Relationship between Endoscopic Hiatus Hernia and Gastroesophageal Reflux Symptoms

Abstract

Little is known about the relationship between hiatus hernia (HH) and gastroesophageal reflux symptoms (GERS). Nine hundred and thirty patients submitted to gastroscopy because of symptoms completed a self-administered questionnaire. Fourteen per cent showed esophagitis (ES) and 17% HH. Forty-nine per cent of the patients with HH had endoscopic ES, and 60% of those with ES had HH. The severity of ES was dependent (p less than 0.05) on both the presence and the size of HH. After exclusion of patients with peptic ulcer and malignancy, patients with and without HH and ES were compared with regard to the presence of single symptoms and a weighted GERS score based on symptoms proven to be typical for ES. Only borderline differences were found between patients with ES and HH and those with ES and no HH. The former group, however, presented with significantly (p less than 0.001) more GERS than the patients with HH only. Nevertheless, the patients with HH as the only pathologic finding had significantly (p less than 0.01) more GERS than the patients with no major endoscopic abnormality. This study indicates a close association between HH and gastroesophageal reflux disease and supports the clinical significance of an endoscopically detected HH.

Impact of spinal kyphosis on gastroesophageal reflux disease symptoms in patients with osteoporosis

“…First, although the FSSG score was highly correlated with endoscopic findings for GERD [27], the questionnaire results were based on selfreported symptoms rather than objective findings and that this was a limitation of the study, and second, the sample size of this study was relatively small compared to previous epidemiologic studies for GERD [20,41,42], and generalization of our findings to other populations may be premature. However, we would like to emphasize that this is the first study to focus on the influence of thoracic and lumbar spinal kyphosis and vertebral fractures on GERD among patients with osteoporosis.…”

The long-term follow-up of patients with a congenital diaphragmatic hernia: a broad spectrum of morbidity

“…Recently the first CDH survivor with esophageal adenocarcinoma has been described, 22 years after CDH repair [101]. Vanamo et al found that hiatus hernia was present in 30 patients, although as such this is not an uncommon finding in the adult population in the western world [102]. The overall prevalence of esophagitis was 54%, which is significantly higher than the expected 2% of endoscopically assessed esophagitis in the general adult population [103,104].…”

A prospective study of the prevalence of gastroesophageal reflux disease and confounding factors

“…Makuuchi 10 reported that the complication of reflux esophagitis was recognized in 31.3% of patients suffering from hiatal hernia. Petersen et al, 11 after recognizing the presence of hiatal hernia in 60% of patients with reflux esophagitis, proposed that the two conditions are closely related. Both Patti et al 12 and Jones et al 13 stated that the severity of hiatal hernia and reductions in LES pressure constituted the most important factors when considering reflux esophagitis.…”