the abdominal cavity with ascites;
frequent manifestations of flatulence

A decrease in the tone of the esophageal sphincter can be affected by bad habits, taking certain medications and the abuse of strong coffee.

Types of disease

There are several types of hiatal hernia:

Axial (axial) - the stomach or part of it moves along the vertical axis and does not depend on the position of the body.

Paraesophageal (paraesophageal) hernia - characterized by displacement of the omentum, intestinal loop and fundus of the stomach into the chest area.

Sliding hernia - organs are located in a thin sac of connective tissue and move from cavity to cavity during changes in body position.

A congenital hernia occurs as a result of a genetic abnormality in the structure of the esophagus, which leads to the placement of the cardiac gastric part in the chest.

Mixed - combines the signs of axial and wandering (sliding) hernia.

According to the severity of the pathology, they are distinguished:

1st degree – protrusion of a small area of the lower esophagus;
2nd degree - there is a shift of the entire lower intestine beyond the abdominal; cavities.
3rd degree - the lower part of the esophagus, as well as the body of the stomach, is displaced into the chest.

Treatment methods for the varieties differ, so therapy is prescribed only after an accurate diagnosis has been made.

Symptoms of a hiatal hernia

A mild degree of hernia protrusion often does not cause any concern to the patient, and the disease can be detected by chance on an ultrasound.

But more severe forms are accompanied by tangible signs:

The first manifestation of the disease is heartburn. An unpleasant burning sensation in the esophagus can be felt after eating a large meal, drinking alcohol, or as a result of prolonged work in an inclined position. Heartburn may cause a sour or bitter taste, nausea, and a feeling of fullness in the stomach.
The most noticeable symptom is pain in the abdomen, heart, under the ribs and behind the sternum. The aching pain may become more intense when lying down, after bending over and eating. Relief occurs at the moment of sighing or after vomiting.
Belching occurs after eating as a result of high intra-abdominal pressure and spasm of the alimentary canal. May be accompanied by an unpleasant odor and the release of part of the stomach contents.
Dysphagia or difficulty swallowing. This symptom occurs during an exacerbation of the disease and appears after eating too cold or hot food. In severe cases, patients stop eating due to the inability to swallow food.
Regurgitation of food can also occur with a hiatal hernia and occurs when lying down, after bending or eating. The contents of the stomach are released in significant volumes and without attacks of nausea, which causes the patient a lot of inconvenience.
While eating, sometimes there is a feeling of a lump behind the sternum. Moreover, in the intervals between meals this feeling disappears.

In some cases, hoarseness of the voice and hiccups are noted. Difficulty breathing, heart pain, and sore tongue may occur.

Treatment

After diagnosing a hiatal hernia and determining its type and severity of the disease, competent therapy is prescribed.

The decision on the choice of treatment method is made by a gastroenterologist after consultation with a surgeon.

Depending on the complexity of the disease, drug therapy or surgical intervention may be prescribed.

Conservative

In most cases, treatment of a small hernia is carried out comprehensively and consists of the following measures:

dietary nutrition;
therapeutic exercises;
medications;
traditional medicine methods.

Most often, drug therapy includes the following groups of drugs:

Antacids – reduce stomach acidity. For example, almagel, maalox.
Histamine receptor blockers - reduces the production of hydrochloric acid: famotidine.
Prokinetics - normalize the movement of food through the digestive tract: motilium, cerucal.
Bile acids – eliminate the effects of bile acid. For example, urochol.

A therapeutic diet and physical exercise program are drawn up with a doctor, taking into account the patient’s condition and the presence of concomitant diseases. A specialist may also recommend using traditional medicine recipes to reduce symptoms.

Surgical intervention

The help of a surgeon is resorted to in cases where a large hernia is detected or the disease is not amenable to drug treatment.

There are the following indications for surgical intervention:

the patient's condition is rapidly deteriorating;
conservative treatment does not bring results;
dysplasia of the esophageal mucosa;
large hernia size;
development of erosions and bleeding against the background of the disease;
risk of hernia strangulation.

Surgery is performed when a sliding and paraesophageal hernia is detected, as well as if intense pressure on the heart occurs as a result of organ displacement.

