Relationship of Hiatus Hernia to Reflux Oesophagitis A Prospective Study of Coincidence, Using Endoscopy

Abstract

A prospective study of the incidence of hiatus hernia and/or reflux oesophagitis was carried out in 670 patients referred for routine upper alimentary endoscopy. Hiatus hernia was found in 16.6% and reflux oesophagitis in 15.1% of the patients. Forty-two per cent of the patients with hernia did not have oesophagitis. whereas 63% of the patients with reflux oesophagitis had hernia. In patients without reflux oesophagitis the incidence of hiatus hernia was 8%. Reflux oesophagitis was significantly (p < 0.001) related to hiatus hernia. The severity of the oesophagitis was significantly (p < 0.05) related to the presence and the size of hernia, and severe oesophagitis without hernia was significantly (p < 0.01) related to chronic alcoholism. The results suggest that a sliding hiatus hernia may play a role in the development of reflux oesophagitis.