A hiatal hernia occurs when the upper part of your stomach pushes up through your diaphragm and into your chest region.

隔膜是腹部和胸部之间的大型肌肉。你用这种肌肉来帮助你呼吸。通常情况下，你的胃低于隔膜，但在患有海绵疝的人中，一部分胃通过肌肉推。它通过的开口被称为中断。

一般都有 two types of hiatal hernia: sliding hiatal hernias and fixed, or paraesophageal, hernias.

Sliding hiatal hernia

这是更常见的疝气疝。它发生在你的时候胃和食管通过Hiatus滑入和胸口。滑动疝气往往很小。它们通常不会引起任何症状，并且可能不需要治疗。

固定疝气疝气

这种类型的疝气是 不那么常见 。它也被称为仇外大疗法疝气。

在a fixed hernia, part of your stomach pushes through your diaphragm and stays there. Most cases are not serious. But there’s a risk that blood flow to your stomach could become blocked. If that happens, it could cause serious damage and is considered a medical emergency.

甚至是固定的海藻疝是罕见的，导致症状。如果您确实经历过任何症状，通常是由胃酸，胆汁或进入食管的空气引起​​的。常见症状包括:

Surgical treatment is sometimes required to repair larger hiatal hernias and treat heartburn symptoms. Surgery for Hiatal herniasis used如果反流症状不能用药物成功控制，或者如果你有一种叫做巨型食管疝的疝气，也称为胃系发生。

手术类型

While hiatal hernias can often be treated with lifestyle changes or medication, some people may need surgery to repair their hiatal hernias.

修复皮肤疝的手术可能涉及拧紧光隔膜并从胸腔抬起腹部射回腹部。

外科医生将推荐基于您的海拔疝气的阶段的手术​​。

常见的手术选择 包括 :

  • 中断修理手术。这种手术使用缝合线和假啮齿物来拧紧并降低扩大的中断的尺寸，这是膜片中的开口，食管通过其前往胃。它可以防止你的胃通过中断向上膨胀，用于早期的海豚疝。
  • Nissen Fundoplication.这个程序涉及使用针脚包裹胃的上部，称为眼镜，围绕食道的底部，以使胃部保持在膈肌的侧面。缝线在食管末端产生压力，这可以防止胃酸和食物从胃部流动。
  • Collis-Nissen gastroplasty.This surgery is used to lengthen the esophagus in patients with more complex forms of Hiatal hernia due to esophageal shortening. In this procedure, a surgeon will use tissue from the upper part of your stomach to extend your esophagus.

什么期待

手术to repair a hiatal hernia typically takes between 2和3小时 并且在您在全身麻醉时完成，因此您将在手术过程中睡着而不感到疼痛。

修复手术疝气可以使用不同的技术完成：

  • 开放式维修。在an open repair surgery, your surgeon will make a large surgical cut in your belly in order to perform surgery.
  • 腹腔镜修复。在腹腔镜手术，你的外科医生将在腹部制作几个小切口，并通过其中一个切口用小相机插入薄管。外科手术工具将通过其他剪切插入。您的外科医生将使用连接到相机的显示器，以便查看胃内部并进行手术。

恢复

您可以期待在手术后留在医院1至2天。一些手术可能要求您遵循柔软或液体饮食，并在手术后几周避免碳酸饮料。

您可能会发现您的食欲下降术后，并且有些患者可能会经历腹泻在他们的疝气修复后的最初几天。

疝疝修补手术后通常没有重大限制，这意味着步行，爬楼梯，有性交，或者锻炼，只要它不会受到伤害。

您的外科医生或医生将提供更具体的指导方针和说明，具体取决于您的手术类型。

大多数疝疝的病例不需要治疗。症状的存在通常决定治疗。如果你有酸回流和胃灼热, you may be treated with medications or, if those don’t work, surgery.

药物

药物你的医生可以规定包括:

Diet

Hiatal hernia 原因 酸回流symptoms. Changing your diet can reduce your symptoms. It may help to eat smaller meals several times a day instead of three large meals. You should also avoid eating meals or snacks within a few hours of going to bed.

还有某些食物这可能会增加风险灼伤。考虑 避免 :

  • 辛辣食物
  • 巧克力
  • 用西红柿做的食物
  • 咖啡因
  • onions
  • citrus fruits
  • alcohol

减少症状的其他方法包括：

  • stopping smoking
  • 将床头抬高至少6英寸
  • 吃完后避免弯腰或躺下

The exact cause of many hiatal hernias is not known. In some people, injury or other damage may weaken muscle tissue. This makes it possible for your stomach to push through your diaphragm.

Another cause is putting too much pressure (repeatedly) on the muscles around your stomach. This can happen when:

  • coughing
  • 呕吐
  • 排便期间的紧张
  • 举重物体

Some people are also born with an abnormally large hiatus. This makes it easier for the stomach to move through it.

可以提高人疝疝气风险的因素包括：

您可能无法完全避免疝气疝气，但是您可以避免使疝气更糟糕：

  • losing excess weight
  • not straining during bowel movements
  • 提升重物时得到帮助
  • 避免紧身巾和某些腹部锻炼

几次测试 可以诊断疝气疝气。

钡燕子

在服用之前，您的医生可能会在其中喝钡饮用液体X射线。这个X射线提供了上消化道的清晰轮廓。图像允许您的医生看到胃的位置。如果它突出通过膜片，你有一个疝气疝。

内窥镜检查

你的医生可以执行endoscopy。他们将在你的喉咙滑薄管和不是s it down to your esophagus and stomach. Your doctor will then be able to see if your stomach is pushing through your diaphragm. Any strangulation or obstruction will also be visible.

医生究竟不知道是什么导致疝气疝或如何防止它们发生的事情。

But certain factors like living with obesity and smoking may increase your risk of a hiatial hernia, so maintaining a moderate weight and quitting smoking may help decrease your risk of developing one.

阻塞或杀死的疝气可能阻止血液流向你的胃。这被认为是医疗紧急情况。如果：

  • 你感觉恶心
  • 你已经呕吐
  • 你不能通到气体或清空你的肠子

不要以为疝气疝气导致胸痛或不适。它也可能是心脏问题的迹象或peptic ulcers。It’s important to see your doctor. Only testing can find out what’s causing your symptoms.

胃食管反流疾病（GERD）occurs when the food, liquids, and acid in your stomach end up in your esophagus. This can lead to heartburn or nausea after meals. It’s common for people with a hiatal hernia to have GERD. However, that doesn’t mean either condition always causes the other. You can have a hiatal hernia without GERD or GERD without a hernia.

Many people with hiatal hernias have no symptoms and do not need medical care. But for people with more severe hernias, treatment with medication, lifestyle changes, and, in some cases, surgery may be needed to repair the hernia and provide relief from uncomfortable symptoms like heartburn and chest pain.

It’s possible for a hiatal hernia to recur after surgery. In a2020年的研究, the recurrence rate for patients who underwent a minimally invasive fundoplication surgery was 18 percent.

生活方式的变化像减肥，保持健康的体重，戒烟，吃少量食物，限制某些脂肪和酸性食物，并在躺下之前吃饭至少3到4小时可以帮助你管理疝气疝的症状。