Hiatal hernia is a very common pathology, sometimes asymptomatic but which can also lead to gastroesophageal reflux. The diagnostic test is gastroscopy which will highlight or deny the presence of mucosal erosions, ulcers and/or stenosis.
This is a cranial migration (into the thorax) of part of the stomach through a sphincter located in the diaphragm, called the esophageal sphincter.
Some favoring factors are: age (leading to a reduction in muscle tone) and excessive intra-abdominal pressure (for example intestinal disorders such as constipation).
The presence of associated gastroesophageal reflux is determined by the fact that due to this ascent, the anti-reflux valve mechanism of the esophagus-stomach and diaphragm joint fails and therefore it happens that the acid that arrives from the stomach and the bile that arrives in the stomach from the duodenum they tend to ascend towards the esophagus due to an inverted praetorium gradient, exposing them to erosive action due to the presence of inappropriate pH.
Symptoms
- retrosternal burning
- regurgitation
- hemorrhage (in the most serious cases) related to ischemia of the gastric mucosa compressed in the diaphragmatic passage
- Chest pain (which may mimic cardiac symptoms) related to spasm of the esophageal muscles or the presence of an air bubble
Therapy
- Diet
- Proton pump inhibitor (PPI) drugs
- Surgery (cause of extreme gastric ascent and erosion)
- Osteopathy treatment has proven to be useful and effective in reducing symptoms