Understanding Disorders of diaphragm: Causes, Symptoms, and Management

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Disorders of diaphragm

by Alike Medical Team ∙ Updated on June 13, 2023

Additional names

This group contains additional names: - Paralysis of diaphragm - Congenital diaphragmatic hernia (CDH) - Acquired diaphragmatic hernia (ADH) - Diaphragmatic tumor

General

The diaphragm is a muscular barrier between the chest and the abdominal cavity. Disorders of the diaphragm often interfere with breathing. There are a number of disorders that can impact the diaphragm, including: * Congenital (present at birth) diaphragmatic hernia (CDH) * Acquired diaphragmatic hernia (ADH) * Hiatal hernia * Diaphragmatic tumor * Paralysis of the diaphragm

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Signs & symptoms

Symptoms of diaphragm disorders vary depending on the type of disorder, but they can range from shortness of breath to dangerously low oxygen levels. Symptoms may include: Congenital diaphragmatic hernia (CDH): * Underdeveloped lungs * Reduced number of alveoli (air sacs) required for normal breathing * Low oxygen levels * Pulmonary hypertension Acquired diaphragmatic hernia (ADH): * Difficulty breathing or rapid breathing * Cyanosis (a bluish tinge to the skin, especially around the mouth, eyes and nails) * Tachycardia (rapid heart rate) * Bowel sounds in the chest * Diminished breath sounds Hiatal hernia: * Heartburn * Chest pain * Burping * A bitter taste in the mouth * Dysphagia (trouble swallowing) * Regurgitation (the return of partially digested food from the stomach to the mouth) * Feeling nauseated * Feeling full after a small amount of food * Abdominal pain * Abdominal bleeding/blood loss * Gastric torsion (twisting of the stomach, cutting off the blood supply) Diaphragmatic tumor: * Difficulty breathing * Chest, shoulder or abdominal pain * Decreased breath sounds * Low oxygen levels * Paralysis of the diaphragm: * Shortness of breath, especially when you are: Lying down, Walking * Low oxygen levels

Diagnosis

Diagnosis of a diaphragm disorder will begin with a physical exam and discussion of your symptoms. Tests may include: * X-ray: A chest X-ray can identify the presence of blockages or fluids creating pressure. * Computed tomography (CT) scan * Magnetic resonance imaging (MRI) * Ultrasound Pulmonary function tests while upright and lying down, including: * Spirometry: This test measures the quantity and speed of air you exhale to estimate how much your bronchial tubes are inflamed and narrowed. * Peak flow meter: This device measures how hard you can exhale. Peak flow meters can be used at home to monitor your condition. * Exercise oximetry: This checks the oxygen level in your blood during moments of exertion with a sensor that’s clipped onto your finger. * Arterial blood gas: This blood test checks the amount of oxygen and carbon dioxide in your blood and measures your blood’s acidity. * Phrenic nerve stimulation test: This test uses electric or magnetic stimulation to the neck to measure the response of the phrenic nerve. * Electromyography (EMG): This test measures the electrical potential of muscle fibers stimulated by electrical impulses.

Treatment

Treatments for disorders of the diaphragm vary depending on the type of disorder, but they can include a variety of surgical options. Treatments for each type of disorder include: Congenital (present at birth) diaphragmatic hernia (CDH): * Emergency surgery to place the abdominal organs back in the abdomen and repair the diaphragm Acquired diaphragmatic hernia (ADH): * Emergency surgery to repair the diaphragm Hiatal hernia: * Lifestyle changes, including avoiding certain foods, losing weight, raising the head of the bed and avoiding tight-fitting clothes * Medications, including antacids and proton pump inhibitors * Surgery to retract the stomach and make the opening in your diaphragm smaller, reconstruct the esophageal sphincter or remove the hernia Diaphragmatic tumor: * Surgical resection (removal) * Chemotherapy or radiation therapy, if it is cancerous Paralysis of the diaphragm: * Watchful waiting, if symptoms are not severe * Supplemental oxygen * Surgically implanted diaphragmatic pacemaker * Tracheostomy and mechanical ventilator

Note

☝ We provide information on prescription and over-the-counter medicines, diagnosis, procedures and lab tests. This material is provided for educational purposes only and is not medical advice, diagnosis or treatment.

National Institutes of Health ∙ World Health Organization ∙ MedlinePluse ∙ Centers for Disease Control and Prevention

☝ All information has been reviewed by certified physicians from Alike

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