Materiały źródłowe

• #1 Hiatal hernia – epidemiology, pathogenesis, diagnostic • Postępy Nauk Medycznych 5/2018 • Czytelnia Medyczna BORGIS

  https://www.czytelniamedyczna.pl/6473,hiatal-hernia-epidemiology-pathogenesis-diagnostic.html

  Hiatal hernia epidemiology, pathogenesis, diagnostic Przepukliny przeponowe epidemiologia, patogeneza, diagnostyka Przeanalizowano epidemiologi wystpowania przepuklin rozworu przeykowego, ich patogenez, symptomatologi, najczciej stosowane metody diagnostyczne oraz moliwoci terapeutyczne. Epidemiology The frequency of occurrence of hiatal hernia increases along with age. Actual frequency of occurrence of hiatal hernia may only be estimated due to the fact that it brings only mild or no symptoms, and diagnostic criteria may differ. Clinical estimations report that approximately 50-60% of patients over 50 years old suffer from hiatal hernia. The frequency of occurrence of symptomatic cases of hiatal hernia is strictly connected with the recognition of gastroesophageal reflux disease (GERD) due to the fact that both those conditions are strongly correlated. Approximately 9% of hiatal hernias are symptomatic. Sliding hiatal hernia (type I) are significantly more frequent and consist of 90-95% of cases, esophageal type (type II) consists of only 5% where LES remains below the diaphragm and the stomach is relocated to the thorax. Hiatal hernias occur the most frequently in highly developed countries of Northern America and Western Europe, and the most rarely in African and Eastern populations.

• #2 Pulsenotes | Hiatus hernia

  https://app.pulsenotes.com/medicine/gastroenterology/notes/hiatus-hernia

  Hiatus hernia is an extremely common anatomical abnormality. […] There is a huge variation in the prevalence of hiatus hernia. […] Traditional risk factors for hiatus hernia include older age, male sex, and obesity. […] In one study, the prevalence of hiatus hernia was 9.9% among 3200 patients undergoing CT imaging. This number varies greatly depending on the study.

• #3 Hiatal Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562200/

  The incidence of hiatal hernias increases with age. Approximately 55% to 60% of individuals older than 50 have a hiatal hernia. However, only about 9% have symptoms, with the manifestations depending on the type and competence of the LES. The vast majority of these hernias are type I sliding hiatal hernias. Type II paraesophageal hernias only comprise about 5% of hiatal hernias where the LES remains stationary, but the stomach protrudes above the diaphragm. The condition’s prevalence is also increased in women, which may be attributed to elevated intraabdominal pressure during pregnancy. Hiatal hernias are most common in Western Europe and North America and are rare in rural Africa. […] Managing hiatal hernias and reflux requires an interprofessional team approach. The team should include primary care clinicians, radiologists, gastroenterologists, and surgeons. Diagnostic studies are required for both diagnosis and operative planning. The workup typically includes endoscopy, pH monitoring, esophagography, and coordinated efforts between multiple teams. The interprofessional approach ultimately results in more accurate diagnoses, better surgical outcomes, and more patient satisfaction.

• #4 Hiatal hernia – Wikipedia

  https://en.wikipedia.org/wiki/Hiatal_hernia

  Incidence of hiatal hernias increases with age; approximately 60% of individuals aged 50 or older have a hiatal hernia. Of these, 9% are symptomatic, depending on the competence of the lower esophageal sphincter (LES). 95% of these are „sliding” hiatal hernias, in which the LES protrudes above the diaphragm along with the stomach, and only 5% are the „rolling” type (paraesophageal), in which the LES remains stationary, but the stomach protrudes above the diaphragm. […] Hiatal hernias are most common in North America and Western Europe and rare in rural African communities. Some have proposed that insufficient dietary fiber and the use of a high sitting position for defecation may increase the risk.

• #5 Hiatus Hernia: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/hiatus-hernia-pro

  How common is hiatus hernia? (Epidemiology) The precise incidence of hiatus hernia is not known, as most studies have looked only at individuals who presented with symptoms of dyspepsia. However, it is estimated that 55-60% of over 50s have a hiatus hernia but that only 9% are symptomatic. Over half of people with reflux oesophagitis diagnosed either endoscopically or radiologically are found to have a hiatus hernia. Estimates for the general population vary enormously – from 10-80% of the adult population in North America, for example. It is more common amongst men. The incidence increases with age and with obesity. […] Hiatus hernias are often intermittent, so investigation may be unreliable. Investigation is needed to rule out sinister causes of symptoms and to exclude complications.

