Cardia failure - what is it? Symptoms and treatment of stomach disease

September 7, 2018
Gastroenterology
Valeria Valeria

Recently, a disease such as gastric cardia insufficiency has become widespread. The presence of a pathological process occurring in the human body may be indicated by symptoms that at first glance do not cause serious concern: heartburn, belching after eating, bad breath. If you ignore the appearance of the first symptoms and start the disease, you can significantly harm your own health.

That is why it is important to know what can provoke gastric cardia insufficiency, symptoms and treatment, as well as preventive measures.

What is cardia?

The digestive tract contains circular muscles that act like valves. They help food move through the esophagus, stomach and intestines. Such muscles are called sphincters, they are able to contract when necessary and close the passage.

The cardia of the stomach is one of these muscles. It is located between the stomach and esophagus and regulates the flow of food. The sphincter is closed when a person is not eating and opens when eating so that food can enter the stomach. This happens during normal muscle functioning. The cardia prevents food and gastric juice from flowing back into the esophagus.

But sometimes the sphincter malfunctions, and then gastroenterologists diagnose “cardia insufficiency.” What it is? The pathology is that the muscle stops contracting or does not close completely, and food, along with gastric juice, is thrown into the esophagus. In medicine this is called reflux. This phenomenon can also occur in completely healthy people. But during normal functioning of the body, the esophagus is protected, the mucous membrane is quickly restored, and inflammation does not occur.

But if the protection of the esophagus is reduced, then the reflux of acid and food leads to burns and inflammation of the mucous membrane. This disease is called reflux esophagitis, and it requires immediate treatment. In advanced cases, ulcerations appear on the lower part of the esophagus.

Externally, the cardia resembles a round rosette. In a healthy body it closes in a circle. With its pathology, gastroenterologists talk about insufficiency of the cardia rosette.

The role of the diaphragm in reflux

The diaphragm plays an important role in preventing reflux. She, together with NSP, restrains the pressure so that there is no reflux higher in the gastrointestinal tract.

The antireflux barrier consists of the LES and the crura of the diaphragm. Since the pressure gradient between the stomach and esophagus is quite high, their coordinated action is necessary. The sphincter takes on a constant load, holding back pressure. The diaphragm helps him when he inhales, at this moment the pressure in the chest increases, and the legs of the diaphragm additionally put pressure on the walls of the esophagus, compressing them.

The formation of such a tandem is weakened by the formation of a diaphragmatic hernia. The cardia of the stomach moves upward, so the diaphragm is no longer able to participate in the antireflux barrier.

Causes of pathology

Cardia failure with reflux esophagitis occurs due to not one, but several reasons. Factors that provoke sphincter weakness are divided into organic and functional. Organic causes are not related to the activity of the cardia rosette, but are caused by the fact that the sphincter has to work in unfavorable conditions. Such reasons include:

excessive eating;
excess body weight;
systematic overeating in the evening;
low mobility;
chronic stomach diseases (ulcers, gastritis);
lower esophageal hernia.

Functional reasons are associated with disruption of the sphincter muscle ring itself. These factors include:

accumulation of fluid in the abdominal cavity (ascites);
pregnancy;
age over 35 years;
physical stress during work or sports;
intra-abdominal hypertension;
unsuccessful operations on the gastrointestinal tract;
pyloric spasm.

Stages of the disease

There are several degrees of gastric cardia insufficiency. What it is? Depending on how much the sphincter loses its ability to close, there are 3 stages of the disease:

Stage 1. Incomplete closure of the cardia rosette occurs. Patients complain of frequent belching. During endoscopic examination, a small gap (about 1/3 of the diameter) can be seen in the cardia when the patient breathes deeply.
Stage 2. With deep breathing, the gap increases to 1/2 the diameter. The patient complains of nausea and a feeling of heaviness in the digestive organs.
Stage 3. The sphincter completely stops closing. If the patient suffers from liver pathologies, this aggravates the development of cardia failure. Symptoms of esophagitis (inflammation of the esophagus) become pronounced.

