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symptoms of hiatal hernia in the elderly, early symptoms and signs of hiatal hernia in the elderly

symptoms of hiatal hernia in the elderly, early symptoms and signs of hiatal hernia in the elderly

Hiatal hernia symptoms in the elderly

Typical symptoms: Burning sensation ranges from mild burning or discomfort to more severe burning pain, which can be induced or aggravated when the intra-abdominal pressure increases due to lying down, bending over, coughing or forced air intake after a full meal.

Related symptoms: Esophageal reflux symptoms Esophageal spasm Foreign body sensation in pharynx Esophageal ulcers Difficulty swallowing Insufficient blood supply to coronary arteries

Hiatal hernia symptoms in the elderly

Sliding hiatus hernia is the most common in esophageal hiatal hernia. Sliding hernia makes the LES insufficiency and the His angle becomes obtuse, which leads to the weakening of the anti-reflux effect at the junction of the gastric tube. Therefore, it is clinically the same as reflux esophagitis. The main manifestations are: Symptoms of gastroesophageal reflux.

1. Symptoms

(1) Burning sensation and acid reflux behind the sternum:

It is the most common symptom. The burning sensation ranges from mild burning or fullness to more severe burning pain, mostly located behind the sternum (middle or lower 1/3), under the xiphoid process, or in the two-quarter rib area. The pain can spread to the neck, back, upper chest, left shoulder and left arm. It occurs more than 0.5 to 1h after a full meal, which is similar to angina. Accompanied by belching or hiccups, the increase in intra-abdominal pressure caused by lying down, bending, coughing, or forced air intake after a meal can induce or aggravate it; standing upright or vomiting can be relieved, and usually relieve itself 1 hour after a meal. Under normal circumstances, small hernias tend to have more severe pain, while those with large hernias tend to have less pain. Often accompanied by nausea, sometimes with more acidic stomach content

It is called acid reflux.

(2) Difficulty or pain in swallowing:

Accompanied by esophageal inflammation, erosion and ulcers, it can be manifested as swallowing pain. Difficulty in swallowing is more common in esophagitis accompanied by esophageal spasm, or accompanied by esophageal scars and stenosis and large paraesophageal hernias compressing the esophagus. It occurs when eating cold, hot or rough food. When the scar is narrow, dysphagia is often persistent.

(3) Heart symptoms:

About one-third of patients may have precordial pain, paroxysmal arrhythmia, palpitations, chest tightness, and tightness in the precordial area. Sometimes it is difficult to distinguish from angina pectoris and myocardial infarction. Hiatal hernia can stimulate the vagus nerve, reflexively cause insufficient coronary blood supply, and myocardial ischemic changes on the electrocardiogram. It is clinically similar to coronary heart disease, but the heart has no organic disease. It is called esophageal-coronary artery syndrome. Similarly, this disease can induce and aggravate angina pectoris.

(4) Other symptoms:

Patients with esophagitis or esophageal ulcers may have a small amount of bleeding, fecal occult blood is positive, and iron deficiency anemia may be present. A herniated cardia into the esophageal hiatus can reflexively cause a foreign body sensation in the pharynx. A huge hernia compresses the heart, lungs and mediastinum, causing symptoms such as palpitations, shortness of breath, cough, hair clamp, and shoulder pain.

2. Signs

There is usually no special discovery when there is no complication, but irregular drums and dull areas can be knocked out on the chest of patients with huge hiatal hernias. After drinking or being vibrated, splashing can be heard on the chest.

3. Diagnosis

In the clinic, people who are older, obese, have symptoms such as heartburn and nausea of ​​varying severity, should be alert to the disease. Further inquire about other factors that induce this disease, such as habitual constipation, chronic cough, frequent bending work, history of surgery, history of trauma to the lower chest and upper abdomen, etc. Sliding hiatal hernia is the most common clinically, and it is often misdiagnosed as reflux esophagitis. It is more common that the two coexist. Don't just be satisfied with the diagnosis of reflux esophagitis and cause missed diagnosis of esophageal hiatal hernia. Difficulty in swallowing caused by paraesophageal hernia and mixed hernia is characterized by sudden onset, repeated attacks, and disappears in a few hours or days. This is different from esophageal cancer; its main symptoms are pain, bleeding and incarceration caused by the hernia entering the chest cavity Caused by obstruction or difficulty swallowing. At the same time, the following imaging examinations can be used to confirm the diagnosis.

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