Digestive Diseases and Sciences

, Volume 24, Issue 4, pp 311–313 | Cite as

Relationship of hiatal hernia to endoscopically proved reflux esophagitis

  • Richard A. Wright
  • Alfred L. Hurwitz
Original Articles


The relationship between reflux esophagitis and hiatal hernia was studied using fiberoptic endoscopy. Of 293 patients having upper-gastrointestinal endoscopy during an 18-month period, 64 (22%) had a hiatal hernia and 38 (13%) had esophagitis. Half the patients with a hiatal hernia had esophagitis, whereas the vast majority (84%) of patients with esophagitis had a concomitant hiatal hernia. The association between esophagitis and hiatal hernia was highly significant (P<0.0001). There was no statistically significant association between the size of the hiatal hernia and the degree of esophagitis on endoscopy. A permissive role of hiatal hernia in the genesis of reflux esophagitis is suggested.


Public Health Esophagitis Hiatal Hernia Reflux Esophagitis Permissive Role 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Dodds WJ, Hogan WJ, Miller WN: Reflux esophagitis. Am J Dig Dis 21:49–67, 1976Google Scholar
  2. 2.
    Pope CE, II: Pathphysiology and diagnosis of reflux esophagitis. Gastroenterology 70:445–454, 1976Google Scholar
  3. 3.
    Palmer ED: The hiatus hernia-esophagitis-esophageal stricture complex. Am J Med 44:466–579, 1968Google Scholar
  4. 4.
    Ellis FH, Jr: Esophageal hiatal hernia. N Engl J Med 287:646–649, 1972Google Scholar
  5. 5.
    Stadelmann O, Elster K, Ottenjann R: Esophagitis. Bibl Gastroenterol 9:2–45, 1970Google Scholar
  6. 6.
    Moossa AR, Skinner DB: Gastro-oesophageal reflux and hiatal hernia. A reevaluation of current data and dogma. Ann R Coll Surg Engl 58:126–132, 1976Google Scholar
  7. 7.
    Castell DO: The lower esophageal sphincter, Physiologic and clinical aspects. Ann Intern Med 83:390–401, 1975Google Scholar
  8. 8.
    Creamer B, Harrison GK, Pierce JW: Further observations on the gastrooesophageal junction. Thorax 14:132–187, 1959Google Scholar
  9. 9.
    Dillard DH, Anderson HN: A new concept of the mechanism of sphincteric failure in sliding esophageal hiatal hernia, Surg Gynecol Obstet 122:1030–1038, 1966Google Scholar
  10. 10.
    Chrispin AR, Friedland GW, Wright DE: Some functional characteristics of the oesophageal vestibule in infants and children. Thorax 22:188–192, 1967Google Scholar
  11. 11.
    Stelzner F: Uber den Dehnverschluss der terminalen Speiseröhre und seine Störungen. Dtsch Med Wochenschr 96:1455–1460, 1971Google Scholar
  12. 12.
    Kobayashi S, Kasugai T: Endoscopic and biopsy criteria for the diagnosis of esophagitis with a fiberoptic esophagoscope. Am J Dig Dis 19:345–352, 1974Google Scholar
  13. 13.
    Hattori K, Winans CS, Archer F, et al: Endoscopic diagnosis of esophageal inflammation. Gastrointest Endosc 20:102–104, 1974Google Scholar
  14. 14.
    Johnson LF, DeMeester TR, Haggitt RC: Endoscopic signs for gastroesophageal reflux objectively evaluated. Gastrointest Endosc 22:151–155, 1976Google Scholar
  15. 15.
    Habibulla KS: The diaphragm as an anti-reflux barrier. A manometric, oesophagoscopic, and transmucosal potential study. Thorax 27:692–702, 1972Google Scholar
  16. 16.
    Johnson LF, DeMeester TR, Haggitt RC: Esophageal epithelial response to gastroesophageal reflux, a quantitative study. Am J Dig Dis 23:498–509, 1978Google Scholar

Copyright information

© Digestive Disease Systems, Inc. 1979

Authors and Affiliations

  • Richard A. Wright
    • 1
    • 2
  • Alfred L. Hurwitz
    • 1
    • 2
  1. 1.Gastroenterology SectionVeterans Administration HospitalSan Francisco
  2. 2.Department of Medicinethe University of CaliforniaSan Francisco

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