Contraindications to surgery are pregnancy, pathologies of the heart and vascular system, malignant tumors, thrombophlebitis and diseases of the endocrine system.

Treatment with folk remedies

The use of traditional medicine will provide effective assistance in the early stages of the development of the disease. In the future, healing drugs can only be used as auxiliary measures of complex therapy to relieve symptoms: heartburn, bloating, constipation.

Decoctions

A decoction of a mixture of dry orange peels and licorice root is good for heartburn relief. Take 7 g of raw material and heat over low heat in a glass of water until the volume of liquid is reduced by half. Divide into three servings and drink 15 minutes before meals.

An unsweetened decoction of dried fruits will have a mild laxative effect.

A mixture of buckthorn, hay leaves and rhubarb roots will relieve constipation. Boil 2 tablespoons of the mixture in a glass of water and drink half a glass at night.

A decoction of chamomile flowers will help prevent bloating. Boil two tablespoons of chamomile for 10 minutes in a glass of water and drink half a glass throughout the day.

Infusions

Heartburn remedy. Boil 2 tablespoons of rowan flowers in a glass of water. Leave until cool and drink 50 ml before meals.

According to Art. l. Grind mint leaves, coltsfoot, calamus roots and flaxseed well. Leave three tablespoons of raw material in a liter of water for an hour. After infusion, boil and drink 100 ml five times a day. This infusion quickly relieves heartburn.

Infuse a pinch of gooseberry leaves in two glasses of boiling water and drink 80 ml three times a day.

Infuse a tablespoon of a mixture of calendula flowers, mint leaves and gentian for 30 minutes in a glass of boiled water and drink it as tea throughout the day.

An effective remedy for constipation is a mixture of a glass of kefir and a spoon of olive oil. Onion juice can also solve this problem if you drink it before meals.

Any folk remedies should be used after consultation with your doctor, since some medications cannot be combined with medicinal herbs.

Diet

Nutritional adjustments play a decisive role in the treatment of esophageal pathology.

Meals should be frequent and in small portions. The last snack is allowed 4 hours before bedtime, otherwise the food will not have time to digest, which will result in heartburn, pain and bloating. After eating, you should not lie down, but rather move around, excluding bending over, or take a walk.

Food should not contain hard pieces that are difficult to swallow. For patients with a hiatal hernia, pureed soft consistency dishes are recommended. When preparing, give preference to steaming and stewing. Frying foods is not recommended.

Foods that cause intense gas formation in the stomach and bloating, such as legumes, cabbage, yeast baked goods, and carbonated drinks, should be removed from the diet. Some people may experience this effect from milk.

You will have to give up dishes containing hot spices, salt, and excess fat. Sour fruits, juices, and alcohol increase stomach acidity. Strong coffee and tea have the same effect.

Pickled, smoked foods, sweets and baked goods are completely excluded from consumption. You should be careful with pasta and rice dishes to avoid constipation.

The basis of the menu should be porridge, low-fat meat and fish products, and slimy soups. Be sure to eat boiled vegetables daily. If there is no individual intolerance to dairy products, then you can eat fermented milk dishes with a low fat content. Bread products are allowed only in dried form.

To reduce acidity, it is useful to drink alkaline mineral water without carbon and consume a spoonful of vegetable oil before or after meals. Among sweets, jelly, honey, and dried fruits are acceptable. Dill, thyme, fennel, cumin, and drinking green tea will help reduce flatulence.

To prevent unpleasant sensations, it is advisable to sleep with your upper body elevated and on your right side.

Therapeutic exercise

The complex of therapeutic measures includes mandatory physical exercises to strengthen the abdominal muscles.

While on your knees, take a deep breath and bend in different directions. Exhaling, return to the starting position. After 7 days, we do everything with movement in a standing position.
Lying on your right side. Place a pillow under your shoulders and head. Inhaling, inflate your stomach, exhaling, relax your muscles. Do the movements slowly and for at least 10 minutes 3 times a day. After 7 days, begin to exhale and draw your stomach in.
Leisurely jumping in place.
Lying on your back, turn your torso to the side - inhale, return to the starting position - exhale.
Deep squats.