• #6 Epidemiology – GPnotebook

  https://gpnotebook.com/pages/gastroenterology/sliding-hiatus-hernia/epidemiology

  The exact prevalence of hiatus hernia is unclear due to the differences in diagnostic criteria (1). […] in the adult population in North America, the prevalence rate varies between 10% to 80% […] prevalence is also thought to be increasing with age […] 30% of the population over 50 yrs are thought to have a hiatus hernia. (1,2,3) […] Frequency of hiatus hernia is reported to be higher in Western population e.g. in Norway 16.6% of 670 subjects, in USA 22% of 293 subjects, and in Sweden 14.5% of 1000 subjects who underwent upper gastro intestinal endoscopy were found to have hiatus hernia (3) […] 90% of patients with marked oesophagitis have a hiatus hernia.

• #7 Hiatal hernia prevalence and natural history on non-contrast CT in the Multi-Ethnic Study of Atherosclerosis (MESA) | BMJ Open Gastroenterology

  https://bmjopengastro.bmj.com/content/8/1/e000565

  Non-contrast CT on 3200 Multi-Ethnic Study of Atherosclerosis subjects followed up over 10 years shows HH prevalence in the general population (aged 5394 years) increases with ageing from 2.4% in the sixth decade of life to 7.0%, 14.0% and 16.6% in seventh, eighth and ninth decades, respectively and is more common in women (PR=1.8) and in those with obesity (PR=1.1). […] Finding HH on chest CT raises the likelihood of gastro-oesophageal reflux disease and patients with high BMI have an association with HH progression. […] This MESA study involving 3179 subjects free of cardiovascular disease shows non-contrast chest CT is highly reproducible for detecting and typing HH and confirms that HH on CT is common in the general population increasing in prevalence with age, female gender and BMI. High BMI is further associated with increasing HH size over a 10-year follow-up.

• #8 The prevalence and risk factors for hiatal hernia among patients undergoing endoscopy | Saudi Medical Journal

  https://smj.org.sa/content/44/5/509

  Objectives: To determine the prevalence of hiatal hernia (HH) and its association with age, gender, and body mass index (BMI). […] The prevalence of HH was 29.8% among all patients and 48.6% among those who underwent EGD for gastroesophageal reflux disease-related indications. […] The prevalence of HH was 28.9% based on this large endoscopy-based population. […] Although several factors are associated with the risk of developing HH, we could not establish a relationship between HH and gender, age, or BMI. […] In conclusion, the prevalence of HH in the Saudi population was 28.9% in this large endoscopy-based population. We found no association between HH and gender, age, or BMI.

• #9 The prevalence and risk factors for hiatal hernia among patients undergoing endoscopy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10187740/

  The prevalence of HH was 29.8% among all patients and 48.6% among those who underwent EGD for gastroesophageal reflux disease-related indications. […] The prevalence of HH was 28.9% based on this large endoscopy-based population. We found no association between HH and gender, age, or BMI. […] The prevalence of HH was 29.8% among patients who underwent EGD for any indication and 48.7% among those who underwent EGD for GERD-related indications. […] Although several factors are associated with the risk of developing HH, we could not establish a relationship between HH and gender, age, or BMI. […] In our study, the prevalence of HH was similar in men (28.6%) and women (30.5%). […] In the present study, no association was observed between obesity, as defined by BMI, and HH, which resembles what has been reported in other studies. […] In conclusion, the prevalence of HH in the Saudi population was 28.9% in this large endoscopy-based population. We found no association between HH and gender, age, or BMI.

• #10 Hiatal hernia – epidemiology, pathogenesis, diagnostic • Postępy Nauk Medycznych 5/2018 • Czytelnia Medyczna BORGIS

  https://www.czytelniamedyczna.pl/6473,hiatal-hernia-epidemiology-pathogenesis-diagnostic.html

  Hiatal hernia epidemiology, pathogenesis, diagnostic Przepukliny przeponowe epidemiologia, patogeneza, diagnostyka Przeanalizowano epidemiologi wystpowania przepuklin rozworu przeykowego, ich patogenez, symptomatologi, najczciej stosowane metody diagnostyczne oraz moliwoci terapeutyczne. Epidemiology The frequency of occurrence of hiatal hernia increases along with age. Actual frequency of occurrence of hiatal hernia may only be estimated due to the fact that it brings only mild or no symptoms, and diagnostic criteria may differ. Clinical estimations report that approximately 50-60% of patients over 50 years old suffer from hiatal hernia. The frequency of occurrence of symptomatic cases of hiatal hernia is strictly connected with the recognition of gastroesophageal reflux disease (GERD) due to the fact that both those conditions are strongly correlated. Approximately 9% of hiatal hernias are symptomatic. Sliding hiatal hernia (type I) are significantly more frequent and consist of 90-95% of cases, esophageal type (type II) consists of only 5% where LES remains below the diaphragm and the stomach is relocated to the thorax. Hiatal hernias occur the most frequently in highly developed countries of Northern America and Western Europe, and the most rarely in African and Eastern populations.

