Abstract

POLEO, José Ramón. La hernia hiatal y su relación con el reflujo gastroesofágico. Gen [online]. 2010, vol.64, n.4, pp.306-310. ISSN 0016-3503.

Hiatus Hernia (HH) is a relatively frequent condition in adult population. Its relation with the gastro-esophageal refl ux disease (GERD) is not clear. The purpose of this study was contributing to the definition of this association. With this aim a prospective analysis was performed on 335 people (ranging and age of 15-92, average age of 50.6, 55.49% women). The study was based on reviewing the clinical records and esophagogastroduodenoscopies (EGD) for determining the presence of hiatus hernia and endoscopic manifestations of refl ux esophagitis (RE) as well in order to define if whether a relationship between HH and GERD does exist or does not. One HH was found in out of 104 cases (31.04%), 78 (75%) were evidences in patients with gastro-esophageal refl ux symptoms (GER), and 26 (25%) in GER-asymptomatic subjects (p= 0.0001). However, when assessing the HH finding in GERD-symptomatic patients - 37.50% (72/208 cases) - and in those without symptoms - 20.47% (26/127 cases) - no significant statistical difference was found - (p >0.05). 40 subjects (11.94%) out of the total amount of the analyzed subjects showed endoscopic GER disturbances - (90%). 36 out of them showed GER symptoms (90%) and 4 (10%) were asymptomatic for this condition (statistically significant difference: P< 0.0001). The association between HH and the ER endoscopic findings was evidenced in 20 out of the 40 cases (50%). From them, 19 showed GER symptoms (95%). Only 1 (5%) was GER-asymptomatic. ER’s GED findings without HH were locate in other 20 subjects, where 17 (85%) were GERD-symptomatic and 15% was asymptomatic. A statistically significant difference (P < 0-001) was found in both subgroups among patients with GER symptoms and those without symptoms, thus strengthening the relation existing among HH, the endoscopic findings, and GERD symptoms. HH without RE endoscopic findings was reported in 84 people, 60 of them with GERD symptoms (71.42%) and 24 without symptoms (28.57%) (statistically significant difference). Hence, this is another finding linking HH and GERD.

Keywords : hiatus hernia; esophagoscopy; gastro-esophageal reflux.