Wednesday, October 31, 2012

Hiatus Hernia

Hiatus Hernia
Diagnosis:
Heart burn increased by lying down and decreased in upright position.
History of dyspepsia and heart burn.
Investigation:
Barium swallow in Trendlenberg position.
Manometric studies to assess lower esophageal sphincter.
Treatment:
1- Antacids. (see gastritis)
2- Drugs of peptic ulcer. (see gastritis)
3- Drugs to assess motility of stomach (prokinetics).
- Domperidone tab. 1×3 before meals.
- Motinorm tab. = Motilium  tab.
- Farcotilium cap. = Dompidone tab.
4- Instructions → decrease body weight, avoiding cigarette, spicy food and heavy meals before sleeping.
Indications of surgery:
- Sliding hernia (small or large).
- Large paraoesophageal hernia.
- Complications (anemia).

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