Hiatal hernia and GERD – What’s the connection?

The contribution of hiatal hernia to GERD has always been a controversial topic. Opinions keep shifting widely. On one end, physicians virtually equated hiatal hernia with the reflux disease.

On the other end, the causal role of hiatal hernia in GERD is completely denied. But still the data collected from various parts of the world confirm the role of hiatal hernia in the causation of GERD.

It has been found that hiatus hernia has a more important relationship in patients, who have developed complications of GERD like severe esophagitis, stricture of the esophagus and Barrett’s esophagus. It has been estimated that hiatal hernia occurs in more than 50% of the patients with esophagitis. This incidence of hiatal hernia is much more than the healthy population confirming the association of hiatal hernia with esophagitis.

There are several mechanisms that are said to be responsible for the occurrence of reflux in patients with hiatal hernia. Hiatal hernia distorts the lower esophageal sphincter. This sphincter is very important in preventing the reflux and distortion of it by the hernia affects this preventive mechanism. The reflux is worse especially in those in whom the hernia remains above the diaphragm between swallows.

Written by admin on May 24th, 2008 with comments disabled.
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