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お腹痛い男
お腹痛い男

その胃もたれ胃のヘルニアかも!食道裂孔ヘルニアの原因と症状

胃もたれの男

 
胃のヘルニアって聞いたことありますか。これは無症状のため、検診で発見されることがほとんどです。症状がある場合は、ほとんど合併する逆流性食道炎によるもので、胸やけ、つかえ感などがあります。

どちらかと言うと女性に多く、太っている人、姿勢の悪い人のほうが発症しやすいそう。胸やけなどが続く人は一度疑ってみてもいいかもしれません。

こちらでは、胃のヘルニア「食道裂孔ヘルニア」についてご紹介します。

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胃のヘルニア

食道裂孔ヘルニアとは

おデブ

私たちの体の胸部と腹部の間には横隔膜という筋肉でできた膜がありますが、この横隔膜には、食道や大動脈、大静脈が通るための穴が開いています。このうち、食道が通っている穴を食道裂孔といいますが、胃の一部がこの食道裂孔から上の胸部に脱出してしまっている病気を食道裂孔ヘルニアといいます。

食道裂孔からの胃の脱出は腹圧のかけ具合によっても変化しますし、立ったり座ったりしている時と横になっている時では変化します。呼吸により出たり入ったりもします。重症例では胃の半分以上、時には全体が縦隔(じゅうかく)内に脱出することもあります。

食道裂孔ヘルニアの原因

食道裂孔ヘルニアは、肥満、喘息、慢性気管支炎などでおなかの圧力が高い状態にあることが原因で起こります。その他にも、加齢によって食道裂孔がゆるくなったり、背骨が曲がったりしている場合にも、起こりやすいといわれます。生まれつき食道裂孔がゆるく、食道裂孔ヘルニアを起こしやすい方もいます。

食道裂孔ヘルニアの症状

食道裂孔ヘルニアがあるだけで自覚症状がなければ、単にヘルニア状態にあるだけで問題となりません。自覚症状や逆流性食道炎を合併して初めて、“ヘルニア症”ともいうべき病態になります。自覚症状としては胸やけ、胸痛、つかえ感が三大症状で、これは逆流性食道炎の症状と同じです。症状をとくに強く自覚するのは夜間就眠時、特に明け方、かがんで草取りなどしている時、食後しばらくした時、酒・たばこ・コーヒー・ココア・チョコレート・油ものなどを摂った時などです。

食道裂孔ヘルニアと逆流性食道炎

横隔膜は食道裂孔の部分で食道を締めつけ、胃の内容物が食道に逆流するのを防ぐ働きを持っています。しかし、食道裂孔ヘルニアになると横隔膜による締めつけができにくくなり、逆流が起こりやすくなって逆流性食道炎が起こりやすくなります。

軽い食道裂孔ヘルニアで症状がなければ、とくに治療を行う必要はありません。食道裂孔ヘルニアによって食道炎を起こし、胸やけなどの症状がある場合には、胃酸を抑える薬などで治療します。薬物療法の効果がない時や、ヘルニアの程度がひどい場合には、手術を行うこともあります。

胃のヘルニアの対策方法

食事に気を付ける

ヘルニアを起こすと胃酸が逆流しやすい状態になります。食道裂孔ヘルニアの症状は逆流性食道炎として現われます。ですから、逆流性食道炎の症状を緩和する食事が必要です。胃酸を過剰に分泌させないように、消化の良い物を意識して食べるようにします。

食事の内容
油ものの多い食事や、刺激の強い食事は控えます。また、酸っぱいものや食べ過ぎ飲みすぎも症状を悪化させてしまうので控えましょう。アルコールやカフェインも刺激が強いので、胃酸を大量に分泌させてしまいます。なるべく控えるようにする方が良いでしょう。

腹八分でゆっくり
特に食べ過ぎや早食いは症状をより悪化させてしまいます。毎回の食事はゆっくりとよく噛んで食べ過ぎないように注意が必要です。

何回かに分けて食べる
一度の食事の量を何回かに分けて食べるようにすると効果的です。一度に沢山食べると、その分胃酸が大量に分泌し逆流を起こしやすくなります。少しづつ何回かに分けて食べる食事療法で、ある程度症状が改善される事が多いです。

姿勢に気を付ける

姿勢が悪いと胃酸が逆流しやすいので気を付けましょう。

食後に横にならない
さらに、食事の後はすぐに横になってはいけません。食後すぐに横になるとお腹の圧があがり胃酸が逆流してしまい症状が悪化します。

服装、姿勢
お腹を締め付ける服装や、背中を丸めるような姿勢も腹圧を高くしてしまい症状を悪化させる原因です。日常生活でもお腹に圧がかからないようにし、胃酸の逆流を予防しましょう。

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まとめ:胃のヘルニアを知っておこう

胃のヘルニアは無症状です。症状としては合併症の逆流性食道炎によるものです。こちらであらためておさらいしておきましょう。

  • 胸やけ
  • 胸痛
  • つかえ感
  • 夜間、明け方に出る
  • 酒やたばこ、コーヒー、油ものなどを摂ると出る

思い当たる方は消化器科に受診して、上部消化管造影と内視鏡の検査を受けましょう。

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