Spiserørsbrok (Hiatushernie)

Definition and causes

Eat tube passes down through the diaphragm (the muscle plate that separates the thoracic cavity and abdominal cavity) to the stomach. This opening in the diaphragm calledhiatus, Hence the name hiatushernie. Between floor separates So esophagus and the stomach and esophagus help close the muscle to prevent the food runs back to the esophagus after a meal. Spiserørsbrok occurs when part of the stomach displaces up in the thoracic cavity. Depending on how this shift happened, talks about two types of spiserørsbrok.

Sliding Brok
80% of all spiserørsbrok due to the upper part of the stomach, including the closing muscle (see esophagus), who sits on the transition between the esophagus and stomach, slipping up in the thoracic cavity (a so-called sliding hernia) through the hiatus. This is a very common condition, and it is expected that 10-30% of the population have this kind of spiserørsbrok. The clamping mechanism weakened, then by sliding scrappy, and many therefore suffer from stomach acids immediately, with the associated symptoms. But not all the bungling of this

Paraesophagealt hernia
In 5% of cases with spiserørsbrok is the muscle in his place, while part of the stomach is shifted up through the hiatus. There is talk of a paraesophagealt hernia. This type of hernia is the valve function, then intact, and there is no stomach acids immediately. But the part of the stomach, which are staggered into the thoracic cavity, giving rise to the prevention of hernia sac, with difficulty in swallowing and pain to follow.

In the remaining 15% of cases is a combination of the two types of spiserørsbrok.

Symptoms of spiserørsbrok

Heartburn.
Eructation.
Pain behind the sternum.
Dysphagia.
Less often seen hiccups, hoarseness or coughing.

Precautions and diagnosis

By sliding type of spiserørsbrok has taken the same as in stomach acids immediately.

Avoid strong or acidic foods.
Avoid high-fat food.
Avoid chocolate and peppermint.
Reducing or stopping of alcohol.
Avoid late and great meals.
Do not lie down or exercise immediately after meals.
Smoking cessation.
Weight loss.
Elevation of bed head-end (slept in a couple of extra pillows).
Avoid foroverbøjning.
Avoid certain types of medicines, including certain types of painkillers and certain types of heart or blood pressure medication.

If you have the paraesophageale hernia, there is little we can do, and you have to consult a doctor.

The diagnosis of both types of hernia can be made through a so-called X-ray contrast study (see below image studies). Another option, which usually can detect both types spiserørsbrok, is making a kikkertundersøgelse. This study, however, is associated with more discomfort, why the former is usually used.

Treatment of spiserørsbrok

Spisrørsbrok of the sliding type usually treated in the same manner as stomach acids immediately with antacid funds. Operation may be envisaged, if the medical treatment is ineffective. The operation is the same as when stomach acids immediately.

It is Monday paraesophageale hernia forced to operate. Usually carried out this operation as a telescope operation in which the stomach is placed back in the abdominal cavity.

Select and complications to spiserørsbrok

Sliding scrappy, which is very common, seen especially in older and overweight. Complication can be spiserørskatar and stricture of the esophagus.

By the paraesophageale hernia, there is great risk of inkarcerering, which means that the blood flow to the part of the stomach, which are staggered into the thoracic cavity, afklemmes and prevented. If that happens, you are forced to operate acute when you run the risk of the afklemte part die with great damage. Therefore this type of hernia surgery always.