Do gymnastics twice a day, gradually increasing the number of repetitions of the exercise and the depth of breathing movements. The first results will be noticeable within 2 months.

It would be a good idea to vary your exercise by walking at an accelerated pace, trying to keep your abdominal muscles toned. Yoga or Pilates complex effectively strengthens muscles. The main rule is regularity of classes.

What to do during attacks of pain

A hiatal hernia is often accompanied by intense pain, which can be reduced by the following methods:

Drink a cup of water and jump off a small hill, such as a step. The stomach will return to its place.
Lying on your back, massage with your hands in the sternum area with downward movements.

For pain relief, you can take Atropine or 3 tablets of No-shpa. Baralgin injection relieves pain well. Usually relief occurs within half an hour.

Conclusion

A hiatal hernia is a serious illness that can lead to problems with the functioning of the lungs and cardiovascular system. Lack of timely treatment for a hernia increases the likelihood of developing esophageal cancer. Therefore, it is important to diagnose and begin treatment for the pathology in a timely manner.

The use of traditional medicine, started in the early stages and agreed with the doctor, will help prevent the progression of the disease and eliminate the need for surgical intervention in the future.

To prevent complications, you need to monitor your diet, excluding overeating and constipation. Loose clothing and avoiding squeezing the abdomen with tight belts will reduce the occurrence of heartburn and belching. Regular walks and moderate exercise will strengthen muscles and improve body tone.

We bring to your attention a video in which a specialist explains the features of the occurrence and fight against the consequences of a hiatal hernia:

Update: November 2018

Today, according to many experts, hiatal hernia is a very common disease of the gastrointestinal tract, ranking third after gastric ulcers and cholecystitis.

Moreover, in 50% of cases, a diaphragmatic hernia occurs latently, either asymptomatically or with minimal symptoms and discomfort. It is often discovered accidentally during an endoscopic examination or x-ray examination of the stomach and esophagus.

In 30% of patients with a hiatal hernia, the primary complaints with which patients consult a doctor are pain in the heart - non-coronarogenic cardialgia and heart rhythm disturbances - paroxysmal tachycardia and extrasystole. This most often leads to diagnostic errors and ineffective therapy by a cardiologist, since a hernia is a possible cause of cardiac disorders.

This disease, as a rule, is combined with gastroesophageal reflux disease, which leads not only to cardiac disorders, but also to a whole complex of pulmonary and dyspeptic disorders in the human body.

A diaphragmatic hernia is an enlargement of the esophageal opening of the diaphragm, in which the ligaments connecting the stomach and esophagus are stretched.

Such a violation leads to the reflux of bile and gastric juice into the esophagus, gradually inflammation and changes in its mucous membrane occur, which over time provokes the formation of malignant tumors.

According to studies of world gastroenterological associations, in the absence of adequate timely treatment for a hernia, after 7-10 years the patient’s risk of developing esophageal cancer increases. If there is no treatment for 7 years, then the risk of developing cancer increases by 280%; if the disease is more than 10 years old, then the risk increases to 400%.

Hernia symptoms

Painful sensations

Pain with a diaphragmatic hernia of the esophagus is very diverse and depends on its type, duration of the disease, and the age of the patient:
The most common localization of pain is in the epigastric region; it appears when changing body position, after eating.
Sometimes the pain can radiate to the area between the shoulder blades or to the back.
It is also possible to experience girdling pain, which may resemble the symptoms characteristic of a disease such as pancreatitis.
A fifth of patients, especially the elderly, experience pain in the heart area; this may also be associated with concomitant diseases - coronary heart disease, angina pectoris.
When a hernia leads to various complications, the direction, nature, and intensity of pain changes. With solarium, the pain becomes unbearably burning, and its intensity increases with pressure in the epigastric region, and when the patient bends forward, it becomes easier. When perivisceritis occurs, the pain is aching, dull, continuous and concentrated high in the epigastric region. In case of infringement hernial sac, piercing, tingling pain appears behind the sternum, radiating to the area between the shoulder blades (see)

Belching sour

When belching, a taste of bitterness or bile remains in the mouth, or the patient experiences very frequent belchings of air, most often they occur after eating.