• #11 Hiatal Hernia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/178393-overview

  Hiatal hernias are more common in Western countries. The frequency of hiatus hernia increases with age, from 10% in patients younger than 40 years to 70% in patients older than 70 years. […] Burkitt et al suggest that the Western, fiber-depleted diet leads to a state of chronic constipation and straining during bowel movement, which could explain the higher incidence of this condition in Western countries. […] Hiatal hernias are more common in women than in men. This might relate to the intra-abdominal forces exerted in pregnancy. […] Muscle weakening and loss of elasticity as people age is thought to predispose to hiatus hernia, based on the increasing prevalence in older people. With decreasing tissue elasticity, the gastric cardia may not return to its normal position below the diaphragmatic hiatus following a normal swallow. Loss of muscle tone around the diaphragmatic opening also may make it more patulous.

• #12 Hiatal Hernia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/178393-overview

  Hiatal hernias are more common in Western countries. The frequency of hiatus hernia increases with age, from 10% in patients younger than 40 years to 70% in patients older than 70 years. […] Burkitt et al suggest that the Western, fiber-depleted diet leads to a state of chronic constipation and straining during bowel movement, which could explain the higher incidence of this condition in Western countries. […] Hiatal hernias are more common in women than in men. This might relate to the intra-abdominal forces exerted in pregnancy. […] Muscle weakening and loss of elasticity as people age is thought to predispose to hiatus hernia, based on the increasing prevalence in older people. With decreasing tissue elasticity, the gastric cardia may not return to its normal position below the diaphragmatic hiatus following a normal swallow. Loss of muscle tone around the diaphragmatic opening also may make it more patulous.

• #13 Epidemiology – GPnotebook

  https://gpnotebook.com/pages/gastroenterology/sliding-hiatus-hernia/epidemiology

  The exact prevalence of hiatus hernia is unclear due to the differences in diagnostic criteria (1). […] in the adult population in North America, the prevalence rate varies between 10% to 80% […] prevalence is also thought to be increasing with age […] 30% of the population over 50 yrs are thought to have a hiatus hernia. (1,2,3) […] Frequency of hiatus hernia is reported to be higher in Western population e.g. in Norway 16.6% of 670 subjects, in USA 22% of 293 subjects, and in Sweden 14.5% of 1000 subjects who underwent upper gastro intestinal endoscopy were found to have hiatus hernia (3) […] 90% of patients with marked oesophagitis have a hiatus hernia.

• #14 Hiatus hernia – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/735

  Hiatus hernia may be asymptomatic or may present with heartburn, dysphagia, odynophagia, hoarseness, asthma, shortness of breath, chest pain, anaemia or haematemesis, or a combination of these. […] Common risk factors are obesity and increased age. Other known risk factors include intra-abdominal pressure from various conditions, and a previous hiatus operation. […] The necessity for, and type of treatment, depends on the patient’s symptoms and the anatomical configuration of the hernia. […] Uncomplicated sliding hiatus hernias are treated symptomatically with medical therapy, although some patients may select surgical therapy. Complicated hiatus hernias (those with bleeding, volvulus, or obstruction) have a stronger indication for surgical repair. […] Risk factors include obesity, increased age, previous gastro-oesophageal procedure, elevated intra-abdominal pressure, male sex, and incisional, umbilical, or inguinal hernia.

• #15 Hiatal hernia

  https://www.epocrates.com/online/diseases/73523/Hiatal-hernia/Epidemiology

  Hiatal hernia may be asymptomatic or may present with heartburn, dysphagia, odynophagia, hoarseness, asthma, shortness of breath, chest pain, anemia or hematemesis, or a combination of these. […] Common risk factors are obesity and increased age. Other known risk factors include intra-abdominal pressure from various conditions, and a previous hiatal operation. […] An upper gastrointestinal fluoroscopy with oral contrast is the key investigation technique and aids the surgeon in characterizing any anatomic variation necessary for preoperative evaluation. […] The necessity for, and type of treatment, depends on the patient’s symptoms and the anatomic configuration of the hernia. […] Uncomplicated sliding hiatal hernias are treated symptomatically with medical therapy, although some patients may select surgical therapy. Complicated hiatal hernias (those with bleeding, volvulus, or obstruction) have a stronger indication for surgical repair.

