Doctors Miss THIS Type of Hiatal Hernia скачать в хорошем качестве

Doctors Miss THIS Type of Hiatal Hernia

Do you have a "subclinical hiatal hernia" despite your doctor's assurance that you don't have a hiatal hernia? If you struggle with acid reflux, heart palpitations, shortness of breath or anxiety you may have this condition. ➡️ Click HERE to Book a Consultation: https://rootcausemedicalclinics.com/h... Call us directly: 727-335-0400 When a body part transitions from functioning optimally to disease, it doesn't happen overnight. It takes many months to years. As you leave optimal functioning you then progress through a zone of more and more malfunction until you finally reaches a disease state. Patients "on their way" to developing a hiatal hernia are experiencing growing levels of malfunction and can experience all the symptoms of hiatal hernia, despite negative testing. Research supports my clinical findings and studies are below. The conventional threshold for diagnosing a sliding hernia is about two centimeters of separation between the lower esophageal sphincter (LES) and the crural diaphragm - the LES has moved above the diaphragm, hence the enlarged separation. Anything less than that is not called a hernia. Studies show that even minimal separations below this cutoff are physiologically significant. Patients with less than two centimeters of separation experience more reflux. Weakness of the esophagogastric junction (where you esophagus joins to your stomach) barrier correlates strongly with GERD. The gastroesophageal flap valve (tissue that flaps over the top of the stomach where the esophagus meets your stomach) is graded during an endoscopy (called a Hill classification) and it shows that a patient can have a normal-appearing hiatus yet an incompetent valve. These patients have severe reflux even when no visible hernia. This is functional failure without a structural label. Meaning that functionally the body malfunctioning despite lacking the full structural distortion associated with a hiatal hernia. Dynamic testing studies confirm that the esophagogastric junction is not fixed. During swallowing, periods of increased intra-abdominal pressure or straining (e.g. constipation) the esophagus shortens, and diaphragm relaxes, allowing the LES to rise above the crural diaphragm. This small migration upwards opens the junction and provokes reflux. Patients may appear normal on static testing like an endoscopy, but experience symptomatic reflux during these transient events, along with shortness of breath, heart palpitations and anxiety potentially. Finally, intermittent or small hernias are often missed. Endoscopy fails to detect sliding hernias up to 40 percent of the time while barium esophagrams are more sensitive but still limited by its snapshot or static nature. Advanced dynamic techniques such as high-resolution manometry and dynamic MRI reveal these more subtle separations and reflux events that static testing overlook. Dynamic testing sees your esophagus operating in real-time and thus can better detect these subtle abnormalities. These findings support the reality of a clinical zone between “normal” and “frank hernia" and patients in this zone have the same symptom profile as those with larger hernias. If you'd like help we're here for you. The next step is to call us for a consultation - we'll determine if what we do is a good fit for you. Call 727-335-0400 or click here: https://rootcausemedicalclinics.com/h... References Kahrilas PJ, Kim HC, Pandolfino JE. Approaches to the diagnosis and grading of hiatal hernia. Best Pract Res Clin Gastroenterol. 2008;22(4):601–616. Pandolfino JE, et al. High-resolution manometry of the EGJ: morphology and relation to GERD. Gastroenterology. 2006;131(3):724–732. Hill LD, Kozarek RA, Kraemer SJ, et al. The gastroesophageal flap valve: in vitro and in vivo observations. Gastrointest Endosc. 1996;44(5):541–547. Nicodème F, et al. Esophagogastric junction morphology: effect of transient LES relaxations and esophageal shortening. Gastroenterology. 2013;144(5):893–901. Wu JC, Sung JJ, Chan FK, et al. Endoscopic diagnosis of hiatal hernia: correlation with radiologic findings. Endoscopy. 1999;31(5):401–404. Rieder F, et al. Barium esophagram versus endoscopy for detection of hiatal hernia. Ann Laparosc Surg. 2017;2:90. #hiatal hernia #acidreflux #rootcausemedicine Disclaimer: The information provided in this video is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of your physician or other qualified health provider with any questions you may have regarding your health, medical condition, or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have seen or heard in this video. The views expressed are based on my clinical experience and current scientific understanding as of the date of publication. Individual results may vary