Regurgitation, vomiting

This symptom most often occurs at night, after eating or while lying down, and is not accompanied by nausea. If the amount of regurgitation is significant, it can cause aspiration pneumonia.

Dysphagia

This is not a permanent symptom of a hiatal hernia; it may come and go. If you eat hot or too cold liquid food or swallow it very quickly, it may be difficult for the food to pass through the esophagus. As for solid food, it moves through the esophagus easier and faster. If this sign of an esophageal hernia begins to be permanent, this is a reason to diagnose oncology, stricture, esophageal ulcer, or strangulated hernia.

Heartburn

The most characteristic, pronounced and frequent sign of a hiatal hernia. It happens after eating, at night and in a lying position. In most patients, it is a constant symptom and plays a decisive role in the diagnosis of diaphragmatic hernia.

Hiccups

Not the most characteristic symptom, since it occurs only in 4% of patients. if it occurs, it is characterized by a long period; the patient can hiccup from several hours to several days.

Pain, burning tongue

A rare symptom, it appears only if gastric contents are thrown into the mouth or larynx, and hoarseness may occur.

Combination of hiatal hernia with disorders in the respiratory system

Most often, a hiatal hernia is accompanied by bronchial asthma, obstructive bronchitis, and aspiration pneumonia. The most dangerous of these pathologies is the aspiration of gastric masses into the respiratory tract. In this case, the patient experiences suffocation, persistent cough and chest pain.

To differentiate pain in the esophagus due to a hernia, the symptoms of which are similar and characteristic of other diseases, the following factors characterizing the presence of a diaphragmatic hernia in a patient should be taken into account:

After eating, in most cases, the pain intensifies, and the intensity of pain increases with coughing, physical activity, any tension, even just in a horizontal position.
After vomiting, belching or regurgitation, or taking a deep breath, the pain weakens or stops. Taking soda, water, and lying down also help reduce pain.
The nature of the pain is rather moderate, aching, dull, only in rare cases can there be extremely strong pain.

What is the difference between a sliding hernia?

One type of diaphragmatic hernia is a sliding hernial protrusion. In this case, part of the esophagus or stomach penetrates into the chest cavity through a weak point in the diaphragm. Periodically, they return to their normal location (in the abdominal cavity), which leads to the disappearance of symptoms. Physical activity, tension in the abdominal muscles and a number of other factors lead to the re-formation of a hiatal hernia.

A characteristic symptom of sliding hernias is burning pain, which is located behind the sternum or in the upper abdomen. It intensifies in the “lying down” position and with strong bends, and is often accompanied by belching, heartburn or nausea.

What are the signs of a strangulated hernia?

One of the most dangerous complications of diaphragmatic hernia is strangulation. It can occur either after a long course of the disease or be the first manifestation of the disease. In order to promptly identify infringement, the patient should be assessed for the following symptoms:

Sudden sharp or shooting pain in the lower half of the chest/upper third of the abdomen. Often, it radiates to the scapula or supraclavicular fossa. Increased pain is provoked by increased intestinal motility (due to food intake, liquids, 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, it intensifies at a height of pain;
Severe abdominal bloating with increased pain.

The presence of one of these signs requires urgent medical care for the patient.

Main causes of hiatal hernia

Signs of a diaphragmatic hernia most often appear in older people, when, for natural reasons, the body wears out, and tissues, muscles, and internal organs lose their elasticity. As the hernia progresses, in some patients by the age of 60, the so-called “hernial orifice” may form, when the esophageal opening can increase by several centimeters.

Causes of hiatus hernia:

Age-related weakening of muscles and ligaments of the esophagus
Resorption of fatty tissue under the diaphragm
Changes in the position of internal organs, for example, during pregnancy
Atrophy of the left side of the liver
Esophageal dyskinesia
, abdominal muscle tension
Increased intra-abdominal pressure
Congenital malformations - shortened esophagus
Surgery on the esophagus
Thermal burns from hot food cause contraction of the esophagus and provoke the formation of a hernia.

