Sliding hernia of the esophagus

With a diaphragmatic hernia or hiatal hernia, the diagnosis can be formulated as a sliding hernia of the esophagus. Obviously, a simplified name that is descriptive is more understandable for patients.

Different names - one pathology

A sliding hernia of the esophagus, diagnosed in 90-95% of cases of hiatus or  diaphragmatic hernia  (hiatus esophageus - the Latin term for the esophageal opening of the diaphragm), is the same axial or  axial hernia of the esophagus  (axis in Latin means axis). [1]

And the essence of this disease is that part of the esophagus located in the abdominal cavity (cavitas abdominis), and even part of the stomach (in particular, its upper cardiac region with the lower esophageal sphincter) slip through the esophageal opening of the diaphragm, moving into the chest cavity (in the back mediastinum), and then - if the patient changes the position of the body - again descends into the abdominal cavity. [2]

The etiology, pathogenesis, symptoms, diagnosis and main methods of treatment are detailed in the publications:

• Hernia of the esophagus: causes, signs, how to treat?
• Signs of a hernia of the esophagus
• Endoscopic signs of a hiatal hernia

So, despite the different names used by gastroenterologists, this is one and the same pathology of the gastrointestinal stroke.

It should be emphasized once again the importance of such risk factors for the development of axial or sliding hernia of the esophagus as old age (with shortening of the esophagus and weakening of the tone of the muscle fibers of the sphincters, which leads to their expansion) and obesity. Moreover, this is a visceral or  abdominal type of obesity , in which, as experts say, the formation of gases in the intestine increases, which causes an increase in pressure in the abdominal cavity (intra-abdominal hypertension). In turn, this increases pressure on the stomach, "pushing" it up and weakening the lower esophageal sphincter, which causes gastroesophageal reflux.

How does a sliding hernia of the esophagus affect the heart?

This question often arises, since an axial or sliding hernia of the esophagus can mimic the symptoms of a heart attack in the form of aching pains felt in the left part of the mediastinum (where, in fact, the heart is located), which, when intensified, can radiate to the left shoulder or scapula - as with angina pectoris...

However, this symptom of a hiatal hernia is not etiologically associated with cardiology. Angina pectoris with chest pain during exercise occurs due to insufficient blood supply to the heart muscle - myocardial ischemia, which is a consequence of atherosclerosis of the coronary arteries.

And with a hernia, pain behind the sternum, which begins some time after eating and increases in the supine position, are explained by two factors:

• irritation of the branches of the vagus nerve passing in the mediastinal region along the surface of the esophagus with the formation of the esophageal plexus;
• damage to the lower esophageal sphincter and the mucous membrane lining the esophagus under the influence of acid reflux and developing (almost 20% of cases)  gastroesophageal reflux disease .

Electrocardiography (ECG) allows differentiation of myocardial ischemia and hiatal hernia. [3]

Diet for sliding hernia of the esophagus

The intensity of the manifestation of axial (sliding) hiatal hernia can be corrected by reducing body weight and changing the nutrition system. [4]

Detailed information about the nutritional characteristics and the optimal diet for this pathology, as well as about prohibited and recommended products in the materials:

Diet for hernia of the esophagus

Diet for hernia of the esophagus: menu for every day, recipes

Exercise therapy for sliding hernia of the esophagus

Part of the treatment is physiotherapy exercises for hernia of the esophagus, the purpose of which is to strengthen the muscle that separates the abdominal and chest cavity - the diaphragm.

What exercises for sliding hernia of the esophagus, including breathing, are recommended by exercise therapy specialists, in detail in the publication -  Effective exercises for hernia of the esophagus .