Association of hiatal hernia and gastroesophageal reflux: correlation between presence and size of hiatal hernia and 24-hour pH monitoring of the esophagus.

Ott, David J.; Glauser, S. J.; Ledbetter, M. Stephen; Chen, M. Y. M.; Koufman, James A.; Gelfand, David W.

doi:10.2214/ajr.165.3.7645469

Cited by 54 publications

(44 citation statements)

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“…Conversely, esophageal motility may be normal. 24-hour ambulatory pH studies are considered the most sensitive means to reveal abnormal acid reflux [7, 11]. In our index case (case 1) the total acid contact time was 5.2% (normal <5%) and there was 100% correlation between reflux episodes and the patient’s reported symptoms of heartburn and chest pain.…”

Section: Discussionmentioning

confidence: 79%

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The Corrugated Esophagus, a Sign of Severe Reflux Disease: Radiographic and Endoscopic Appearance

Low¹,

O’Connor

2001

Dig Surg

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Purpose: To present the appearance of esophageal scarring resulting in a corrugated configuration seen on barium radiographs and through the endoscope. Materials and Methods: Barium radiographs and endoscopic images obtained in 8 patients with a fixed deformity of the esophagus which resulted in a corrugated pattern were retrospectively reviewed. All patients (6 males, 2 females) presented long histories of gastroesophageal reflux disease; they were aged 29–84 (mean 46.0) years. Six patients complained of obstructive symptoms (dysphagia or recurrent food impactions). Results: All of the lesions occurred in the mid or distal esophagus, with an average length of 11.1 (range 4–22) cm, and an average diameter of 15.4 (range 9–22) mm. Additional findings included hiatal hernia (n = 6), distal esophageal scarring (n = 3), esophageal fold thickening (n = 1) and intramural pseudodiverticula (n = 1). Conclusion: The finding of a corrugated pattern of the esophagus is suggestive of chronic severe gastroesophageal reflux disease. The reduction in esophageal caliber as a consequence often leads to symptomatic dysphagia.

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Section: Discussionmentioning

confidence: 79%

“…These changes will be visible using double contrast barium esophagography in up to 90% of cases with moderate to severe reflux esophagitis [5, 6]. There is a high association with the presence of a hiatal hernia [6, 7](fig. 2).…”

Section: Discussionmentioning

confidence: 99%

The Corrugated Esophagus, a Sign of Severe Reflux Disease: Radiographic and Endoscopic Appearance

Low¹,

O’Connor

2001

Dig Surg

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“…Although, based on the DeMeester score, the positive rate of pathologic acid reflux in the EE group was higher than in the PGS group (76.2% vs 53.8%), our data show a meaningful rate of pathologic reflux in PGS patients, based also on the fact that we excluded other possible factors leading to reflux. In previous reports, hiatus hernia, which has been regarded as predictor of gastroesophageal reflux disease (GERD) [21,22] and NERD, revealed incidences of acid reflux of 26%-57% [23,24] and 40%-63% [25,26] , respectively. By comparison with these previous reports, the incidence of pathologic acid reflux in the PGS group is substantial.…”

Section: Discussionmentioning

confidence: 99%

Prolapse gastropathy syndrome may be a predictor of pathologic acid reflux

Kim¹,

Cho²,

Chae³

et al. 2008

WJG

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AIM:To assess the occurrence of gastric acid reflux into the esophagus in endoscopically confirmed prolapse gastropathy syndrome (PGS). METHODS: Using ambulatory esophageal pH measurement (BRAVO TM wireless esophageal pH monitoring system), twenty-six patients with PGS were compared with twenty-one patients with erosive esophagitis (EE) as controls. We assessed several reflux parameters, including the percentage of total time at pH < 4, and the DeMeester score. RESULTS: There were no statistical differences between the PGS group and the EE group as to mean age, sex ratio and pH recording time. The EE group showed more severe reflux than the PGS group, as evaluated in terms of the longest duration of reflux, the number of reflux episodes, the number of reflux episodes lasting > 5 min, the total time with pH < 4 during acid reflux episodes, and the DeMeester score, but none of these parameters showed statistically significant difference. Although 53.8% (14/26) of the PGS group and 76.2% (16/21) of the EE group demonstrated pathologic acid reflux (DeMeester score > 14.72), there was no statistically significant difference between the two groups in the incidence of pathologic acid reflux (P = 0.11). CONCLUSION: There was no statistically significant difference in pathologic acid reflux between the PGS and EE group. These data suggest that endoscopically diagnosed PGS might be a predictor of pathologic acid reflux.© 2008 The WJG Press. All rights reserved. K e y w o r d s : P r o l a p s e g a s t r o p a t h y s y n d r o m e ;Pathologic acid reflux; Erosive esophagitis; Ambulatory esophageal pH monitoring; Retching

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“…Proportions with abnormal acid exposure may not significantly differ between GERD patients who have a hiatal hernia and those who do not [78]. In another study of over 300 patients, most patients had normal pH monitoring parameters regardless of the presence of a hiatal hernia, but those with larger hernias were more likely to have abnormal pH-monitoring parameters [80]. The presence of a hiatal hernia does appear to decrease the likelihood of symptom response to PPI in patients with GERD [81].…”

Section: Barium Radiographymentioning

confidence: 99%