Diaphragm represents main respiratory muscle and it separates thoracic from the abdominal cavity. Normal respiratory function depends on the function of diaphragm. Every diaphragm contraction causes a decrease of intrapleural pressure, expansion of the rib cage by generating positive intraabdominal pressure, expansion of the rib cage using abdomen as a fulcrum.
Every time there is a decrease in diaphragmatic function it represents itself as a concomitant respiratory dysfunction. Our body has compensatory mechanisms for decreased diaphragmatic function, but none of them can successfully prevent respiratory compromise when excursion of the diaphragm is diminished.
Symptoms And Causes
Most common symptoms caused by the diaphragm spasm are hiccups and symptoms of a disorder called hiatal hernia, which occurs often in diaphragm strain. The majority of people live for a long time with a strain of diaphragm with or without symptoms. Some of them go through their whole life without even knowing they have this condition.
As already mentioned, the diaphragm is the largest and strongest respiratory muscle in the body. It is located between two cavities and in order for certain organs to pass from thoracic to abdominal cavity there are physiologically few openings in the diaphragm.
One of them is esophageal hiatus, as the name says, esophagus passes to abdominal cavity continuing to stomach. When the diaphragm is strained, the stomach is being pushed through esophageal hiatus and it enters the thoracic cavity causing various symptoms.
These abdominal structures that are not physiologically present in the thoracic cavity can press the lung tissue causing the patient to experience hunger for air and a thoracic pressure.
Heart function can be compromised due to the pressure of these strange structures, causing the heart not to be able to pump adequate amounts of blood into the aorta.
Compromisation of the large blood vessels, mainly Vena Cava, can stop the returning of the blood from the systemic circulation to the heart.
This malposition of the stomach can cause disruption in stomach content passage, leading to the acid reflux which can represent itself as gastroesophageal reflux disease or the acid reflux condition.
A hiatal hernia is mostly misdiagnosed condition and people often get therapy to treat various symptoms caused by this state like heart, stomach or circulatory problems. When properly detected as a hiatal hernia, in most cases, it can be solved by stretching of the diaphragm, thus allowing the stomach structures to return to their natural place. This automatically leads to improvement of the respiratory, circulatory and the function of the digestive tract.
With every breath air travels through the nose passing the pharynx and glottis, then entering larynx, traveling through the trachea and finally reaching the lungs where on the alveolar level the exchange of gasses is happening. Movement of the air through the lungs is mainly controlled by the function of diaphragm. Every inhale is followed by the movement down while every exhale returns diaphragm up.
Two phrenic nerves are responsible for the innervation of the diaphragm. Irritation of these leads to spasm of the diaphragm. This spasm causes short, quick breaths interrupted by epiglottis closure. This closure of epiglottis produces a specific hiccup sound.
Extended stomach, caused by the ingestion of a great amount of food or even air, can lead to the irritation of above mentioned phrenic nerves. This irritation can result in hiccups. The nerves can also be irritated by hot spicy food.
Those who consume great amounts of cigarettes and alcohol regularly may develop hiccups. Stress, excitement, shock and another strong feeling can result in causing this disorder.
Wind Knocked Out
An abrupt force applied to the abdomen often leads to the irritation of the solar plexus resulting in diaphragm spasm. This is mostly experienced by boxers and other sports with forceful punches in the abdominal region. Feeling individuals experience in these moments is described as the wind knocked out.
This force may also occur after the fall on back, which can cause temporary paralysis of the diaphragm manifesting itself as a difficult breathing. The pain felt during the paralysis can remain certain time after the spasm and leads to difficulties in breathing, standing and sitting.
When experiencing symptoms of diaphragm spasm that do not subside over a period of 48 hours, it is very important to see the doctor. As already mentioned, some disorders provoked by the spasm can lead to more serious problems. On the other hand, serious problems like heart attacks, hysteria, and mental health issues may be the one to provoke a spasm of the diaphragm. Regardless of how the process evolves, all these conditions require proper diagnostic methods and treatment. When left untreated they may have serious consequences.
A hiatal hernia requires the diaphragm to be pushed physically in order for the stomach to be released back to its natural position. This procedure is the one that needs to be done by a qualified doctor.
The cause and the suitable treatment of hiccups, especially those lasting longer than 48 hours, must be determined by a qualified doctor. Conditions hiding behind hiccups can be very serious.
In the case where a spasm of the diaphragm is caused by a blow or falling on back, this feeling of spasm will most often clear out in a minute or two. The symptom that could remain is the pain this blow induces. When the blow happens, it is often residual pain that needs to be treated.
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