There is both an asymptomatic course of the disease, and vice versa, in patients in combination with various diseases of the gastrointestinal tract, an esophageal hernia is also detected. So, according to some data, 40-60% of patients with gastric or duodenal ulcers, 50% of patients with chronic gastroduodenitis, 20-40% of people with cholecystitis (see and pancreatitis (see) are diagnosed with a diaphragmatic hernia.

Diagnostics

The first step in detecting a diaphragmatic hernia is to look for the patient's characteristic symptoms and possible causes. After this, it is necessary to proceed with a direct examination, during which the following signs of the disease can be detected:

Inspection - with a hiatal hernia, the chest practically does not move during breathing, due to dysfunction of the diaphragm. If a person suffers from this pathology for a long time, the stomach becomes “sunken”. This symptom may not be observed in people who are overweight;
Feeling the abdomen (palpation)– it becomes dense in the upper parts of the abdominal wall, due to strong muscle tension. Pain on palpation is also possible;
Auscultation (listening with a phonendoscope)– a characteristic sign of a diaphragmatic hernia is the appearance of bowel sounds in the chest cavity. The normal sound of breathing is usually absent or significantly reduced.

The above signs are enough to suggest a diagnosis. However, the presence of a hiatal hernia can only be reliably confirmed using instrumental diagnostic methods.

Plain chest x-ray/fluorography

This is not a sufficiently informative method, but it is necessary to distinguish the pathology of the diaphragm from diseases of the chest cavity (pneumothorax, pleurisy, pneumonia, etc.). You can also detect some indirect signs of a hiatal hernia:

The dome of the diaphragm is located above normal;
The presence of intestinal loops/gastric gas bubble in the chest cavity;
Displacement of the mediastinal shadow (the white area between the lungs on an x-ray) away from the midline.

It is quite difficult to detect these changes on an x-ray/fluorography without appropriate experience. Therefore, it is important that the image is examined by a qualified doctor.

X-ray of the esophagus and stomach with contrast

In the absence of a CT scan, X-ray contrast is the best way to confirm a diaphragmatic hernia. For this purpose, the patient is given a solution of a contrast agent to drink (about 200 ml of Barium sulfate), after which an X-ray is taken. A reliable sign of a diaphragmatic hernia is the presence of the stomach or small intestine in the chest.

How to prepare for research?

For optimal X-ray quality, preparation should begin 3 days before the procedure:

During this period, the patient is prescribed a diet with a minimal amount of fiber. The following should be excluded: rye bread, pearl barley and corn cereals, dairy products, fruits, vegetables and their derivatives (juices, jam, etc.);
12 hours before contrast radiography, you must adhere to a “starvation” diet;
In the evening and morning before the procedure, the patient is given one cleansing enema.

It should be noted that taking laxatives is not recommended, as they increase the amount of free gas in the intestines and reduce the quality of diagnosis.

Ultrasound of the pleural cavity

An additional method that is used when X-ray results are questionable. Using ultrasound, loops of the small intestine or stomach are distinguished from other pathological processes in the chest. The procedure does not require any preparation and takes 7-10 minutes.

CT scan of the chest and abdomen

Using this expensive X-ray examination, a diaphragmatic hernia is detected in 100% of cases. The presence of false results is excluded due to excellent visualization. Unfortunately, only hospitals in large cities and regional centers have CT scanners. The study, as a rule, is carried out for a fee (the average price is about 2000 rubles). This explains its rare use.

Laparoscopy/Thoracoscopy

This is not just a way to diagnose a diaphragmatic hernia, but a full-fledged surgical intervention. Its principle is simple - in a certain anatomical area (abdomen or chest, respectively), two incisions 1-2 cm long are made. Through them, an endoscopic instrument made in the form of narrow metal tubes with some kind of working tip (branches) is inserted into the cavity. One of them must have a video camera with a light source. Thus, the surgeon can directly examine the diaphragm and choose further tactics.

It should be noted that these procedures are most often used for severe injuries to the abdomen or chest. As a diagnostic method, laparoscopy and thoracoscopy are rarely used.

Treatment of diaphragmatic hernia

First of all, it must be emphasized that treatment of a hiatal hernia without surgery is impossible. The only way to get rid of this disease is surgery. It should be performed as early as possible, since a long wait can lead to the following complications: strangulated hernia, obstruction of the digestive tract, respiratory failure, etc.

