Diaphragm elevation - causes, symptoms and treatment
- Diaphragm elevation by diaphragmatic diseases
- Diaphragm elevation due to liver and spleen disorders
- Other causes of diaphragmatic elevation
- Symptoms of diaphragmatic elevation
- Diagnosis of diaphragmatic elevation
- Therapy at diaphragmatic high
The diaphragm forms an essential part of the respiratory muscles. It consists essentially of a muscle plate that lies between the chest and abdomen just below the lung (Pulmo) and is held by various tendons in a stable position. To ensure breathing, the respiratory center in the brain sends nerve impulses to the phrenic nerve (phrenetic nerve) at regular intervals, which cause the diaphragmatic muscles to lift and lower again. This continuous movement stimulates the lungs from below to contract and then deflate, allowing natural air in and out.When the diaphragm moves up, it has far-reaching consequences. In addition to breathing difficulties u. a. also pressure feelings in the upper abdomen arise. (Image: michaelheim / fotolia.com)
In the immediate vicinity of the diaphragm are next to the lungs even more organs that share their place in the upper body with the respiratory organs. These include primarily the liver (Hepar), the spleen (Splen) and the stomach (Gaster). Although the heart (cardia) is not directly next to the diaphragm, but can also be counted among those organs that help shape the space requirement in the upper body.
A diaphragmatic high is now enormously impairing this intended distribution of space in the upper body. In addition, the essential for the breathing process muscle movements are greatly affected by the organ displacement. Starting position of the diaphragmatic high is a displacement of the diaphragmatic dome into the chest cavity, whereby the lower lung section undergoes a prolonged compression. A distinction is made between three main forms of diaphragmatic elevation, which, depending on the type, also give first indications of the underlying causes:
- Left-sided diaphragmatic elevation - In the left-sided diaphragmatic elevation, only the left half of the diaphragmatic dome is affected by the elevation. Among other things, it can be caused by space-occupying changes in the digestive organs, the stomach and spleen, which are also on the left.
- Right-sided diaphragmatic elevation - If the right diaphragmatic elevation is present, the diaphragmatic dome is only shifted upwards on the right side. This is often due to organ enlargements in the right liver area.
- Bilateral diaphragmatic elevation - In the case of a bilateral diaphragmatic elevation, the entire diaphragmatic dome is affected by the elevation. The causes here can be very versatile and affect either the diaphragm itself or surrounding organs or surrounding tissue.
When upper body organs move away from their original position, this almost always has to do with a predominant lack of space in the ribcage. Organ enlargements, so-called megaliens, are most often considered for a diaphragmatic elevation. However, injuries, spinal diseases, inflammation and tissue proliferation can not be ruled out as the cause of the high diaphragm.
Diaphragm elevation by diaphragmatic diseases
Of course, the organ enlargement already mentioned may, of course, affect the diaphragm itself. For example, if a patient suffers from a so-called diaphragmatic inflammation, inflammatory swelling may temporarily enlarge the diaphragmatic dome, pushing the dome in succession on the lungs. Typical causes of the - very rare - inflammation include:
- chronic cough,
- Roundworm infections (trichinosis),
- Injuries of the diaphragm.
Even a diaphragmatic hernia (hiatal hernia) is not to be underestimated as a trigger of the high. Similar to a serious bone fracture, in which fracture fragments are postponed due to injury, the ancestral position of the diaphragm segments in this scenario is no longer guaranteed and a shift in the diaphragmatic dome may occur.
Also conceivable is a phrenic palsy (diaphragmatic palsy) as the cause of the diaphragmatic high. The signal line between the respiratory center and phrenic nerve is interrupted, which means that the diaphragm can no longer fulfill its function. In addition to lack of muscle contractions to maintain breathing, this circumstance also means that the abdominal organs migrate more and more upward below the diaphragm. The reason for this is the lack of muscle tension of the diaphragm, which normally pushes down the organs.
Caution: Depending on whether the phrenic nerve is paralyzed on one or both sides, it can lead to very serious complications! While a left- or right-sided paralysis triggers "only" respiratory problems, which are survived by the patient mostly unscathed due to adequate treatment, bilateral diaphragmatic paralysis can provoke life-threatening respiratory arrest.
Diaphragm elevation due to liver and spleen disorders
The organs, which are located in the vicinity of the diaphragm, can also trigger a diaphragmatic elevation with corresponding enlargements. In cases of right diaphragmatic elevation, liver enlargement (hepatomegaly) may be considered. This is most commonly associated with fatty liver, which indicates that a person's individual lifestyle and diet may also contribute to the development of diaphragmatic elevation. Furthermore, liver inflammation (hepatitis) is again and again the cause of hepatomegaly. The causes are very diverse and range from infectious diseases such as malaria, injuries and symptoms of poisoning to metabolic and storage diseases.