In the photo you can see endoscopic changes in the cardia with insufficiency: gaping gaps and inflamed areas.

Lifestyle

If you suffer from insufficient gastric cardia, this means that you will have to change your lifestyle:

First of all, take care of your diet. Eat food in small regular portions 5-6 times a day. Watch your weight. Don't overeat.
If you have a bad habit like smoking, you will have to give it up.
Raise the pillow you sleep on so that it is slightly above body level. This will help eliminate heartburn and reduce pressure on the stomach.
Do not wear restrictive, tight clothes or belts.
Maintain a sleep schedule. Healthy sleep is the key to a healthy body as a whole.
Reduce the amount of caffeine you consume.
Try to keep stress to a minimum.
Exercise. Avoid a sedentary lifestyle.

Symptoms of cardia failure

It is difficult for a patient to determine on his own that he suffers from cardiac insufficiency. The symptoms of this disease are similar to those of many other stomach ailments. The following manifestations should be the reason for contacting a gastroenterologist:

bitterness in the mouth;
admixture of bile in vomit;
belching with a sour taste;
pain in the stomach and esophagus;
dizziness, weakness, loss of appetite;
frequent heartburn;
burning sensation behind the sternum;
nausea;
rumbling in the stomach;
a feeling of spasms in the area where the esophagus enters the stomach.

With cardia insufficiency, superficial gastritis is a common occurrence. These two diseases often accompany each other. Inflammation of the stomach can cause sphincter weakness. In this case, there is pain behind the sternum, constant rumbling in the abdomen, general weakness, the tongue is coated with a white coating. Superficial gastritis can be provoked not only by poor nutrition, but also by wearing tight clothing that squeezes the waist.

Gastroesophageal reflux disease is a common complication of cardia failure. What it is? The disease develops due to chronic reflux of stomach contents into the esophagus. Severe pain occurs in the chest, which patients sometimes mistake for myocardial infarction. Symptoms from the stomach are accompanied by signs of damage to the upper respiratory tract: sore throat, hoarseness, difficulty swallowing.

The most dangerous complication of cardia insufficiency can be malignant degeneration of the cells of the esophageal mucosa. The aggressive effects of hydrochloric acid negatively affect the condition of the epithelium and over time can provoke the growth of tumors.

1.General information

Epicarditis, pericarditis, endocarditis - these terms summarize a large group of cardiovascular diseases in which certain membranes of the heart become inflamed. The etiology can be either infectious (the cause is viral or bacterial pathogens), or other - allergic, rheumatic, secondary (with any lesion and subsequent infection), or idiopathic, i.e. unidentified.

The term “viral carditis” thus indicates an infectious-inflammatory process in the membranes of the heart caused by viruses. There are no exact epidemiological data (estimates of incidence) regarding this pathology.

A must read! Help with treatment and hospitalization!

Diagnosis of cardia failure

The disease is diagnosed based on the results of an X-ray of the stomach. Esophagoscopy will help determine the stage of the disease. The methylene blue test determines the presence of reflux esophagitis in cardiac insufficiency. What it is? During an endoscopic examination, a dye is injected into the patient's stomach. The substance colors only healthy areas; inflamed areas do not change color.

In addition, additional studies are prescribed:

stomach acid test;
ultrasound examination of the abdominal organs;
fibrogastroduodenoscopy.

Based on all the studies, the doctor makes a diagnosis of “cardia insufficiency.” How to treat this pathology depends on the cause and stage of the disease.

Physiotherapy

The muscular structures of the gastric cardia can be easily strengthened. For this purpose, specially designed breathing exercises are used. Particularly popular is Strelnikova’s gymnastic method, which involves performing training twice during the day: in the morning and in the evening before a meal, and also after an hour and a half after its end, for 1500 breaths.

As a preventive measure, gymnastics is performed in the morning or evening period. Such breathing exercises help strengthen the body and improve the health of internal organs due to increased blood flow.

