Type II hiatal hernias are also known as para-esophageal hernias. They may diagnosed barium swallow or endoscopy, but barium swallow may more sensitive.
The natural history type II hernias progressive enlargement. They have a much higher complication rate compared type I hernias, and complications may include obstruction, bleeding, intra-thoracic gastric dilation, volvulus, and infarction.
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In general, the recommended therapy surgical resection. Selected Non-Neoplastic Esophageal Disorders The symptoms gastroesophageal reflux may include positional or postural heartburn and regurgitation.
Dysphagia may occur with reflux esophagitis despite absence a stricture. Patients with reflux frequently have writing help with writing a good thesis statement helper post prandial symptoms including nausea and epigastric abdominal pain.
Other possible symptoms are odynophagia and chest pain. Gastroesophageal reflux may evaluated Who wants to write my essay barium swallow, nuclear scan, endoscopy, Bernstein test, SART, or esophageal manometry. Complications include esophagitis, stricture formation, upper GI bleeding, aspiration pneumonia, and Barrett's esophagus. Treatment gastroesophageal reflux includes lifestyle changes, antacids, H blockers, prokinetic drugs, and surgery. The primary esophageal motility disorders interest include achalasia, diffuse esophageal spasm, and nutcracker esophagus. Achalasia characterized lack peristalsis in the esophageal body, a hypertensive lower esophageal sphincter, and impaired lower esophageal sphincter relaxation upon swallowing.
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The symptoms achalasia include progressive dysphagia for solids and liquids and positional or nocturnal regurgitation.
The diagnosis achalasia may suspected barium swallow or upper GI endoscopy. The esophageal scan may show decreased transit time but manometry diagnostic.
Achalasia may also present with pulmonary symptoms due aspiration. Weight loss common, and untreated achalasia patients are at increased risk for esophageal cancer. Medical treatment achalasia includes use long-acting nitrates, calcium channel blockers, tranquilizers, andrdepressants, antrcholinergics, glucagon and beta agonist. Esophageal dilatation with pheumatic dilatation effective cases. Surgical myotomy may required for relief symptoms achalasia. Diffuse esophageal spasm characterized a normal or high esophageal sphincter pressure and high amplitude nonperistaltic esophageal contractions which occur with greater swallows. Abnormal motor responses such as retrograde college application essay writing help contraction, simultaneous waves or repetitive waves original essay writing service may occur. Triple peaked waves are characteristics for a diffuse esophageal spasm.
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