Esophageal cardiospasm is a complex disease. With it, inflammation of the esophagus occurs due to the shrinking of the walls. According to statistics, 6% of patients with functional diseases of this body have cardiopathy. Disease is the most common cause of dysphagia, that is, a violation of the swallowing function.
What is esophageal cardiopathy?
The first description of the disease was in 1674.T. Willis made it.
Most often, according to epidemiological indicators, this disease occurs in underdeveloped countries. This is due to malnutrition, avitaminosis, as well as the spread of special parasitic infections.
The disease is observed in people of different ages, but is more common in the adult population. The incidence of the disease in men and women is approximately the same. The ICD-10 code: Q 39.5.
Cardiospasm occurs due to a violation of healthy esophageal motility. It is common among people who have a tendency to unstable psychoemotional diseases.
The disease is characterized by relaxation of the lower sphincter of the esophagus or a prolonged narrowing of the terminal department. At the very beginning of the disease, functional disorders manifest themselves. Then organic changes are added to them.
The disease can occur in children of any age, but most patients are schoolchildren and preschool children. The onset of the disease is always gradual, periods of deterioration alternate with the usual. But over time, there is a progression of symptoms.
Reasons for
The cause for the development of the disease can be various internal and external factors, violations during embryogenesis, neurogenic disorders.
Internal causes: prolonged cramping of the cardia arising from ulcers, trauma, neoplasms.
The condition can be exacerbated by exposure to toxins when smoking, drinking alcoholic beverages. Cardiac spasm may also occur as a complication in scarlet fever, typhoid, syphilis, tuberculosis.
External causes:
- sclerosis of the food aperture of the diaphragm, accompanied by adhesions.
- pathological processes occurring in the abdomen.
- overdiaphragmatic diseases.
In rare cases, the ailment develops due to congenital problems with the esophagus. Under the influence of various factors, the walls of the esophagus begin to change. They can be thinned.
Sometimes a prerequisite is vascular sclerosis. The genetic predisposition of scientists assigns a secondary role, since it does not explain all the causes of the development of the disease.
Complexity in the study of causes is due to the fact that cardiopathism of the esophagus is a fairly rare disease.
Classification
Depending on the clinical picture and the peculiarities of the course of the disease, four stages are distinguished:
- The first is not characterized by a significant expansion of the esophagus. The cardiac dilatation reflex is preserved, but esophageal motility becomes strengthened. The latter has no clear coordination.
- The second stage is characterized by the absence of a cardiac dilatation reflex. Increased esophagus insignificant, usually not more than a few centimeters.
- In the third stage, a significant extension of the organ is revealed. It can reach 8 cm. There is a delay in food and liquid. The motor is broken.
- In the fourth stage, the esophagus not only becomes enlarged in diameter, but also elongates, curved. Food and drinks are delayed for a long time, which leads to the development of concomitant diseases.
At the same time, the duration of the disease does not affect the stage of cardiospasm.
Achalasia of cardia and cardiospasm: differences
Both diseases belong to the neuromuscular group. Akhalasia is a disease of an unknown etiology. It is characterized by a disruption of the lower esophageal sphincter. There is an ineffective reduction in the esophagus and a lack of relaxation of the corresponding sphincter.
For cardiospasm, it is characteristic that the fibers of the lower sphincter become hypersensitive to gastrin.
Therefore, there is a true spasm of the cardia. With achalasia, postganglionic neurons are involved. Because of this, the opening reflex falls out.
Symptoms of
At the initial stage of the disease development there are no noticeable manifestations. The disease can occur acutely or manifest gradually with increasing symptoms.
In the first case, if there are prerequisites, it begins with a feeling of bursting pain. This is due to the delay of the food lump in the esophagus. A few minutes later the unpleasant sensation passes.
With gradual development, initially there are hardly noticeable difficulties in the passage of dense food products, and fluids pass freely. Disturbance of swallowing occurs only with the progression of the disease.
Among the symptoms of esophageal cardiopathy:
- chest pains during eating,
- swallowing disorders,
- pains characteristic of angina pectoris appearing outside the intake of food.
It is easy to differentiate from other diseases cardiospasm of the esophagus, because it is characterized by inconstancy of dysphagia, its paradoxical nature. Symptoms of the disease intensify, then also suddenly disappear. Ability to work is usually not violated.
Diagnosis
Usually the doctor can correctly diagnose, based on anamnesis and patient complaints.
Confirm the findings of the doctor's objective research methods. The main one is esophagoscopy. The procedure is for children and adults.
This is an examination of the esophagus with the help of a special technique. Produced under local anesthesia or general anesthesia. Manipulation can be planned or emergency.
The endoscope is injected under constant monitoring. The tube gradually moves along the root of the tongue, it goes down. Using the method, it becomes possible to exclude organic diseases.
In the diagnosis it is possible to establish the form of a cardiospasm. It can be:
- complicated,
- compensated,
- decompensated.
The second important method is the X-ray study. A characteristic feature of the disease is the expansion of the esophagus with the presence of a narrow section. The gas bubble is not found in this disease. Do not find in the initial stages and other changes.
With a serious pathology, a large lumen is seen. Sometimes it happens with liquid, mucus or food remnants.erosions and ulcers can be detected.
Basic treatments for
In the initial stages, a conservative effect is suggested. It assumes normalization of the general and food regimes. Prescribe holinoblokiruyuschie and spasmolytic drugs. Possible use of calcium antagonists and sedatives.
Non-operative treatment is divided into general and local. In the first case, the use of products with a soft or semi-liquid consistency is prescribed. In some clinics, methods of hypnosis and suggestion, which were developed in the middle of the last century, are prescribed.
Surgical treatment of
An effective method is balloon hydration, which involves the introduction of a probe into the esophagus. The pneumatic cardiovascular system includes a special tube. At one end is a balloon.
It creates a certain pressure, which is controlled by a special manometer. Smaller expanders are first used.with further their diameter increases.
The operation to eliminate cardiospasm of the esophagus is prescribed:
- If cardiodilation is impossible. Especially it concerns children.
- No effect on other therapies.
- There are gaps in the esophagus.
- The doctor suspects the presence of malignant processes.
Complications in treatment often occur during the first hours of surgery. Usually it is damage to the esophagus.
Folk remedies
As additional impact, the following are used:
- Chinese magnolia vine,
- eleutherococcus,
- ginseng.
The herb of oregano and althea root have a good anti-inflammatory effect.
Infusion and decoction of these herbs are used for both prevention and during the period of exacerbation. If symptomatic signs of regurgitation and heartburn, appointed infusion of chamomile. It has a mild sedative effect, relieves inflammation. Additionally, can be prescribed: motherwort, peony or valerian.
Prevention
The main way to prevent the development of the disease, prevent exacerbations - proper nutrition. Take meals in a relaxed environment. Positively affect the use of calm music.
Refuse from eating monotonous or rough food, fast food. It is necessary to avoid three meals a day with large portions. It is better to divide them into 6 receptions. Thoroughly chew food. If at the same time feel the pain when passing the food, immediately take a few sips of water.
In conclusion, we note that with early treatment 84% of patients are cured. At advanced stages, infection of the respiratory tract, severe depletion and dehydration of the body can occur.