Regular breathing exercises for insufficiency of the gastric cardia will be no less useful:

The training should be carried out on an empty stomach, since any activity performed on a full digestive organ weakens the sphincter, which is explained by the pressure of gastric contents on the valve.

The lungs are perhaps the only organ that can be controlled externally. For this reason, you need to start gymnastics with normal inhalations and exhalations.

Exercises should be performed simultaneously with thoracic and abdominal breathing, when the muscular structures of the abdominal cavity become involved in the respiratory process.

Inhalations and exhalations must be carried out in compliance with different speed limits.

If the disease occurs in the final stages, then the listed gymnastic exercises become useless.

Drug treatment

Cardia failure is a chronic disease. It is difficult to cure it completely. But it is possible to reduce the relapse rate.

First of all, you need to eliminate the cause of sphincter weakness. If you are overweight, then diet and exercise are necessary to reduce body weight. Lifestyle changes are required: proper nutrition, refusal to wear tight clothes. It is recommended to sleep with your head elevated. Excessive physical exertion and sudden bending of the body should be avoided.

Drug treatment is aimed at strengthening the sphincter and relieving pain attacks. The following drugs are prescribed:

means for increasing motility and tone of the digestive organs: “Metamol”, “Motilium”, “Propulsid”, “Raglan”, “Perinorm”, “Metoclopramide”;
painkillers: “Ibuprofen”, “Tempalgin”;
medications that coat the gastrointestinal mucosa: “Almagel”;
Heartburn relievers: Ranitidine, Smecta.

Diet for cardia deficiency

If the sphincter is weak, split meals are useful. You need to eat often, but in small portions. If you eat too much food at one time, the rosette of the cardia will stop closing. The following nutritional principles must be observed:

After eating, you cannot lie down for 2 hours, you can only walk or stand.
You should eat food in semi-liquid form: porridge, low-fat broths.
You can't overeat in the evening.
You need to exclude chocolate, spicy, fried and fatty foods. Excessive amounts of salt and coffee can also aggravate symptoms of the disease.
The consumption of alcohol and carbonated drinks is strictly prohibited.
During each meal, you do not need to fully load your stomach.
Food should not be too hot or too cold.

Surgical treatment of cardia failure

Surgical treatment is used in advanced cases. Sometimes surgical methods help get rid of the cause of cardia insufficiency, for example, a hernia.

To eliminate sphincter weakness, the following operations are performed:

The wall of the esophagus is sutured to the stomach.
Additional folds are surgically made in the esophagus.
The muscles are sutured and the cardia ring is narrowed.

The surgeon decides which method to eliminate cardia insufficiency in each specific case.

Surgical intervention

If complications occur or there is no result from conservative treatment, surgical intervention is used: vagotomy, fundoplication, pyloroplasty, etc. Vagotomy involves dissection of the main trunk or branch of the vagus nerve. Fundoplication is an antireflux operation in which the fundus of the stomach is wrapped around the esophagus, creating a cuff that prevents gastric contents from refluxing into the esophagus. Pyloroplasty is a surgical intervention during which the pyloric fissure is widened by reconstructing it.

Traditional methods of treatment

Therapy with home remedies can only be carried out as an addition to the main treatment. Before using traditional medicine, you should consult your doctor. When treating insufficiency of the esophageal cardia, the following traditional medicine recipes are used:

Juice is squeezed out of plantain leaves and taken 1 teaspoon before meals during an exacerbation of the disease.
A mixture of St. John's wort, motherwort and valerian herbs is brewed in equal proportions, filtered and taken with honey.
Dandelion flowers are ground with sugar to form a syrup. Dissolve 1 teaspoon of the composition in a glass of water and drink before meals.
Cumin (1 teaspoon) is brewed in a glass of boiling water and drunk before meals. This drink perfectly relieves spasms in the gastrointestinal tract.

We can conclude that cardia failure is accompanied by unpleasant symptoms. Such manifestations also occur in other gastrointestinal diseases. Therefore, you should not try to diagnose yourself. You need to contact a gastroenterologist as soon as possible for diagnosis and treatment.