This operation has no absolute contraindications and can therefore be performed on all patients. Depending on the severity of their condition, it is carried out either urgently (within 2 hours) or planned. Emergency intervention is indicated for the following patients:

With strangulation of a hiatal hernia;
With severe respiratory failure;
For disturbances in the functioning of the heart caused by a hernia;
With severe symptoms (uncontrollable vomiting, intense acute pain, etc.).

In other cases, the operation is carried out as planned (the duration is not limited, but it is recommended within several weeks) in a specialized department of “thoracic surgery”.

Preparing for planned surgery

Before surgical treatment, the anesthesiologist/surgeon questions the patient in detail about his state of health, allergies, previous blood transfusions, etc. The patient is prescribed a series of tests that will allow the functions of the main organs to be assessed: general blood and urine tests, biochemical analysis of venous blood, acid-base status, ECG.

If necessary, the patient’s condition is somewhat improved (pressure, heart activity, respiratory function are stabilized, etc.). Immediately before the operation, the intestines are cleansed (if there is no strangulation of the esophageal hernia), the bladder is catheterized and the necessary medications are administered.

How to treat a hiatal hernia?

The main goal of the operation is to reduce the hernial protrusion back into the abdominal cavity and suture the damaged area of the diaphragm. To do this, the surgeon can perform one of two approaches: cut the anterior wall of the abdomen along the midline or perform a thoracotomy (open the lower parts of the chest). For a strangulated diaphragmatic hernia, the doctor needs both of these approaches.

If the operation is performed as planned in the thoracic surgery department, the doctor can use a more modern method of treating a hernia - video endoscopic surgery. As with diagnostic laparoscopy, two 1-2 cm incisions are made through which special instruments are inserted into the chest cavity. One of them is necessarily equipped with a video camera with a flashlight, through which the surgeon controls his actions. The second one can perform the function of tweezers, electric/plasma knife, liquid suction, etc.

After the organs are repositioned into the abdominal cavity, the diaphragm is sutured and strengthened with body tissue (most often a tendon or aponeurosis) to prevent the reoccurrence of a hiatal hernia.

Rehabilitation after surgery

Surgical treatment of an esophageal hernia is quite traumatic. Therefore, in the postoperative phase, the patient may experience pain, digestive disorders or infectious complications. To avoid this, clinicians recommend the following measures:

Adequate pain relief

As a rule, NSAIDs are sufficient for this, which are administered by intramuscular injection (into the buttock). Most often - Ketorolac/Ketorol. In case of severe pain, it is possible to introduce local anesthetics (Lidocaine or Novocaine) into the surgical incision or using epidural anesthesia.

How is epidural anesthesia (pain relief) done? The doctor uses a blunt needle to inject the drug (Lidocaine, Novocaine) into the spinal canal, into the space between the spinal cord and the inner surface of the vertebrae. If necessary, epidural analgesia can be maintained continuously if a tube is installed in the indicated space through which the anesthetic is constantly supplied.

Diet

Dietary treatment: A hiatal hernia often disrupts the normal movement of food through the intestines. Therefore, in the postoperative phase it is important to gradually restore its function. Patients are recommended to eat a diet that excludes flour, salty, spicy and fatty foods. The diet should include porridge (rice, buckwheat, corn), which contain a moderate amount of fiber; boiled meat (chicken or beef); soups made with chicken broth;

Prevention of thromboembolic complications

After most operations there is a risk of developing these complications. In this case, a blood clot grows on the wall of a vessel in the patient, which can break off and close the lumen of vital arteries (pulmonary, coronary, vertebral, etc.) or enter the heart cavity. To prevent this from happening, patients are recommended to wear compression stockings and undergo heparin injections (if there is no significant bleeding).

A hiatal hernia can become a life-threatening condition if you choose wait-and-see tactics or treat with folk remedies. Therefore, after making a diagnosis, it is necessary to decide on the date of the operation and the technique for its implementation. If surgery was performed in a timely manner, the prognosis for the patient is, in most cases, favorable. Proper rehabilitation and prevention of postoperative complications allow the patient to return to their previous quality of life within a short period of time.