Diaphragmatic cramp
introduction
Under a Diaphragmatic cramp one understands suddenly occurring acute contraction and cramping of the diaphragm with sometimes very strong ones colicky pain and other accompanying symptoms. But it can also be safe through simple hiccup express.
causes
The diaphragm is a muscle that works in the chest under the lungs tense and ensures that the lungs fill with air as it contracts. It is partial vegetative innervated, i.e. nerves lead to the diaphragm, to which we are no influence to have. This ensures that it contracts even when you sleep, allowing perfect breathing. On the other hand, nerve pathways also lead to the diaphragm, which we control and can control. Because of this, we can too active air by consciously causing the diaphragm to contract.
Click here for more information on the Structure of the diaphragm
Sometimes it can be called a Diaphragmatic cramp or diaphragmatic irritation. The exact causes are unknown. stress or that Swallowing too much air but are among other things suspected as a trigger. Especially when you eat too hastily, it can happen that the amount of air that is taken in and suddenly enters the stomach expands it. Because the phrenic nerve is near the stomach, it can become a irritation come, which can then lead to a preliminary stage of the diaphragmatic cramp: the so-called Singultus or hiccup. This occurs because the diaphragm contracts suddenly, causing the air in the lungs to be pushed outwards in jerks. Other types of irritation or cramping can also cause hiccups.
It is believed that a hiatus or Diaphragmatic hernia cause diaphragmatic spasm. This is a Break point in the diaphragmthrough which part of the stomach pushes through. The stomach can either slide back immediately or remain in this hernia for a longer period of time. This in turn causes irritation, which can lead to cramps.
There are some too rare caseswho have diaphragm irritation or frequent cramps caused by a malignant neoplasm in the sense of a tumor can arise.
Symptoms
The symptoms of diaphragmatic cramp are varied. So it can only be, for example hiccup come, but also colicky upper abdominal pain can occur.
Read more about the topic here Baby hiccups
Furthermore, the rhythmic contraction of the diaphragm affect other organs. It can be due to the irregular work too Shortness of breath come. The function of the Stomach can be restricted. A diaphragmatic spasm combined with the resulting irregular distribution of air in the abdomen can also lead to increased pressure on the heart, which in turn Cardiac arrhythmias can trigger. Breathlessness and impairment of other organs are rarely associated with diaphragmatic spasm, and hiccups are more common.
Pain
Since the diaphragm is a Muscle plate the pain associated with it is mostly of a muscular nature. A cramp leads to one, similar to the muscles of the arms or legs hardening those with nerves muscle fibers. This leads to the familiar Cramping pain. The pain is called dull to pulling and described as extremely uncomfortable, but since the diaphragm begins to loosen again after a short time, these initially do not last longer than a minute or two on. The next cramp can occur again very quickly. That is why it often comes to the typical rhythmic colicky, wavy epigastric pain.
Shortness of breath
The diaphragm is one for that regular breathing responsible body. By contracting, it expands the chest in which the lungs are suspended. The required air is passively sucked into this through the negative pressure in the surrounding chest area. If there is a spasm or irritation of the diaphragm, the Breathing movement only incomplete executed, which has the consequence that there is a reduced negative pressure and thus a lower air inflow. As a result, the body lacks the necessary oxygen and there is a shortage of breath, which is caused by so-called vegetative symptoms such as fast pulse and Racing heart, fear and Tightness in the chest as well Sweats can be accompanied. If a diaphragmatic spasm causes difficulty in breathing, this is a serious complication needs to be treated. Diagnosing diaphragmatic spasm as a certain cause is rather difficult, as other organs such as the heart and lungs are initially suspected and examined as triggers.
Duration
A diaphragmatic cramp often lasts only a few times Seconds or Minutes on. But the ones that follow one another are more disturbing and agonizing Convulsionsthat even Hours or Days can last. After every seizure - which can lead to pain - there is a relaxation phase and thus a symptom-free interval, which can then be followed by another convulsive phase. Complaints that last hours or days should be urgent medically presented to find out the exact cause.
diagnosis
The suspected diagnosis is mainly made by the Health survey (anamnese) posed. However, to hedge also imaging procedures used. Providing definite evidence of diaphragmatic spasm is extremely difficult because the spasms are time-limited states acts that may not occur during the medical examination.
The diagnosis is usually adapted to the patient's level of suffering. In the case of occasional hiccups, you will usually not initiate any further diagnostics severe pain, Long persistent hiccups or Effects on other organslike stomach or heart one should Investigate further. This also includes CT of the abdomen or a MRI.
A Ultrasonic or one Gastroscopy can be performed if a hiatal hernia is suspected. A so-called esophagus Pap swallowing examination can also reveal a causative diaphragmatic hernia. For this, the patient eats a porridge, with various X-ray images being taken at the same time during the swallowing phase. Bulges, Indentations and Fracture ports can be represented like this.
treatment
The treatment of diaphragmatic cramps depends entirely on the patient triggering cause. So is one Irritation of the nerveswhich mostly supplies the diaphragm not in need of treatment. In order to treat this, one can reduce any underlying stress or counteract an overinflation of the stomach by eating more slowly.
In extreme cases and if the cramps cannot be controlled in any other way, one of the two, the diaphragmatic supply, may be necessary annoy to ligate, that is, to ligate it severto keep hitting the diaphragm Stimuli too reduced . Both diaphragmatic nerves cannot be ligated, otherwise breathing is no longer possible.
If the triggering cause is a diaphragmatic hernia, if symptoms are common, one should consider one operative closure of the hernia to undertake. This is mostly done today endoscopic (Keyhole surgical technique) sutured the open area on the diaphragm again. Sometimes, however, a hernial orifice can reappear over time, which may require further surgery.
There are also some measures that every patient must take do it yourself can to prevent recurring diaphragmatic cramps. For example, you should try to eat small bites take your time and take your time. Eating hectically can always lead to excessive diaphragm irritation. There are also a few exercises that anyone can do at home or at work. It's changing Tension and relaxation exercisesthat train the diaphragm and make it less sensitive to cramps.
Release diaphragmatic spasm
In order to quickly resolve a diaphragmatic spasm, there are a few measures that each person affected can carry out themselves. However, the effectiveness is controversial. That is part of the exercises Inhalation of air with subsequent actuation of Abdominal press for a few seconds. Furthermore, drinking from ice cold water help. That too Hold your breath for 20-30 seconds is described as antispasmodic. In the case of a strong spasm, the upper abdomen appears as firm and distended. If the complaints that are causing this permit, a certain one can also be tried Massage technique loosening the diaphragm from the outside. To do this, you should stroke the upper abdomen with the palm of your hand.
Since a cramp usually lasts only a few seconds, such measures are often not necessary. The treatment with ice water and the maintenance of air is described as the most effective. It should be noted that these treatment measures just simple diaphragmatic irritation and treat cramps caused by it. These measures will not help with more serious causes, such as a hiatal hernia.