On the left side of the diaphragm, on the other hand, a high position is usually triggered by spleen enlargement (splenomegaly). Here are various inflammatory and infectious diseases of the spleen and chronic blood diseases for the health problem in question. Cirrhosis of the liver can also cause splenomegaly, as it causes blood backflow into the splenic vein due to internal vascular damage.Spleen enlargement (splenomegaly) can - as well as a liver enlargement - also lead to diaphragmatic elevation. (Image: pixdesign123 / fotolia.com)
Speaking of vessels: There are numerous cardiovascular diseases that can affect the spleen volume. From heart disease such as right heart failure to more specific diseases such as splenic vein thrombosis or leukemia, splenomegaly can be due to circulatory disorders in many ways come about. Also, bruising due to an accidental spleen trauma can not be ruled out as the cause. Furthermore, the following diseases are mentioned as possible causes of spleen enlargement:
- Abscesses, cysts and tumors in the area of the spleen,
- hydatid disease,
- Epstein-Barr infection,
- Gaucher's disease,
- Pfeiffer's glandular fever,
- Rheumatism (Felty syndrome),
Other causes of diaphragmatic elevation
Mention should be made with regard to diaphragmatic high and organ malformations. In addition, of course, pregnancy is an organ enlargement, namely that of the uterus dar. It commonly leads to a shift of many organs and can also influence the seat of the diaphragm.
In the area of the gastrointestinal tract, especially digestive complaints such as chronic flatulence (meteorism) often cause a diaphragmatic elevation. The persistent accumulation of gas in the gastrointestinal tract causes a permanent expansion of the digestive organs, so that it can easily lead to a protrusion of the diaphragm.
Symptoms of diaphragmatic elevation
Symptoms of diaphragmatic elevation are mainly due to impaired lung function, which can lead to persistent breathing difficulties if the cause is not resolved. In addition, it can also lead to discomfort as well as a disturbed gastrointestinal function. Overall, patients with diaphragmatic elevation must expect the following symptoms:
- difficulty breathing,
- difficulty in breathing,
- shortness of breath,
- Pressure in the upper abdomen.
Diagnosis of diaphragmatic elevation
Initial signs of a diaphragmatic elevation can be detected during diagnosis in the course of a patient discussion on existing symptoms and possible pre-existing conditions. Thereafter, however, imaging procedures are necessary to obtain a reliable finding and confirm the protrusion of the diaphragm. For example, CT, X-ray or ultrasound are possible. Also, laboratory tests, such as to detect infections, are conceivable.In order to obtain a reliable finding for diaphragmatic elevation, methods such as CT, X-ray or ultrasound may also be required. (Image: skvalval / fotolia.com)
Therapy at diaphragmatic high
Fortunately, it is fortunately possible today to treat diaphragmatic supremacy without any problems. However, the prerequisite is that the underlying cause has been determined. Depending on the cause of the illness, the treatment may then include the following steps:
Of course, infections and organ inflammation require the use of medication when the diaphragm is raised. Antibiotics come into consideration as well as anti-inflammatory drugs. Cardiovascular disease may require the use of antihypertensive agents or beta-blockers. If a tumor is present, cytostatics and chemotherapeutic agents are likely to be unavoidable.
Medicinal herbs can be of great help for many causes and ailments that cause diaphragmatic elevation. For example, herbal teas made from fennel or anise help to relieve flatulence by relieving the gastrointestinal tract. Herbal oils such as caraway oil or peppermint oil have the same effect, with peppermint oil also having a breath-stimulating effect at the same time.
Therapeutic breathing exercises are recommended to improve breathing during and after diaphragmatic suprarenal therapy. A visit to the physiotherapist is particularly advisable for pregnant women, because the protrusion of the diaphragmatic dome can cause increasing breathing difficulties until birth. Of course, patients with high diaphragms of the diaphragm should also refrain from smoking, since cigarette smoke, on the one hand, aggravates breathing difficulties and, on the other, can also exert disturbing nerve stimuli on the diaphragm.
If overweight, a fatty liver or other liver disease has caused the diaphragmatic high, a change in diet is very important. The less pressure exerted by excess tissue on the diaphragm and liver, the better. In addition, some foods aggravate the state of health in such a case in addition. High-fat foods should be avoided in this context not only in obesity. Because corresponding foods also increase the liver severely. Even roasting substances, such as those found in coffee and grilled meat, should be spared the liver in the event of illness. The same applies, of course, to alcohol, the degradation of which is particularly troublesome for the liver. The focus is therefore on a high-fiber diet with plenty of fresh fruits and vegetables with corresponding causes for the diaphragmatic high. Especially artichokes and the use of milk thistle extract in this regard should be particularly beneficial for the health of the liver.
Surgical measures are necessary in the case of diaphragmatic elevation when tissue growth or wounds are behind the disease. Abscesses and cysts may need to be evacuated within a surgical procedure. Internal injuries can be surgically treated, sutured or stapled. In tumors, doctors often decide on a case by case basis whether to work with suitable medicines prior to an operation in order to reduce cell degeneration.
If organs or the diaphragm are permanently out of their position, surgery is more likely to bring them back to their original position. Emergency operations, such as threatening respiratory distress, are conceivable in the worst case and may even involve surgical lung volume reduction.
Causes of diaphragmatic elevation: phrenic inflammation, diaphragmatic hernia, diaphragmatic paralysis, hepatomegaly, splenomegaly, accidental injuries, organ malformation, meteorism, pregnancy, obesity. (Ma)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)