sábado, 29 de septiembre de 2007

DIETOTERAPIA EN HERNIA DIATAL

HERNIA DIATAL DIETOTERAPIA

Protusión parte baja del estomago
Deslizamiento corto arriba del diafragma
Rodamiento del hiato o orifico esofagico.
La causa es ideopatica.
Cuadro clínico presenta pirosis acompañada con dolor epigastrico.
DX
Endoscopia, y biopsia, medico manometrica, radiación del esófago, reducir el tabaquismo, y régimen antireflujo como tratamiento.
Definición.
Es el paso de una víscera intra-abdominal (estomago) a través de un orificio llamado "HIATO DIAFRAGMATICO"
SE CLASIFICA EN TIPO 1 HD POR DESPLAZAMIENTO
TIPO 2 HD PARA ESOFAGICA POR ENROLLAMIENTO.
H
SU ETIOLOGIA:
Es ideopatica, anomalías congénitas, alteraciones anatómicas y funcionales del hiato diafragmatico.
Asociado con la obesidad.
Características generales: desplazamiento (la más frecuentes) presenta insuficiencia del ligamento freno esofagico, dentro del hiato, alteración o insuficiencia del esfínter esofagico, inferior o cardias.
Aumento de presión intra abdominal, que permite EI ocasione la hernia o desplazamiento del estomago hacia arriba del diafragma. Alargamiento y adelgazamiento del ligamento frenoesofagico, esofagitis por reflujo.
Cuadro clínico
Mayoría de los pacientes no presenta síntomas asintomaticas, otros presentan síntomas cardinal pirosis, dolor localizado en el epigastrio que se exacerba con ingestión de alimentos irritantes y estimulantes y con la posición. Presenta reflujo gastroesofagico, regurgitación que lleva alimentos y ácidos.
Esofagitis
Diagnostico clínico: interrogatorio y explorar estomago región epigastrica.


Laboratorios
Biometria hemático, faringe o excremento, rx tomográficos, ultrasonidos, o estudio de serie esófago, gastroscopia, esofagoscopia.
Ph metria
Manejo medico.
Antiácidos geles
Dietético: dietas blanda gral., y no lleve irritantes.

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