The diaphragm, also known in anatomy as the diaphragm (Greek: partition-intermediate wall), is a flat, disc-shaped muscle that divides the upper body (torso) into the chest and abdomen. It separates the left half of the lung from the stomach and spleen and the right half of the lung from the liver. Attached dome-shaped, the diaphragm is attached to the sternum, costal arches and lumbar vertebrae. Its function comes into play during breathing. During inhalation, the muscle fibers of the diaphragm contract, the domes flatten, and the chest cavity is enlarged. During exhalation, the muscle fibers relax and the diaphragm returns to its original shape. The diaphragm is also referred to when someone’s stomach hurts from laughing so much and so extensively. Laughter involves many different muscles, including the diaphragm.
How does a hiatal hernia occur?
A hiatal hernia occurs where the esophagus passes into the stomach through an opening in the diaphragm. If the muscle tissue at this point is weakened, the upper region of the stomach can bulge through the diaphragm and into the chest. Sporadically, this creates pressure on the lungs, resulting in difficult breathing.
If this part of the stomach also twists, a so-called gastric volvulus develops. This manifests itself as severe difficulty in swallowing, vomiting and a feeling of fullness. In addition, the esophagus may become blocked, cutting off the blood supply to the stomach. This can cause significant chest pain and must be treated surgically.
A hiatal hernia occurs in about a quarter of all middle-aged people. Among them, women and overweight people are particularly often affected. It is triggered by excessive pressure on the abdominal cavity, for example by frequent coughing, vomiting or lifting heavy objects. It is also not uncommon for a hiatal hernia to occur during pregnancy.
Symptoms of a hiatal hernia
The clinical picture of a small diaphragmatic hernia is usually symptom-free. The affected person does not feel any pain and therefore often does not notice the hernia. That is why the diagnosis of a diaphragmatic hernia is usually made by chance during a medical examination of the chest and abdominal region.
However, a large diaphragmatic hernia can lead to severe pain if the muscular closure apparatus of the esophagus is impaired. Stomach contents and acid can then flow back into the esophagus, causing heartburn. This process is known in medicine as gastroesophageal reflux disease.
Affected individuals should avoid all physical activities that put a lot of pressure on the abdomen. For the night, it is recommended to rest in an upright position so that no stomach acid can rise during sleep.
Trauma: rupture of the diaphragm
A hole or tear in the diaphragm is usually the result of a collision on the road. If such an injury is present, it is also called a diaphragmatic rupture. If a diaphragmatic rupture remains undetected, it can have devastating consequences for the entire chest cavity: This is because the tear can cause the abdominal organs to shift into the chest cavity. This severely impairs breathing.
