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During endoscopy, as a rule, the displacement of the esophageal-gastric line above the diaphragm, signs of esophagitis and gastritis, erosion and ulcers of the mucosa are determined. To exclude tumors of the esophagus, an endoscopic biopsy of suprax pills and a morphological study of the biopsy are performed. In order to recognize latent bleeding from the gastrointestinal tract, feces are examined for occult blood.

A special place in the diagnosis of hiatal hernia is given to esophageal manometry, which allows assessing the state of the sphincters (pharyngeal-esophageal and cardiac), motor function of the esophagus at various levels (duration, amplitude and nature of contractions - spastic or peristaltic), as well as to buy suprax online the effectiveness of conservative therapy. To study the environment of the gastrointestinal tract, impedancemetry, gastrocardiomonitoring, intraesophageal and intragastric pH-metry are performed.

Treatment begins with conservative measures. Since the symptoms of gastroesophageal reflux come to the fore in the clinic, conservative treatment is mainly aimed at eliminating them. The complex drug treatment includes antacids (aluminum and magnesium hydroxide, aluminum hydroxide, magnesium carbonate, magnesium oxide, etc.), H2-blockers of histamine receptors (ranitidine), proton pump inhibitors (omeprazole, pantoprazole, esomeprazole). It is recommended to normalize weight, follow a sparing diet, split meals with the last meal no later than 3 hours before bedtime, sleep in a bed with a raised headboard, and exclude physical activity.

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Surgical methods are used for complicated forms of hernias (narrowing of the esophagus, strangulation of diaphragmatic hernia), failure of drug therapy or dysplastic changes in the esophageal mucosa. Weddi all the variety of ways, the following groups of interventions are distinguished. operations with closure of the hernial orifice and strengthening of the esophageal-diaphragmatic ligament (diaphragmatic hernia repair, crurorrhaphy), operations with fixation of the stomach (gastropexy), operations to restore an acute angle between the fundus of the stomach and the abdominal esophagus (fundoplication). In the formation of cicatricial stenosis, resection of the esophagus may be required.

Prevention of hernia formation, first of all, consists in strengthening the abdominal muscles, exercise therapy, treating constipation, and eliminating heavy physical exertion. Patients with a diagnosed diaphragmatic hernia are subject to order suprax observation by a gastroenterologist.

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Hernia of the esophageal opening of the diaphragm. signs, diagnosis and treatment methods. Hiatus hernia (HH) belongs to the category of fairly common pathologies, the risk of which increases in patients in proportion to their age.

So, in patients under the age of forty, they occur in 8% of cases, while in patients over the age of seventy, their number increases to 70%, and women are more susceptible to them. In almost half of the patients, this pathology is completely asymptomatic and remains unrecognized. Patients can be under the supervision of a gastroenterologist for years and treat concomitant diseases (gastric ulcer, chronic gastritis, cholecystitis) with similar clinical symptoms.

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In the international classification of diseases, hiatal hernia is assigned code K44.9. Diaphragmatic hernias are accompanied by severe retrosternal pain, arrhythmia, dysphagia (difficulty passing food through the esophagus), heartburn, regurgitation (belching) and hiccups. Based on the anatomical features, hernia of cefixime pills opening of the diaphragm is divided into.

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In pathologies of this type, manifestations of two mechanisms are combined. paraesophageal and axial. A sliding hernia (they are also called axial or axial) of the esophageal opening of the diaphragm is characterized by the free movement of the abdominal part of the esophagus (the so-called small - about two centimeters long - piece of the esophageal tube located under the diaphragm), cardia (an annular sphincter located between the stomach and esophagus) and the bottom of the stomach into the chest cavity and the equally free independent return of the listed organs into the abdominal cavity.

Not being fixed, they do not appear constantly, but only under the influence of certain factors. They are of paramount importance. position of the body, the degree of fullness of the stomach and intra-abdominal pressure. Weakened muscles of the diaphragm allow the lower esophageal tube and part of the stomach to buy cefixime online freely both into the chest cavity and vice versa. Axial hernias are the most common pathologies. The volume and level of elevation above the diaphragm of the displaced areas allows them to be divided into.

The reason for such movements may be the usual change in body position. Axial hernias of the esophageal opening of the diaphragm are formed as a result of weakening of the diaphragmatic muscles surrounding it. Hernias of this type are characterized by free movement of the upper part of the stomach. Subtotal and total-gastric. With these types of hernias, either a large part of the stomach or its entire body is above the level of the diaphragm. With this type of pathology, only the cardiac sphincter slips through the esophageal opening of the diaphragm, separating the esophagus from the stomach.

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As a result of the migration of the peritoneal sac surrounding the stomach into the chest, there is a gradual movement into it first of the fundus of the stomach, and then its greater curvature.

Their radical difference from sliding hernias is that the greater curvature of the stomach, its bottom, as well as part of the loops of the small or large intestine, move to the area of the epithelial tracheoesophageal septum with a fixed position of the cardiac valve. it continues to remain under the diaphragm.

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Over time, the entire stomach (along with the tissues of the parietal pleura) can move into the chest cavity. Despite the movement of the stomach and a number of abdominal organs to the chest area, the fixation of the gastroesophageal junction continues to maintain a normal subdiaphragmatic position.

In the process of lifting, the greater curvature turns upward, while the lesser curvature, held by the cardiac valve, continues to maintain its downward position.

In very rare cases, when there is a migration of the gastroesophageal junction into the chest cavity, they speak of the presence of a mixed hernia, often accompanied by insufficiency of the cardiac sphincter (cardia). A fixed hernia of the esophageal opening of the diaphragm is a pathology in which the cardial part of the stomach moves to the chest area and its constant (without slipping back) stays in the zone of a new localization. This explains not the transient, but the permanent nature of the clinical symptoms that accompany this pathology.

Strangulated hernia usually requires surgery.

Fixed hernia is quite rare, but much more dangerous (than axial hernia) form of pathology, which often leads to complications that require immediate assistance from a qualified specialist. Non-fixed hernia of the esophageal opening of the diaphragm (also called sliding or axial) is a chronic disease in which free movement (migration) of the abdominal segment of the esophageal tube, lower esophageal sphincter and stomach from the abdominal cavity into the chest occurs through the aforementioned opening.

Being a less complex type of disease than the pathology described above, an unfixed hernia, however, requires equally serious and immediate therapy.

Cases of hernia of the esophageal opening of the diaphragm are detected in 6% of the adult population, and half of these cases occur in people over fifty-five years old, in whose body age-related changes (atrophy, dystrophic processes and loss of elasticity) have led to a significant weakening of the ligamentous apparatus that holds the esophageal tube in the correct position.

Another category of people prone to this disease are people with an asthenic body type or who have never played sports.

The weakening of the ligamentous-muscular apparatus and the formation of hernias of the esophageal opening of the diaphragm can occur under the influence. In half of the patients, a hernia of the esophageal part of the diaphragm proceeds either asymptomatically or with a minimal set of clinical manifestations. Hernial protrusions of small sizes are asymptomatic. As a rule, they are detected quite by chance in the course of diagnostic studies undertaken for other diseases.