• #16 Hiatal Hernia | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/22859

  Hiatal hernias may be congenital or acquired. The condition’s prevalence is increased among older people. Muscle weakness due to age-related loss of flexibility and elasticity is believed to be a predisposing factor to the development of a hiatal hernia. The incidence of hiatal hernias increases with age. Approximately 55% to 60% of individuals older than 50 have a hiatal hernia. However, only about 9% have symptoms, with the manifestations depending on the type and competence of the LES. The vast majority of these hernias are type I sliding hiatal hernias. Type II paraesophageal hernias only comprise about 5% of hiatal hernias where the LES remains stationary, but the stomach protrudes above the diaphragm. The condition’s prevalence is also increased in women, which may be attributed to elevated intraabdominal pressure during pregnancy. Hiatal hernias are most common in Western Europe and North America and are rare in rural Africa.

• #17 Hiatal Hernia: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/178393-overview

  Hiatal hernias are more common in Western countries. The frequency of hiatus hernia increases with age, from 10% in patients younger than 40 years to 70% in patients older than 70 years. […] Burkitt et al suggest that the Western, fiber-depleted diet leads to a state of chronic constipation and straining during bowel movement, which could explain the higher incidence of this condition in Western countries. […] Hiatal hernias are more common in women than in men. This might relate to the intra-abdominal forces exerted in pregnancy. […] Muscle weakening and loss of elasticity as people age is thought to predispose to hiatus hernia, based on the increasing prevalence in older people. With decreasing tissue elasticity, the gastric cardia may not return to its normal position below the diaphragmatic hiatus following a normal swallow. Loss of muscle tone around the diaphragmatic opening also may make it more patulous.

• #18 Hiatus hernia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Hiatus_hernia_epidemiology_and_demographics

  Hiatus hernias affect around 1 to 20% of the population. Out of this 9 % are symptomatic, depending on the ability of the lower esophageal sphincter (LES). Approximately 95% of these categorize under „sliding” hiatus hernias, in which the lower esophageal sphincter protrudes above the diaphragm along with the stomach, and only 5% is the „rolling” type (paraesophageal), in which the lower esophageal sphincter (LES) remains stationary but the stomach protrudes above the diaphragm. A hiatus hernia is more common in older people. […] It is estimated that greater than 95 percent of hiatus hernias are type I (sliding) hiatus hernia. […] Approximately 5 percent of the hiatus hernias are with type II, III, and IV (paraesophageal) hernias. […] Hiatus hernias commonly affects individuals older than 50 years of age. […] There is no racial predilection to hiatus hernia. […] Women are more commonly affected by Hiatus hernias than men.

• #19

  https://step2.medbullets.com/gastrointestinal/120143/hiatal-hernia

  Epidemiology […] Incidence […] under detected due to asymptomatic hernias […] […] […] Demographics […] majority are 50 years of age […] […] […] Risk factors […] obesity […] […] […] older age […] […] […] trauma […] […] […] valsalva

• #20 Hiatal Hernia Clinical Presentation: History and Physical Examination

  https://emedicine.medscape.com/article/178393-clinical

  Hiatal hernias are relatively common and, in themselves, do not cause symptoms. For this reason, most people with hiatal hernias are asymptomatic. […] The prevalence of large hiatal hernias in patients with iron deficiency anemia is 6%-7%. […] Certain conditions predispose to the development of hiatus hernia. These include obesity, pregnancy, and ascites.

• #21 Hiatus hernia – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/735

  Hiatus hernia may be asymptomatic or may present with heartburn, dysphagia, odynophagia, hoarseness, asthma, shortness of breath, chest pain, anaemia or haematemesis, or a combination of these. […] Common risk factors are obesity and increased age. Other known risk factors include intra-abdominal pressure from various conditions, and a previous hiatus operation. […] The necessity for, and type of treatment, depends on the patient’s symptoms and the anatomical configuration of the hernia. […] Uncomplicated sliding hiatus hernias are treated symptomatically with medical therapy, although some patients may select surgical therapy. Complicated hiatus hernias (those with bleeding, volvulus, or obstruction) have a stronger indication for surgical repair. […] Risk factors include obesity, increased age, previous gastro-oesophageal procedure, elevated intra-abdominal pressure, male sex, and incisional, umbilical, or inguinal hernia.

• #22 Surgical management of paraesophageal hernia – UpToDate

  https://www.uptodate.com/contents/surgical-management-of-paraesophageal-hernia

  Paraesophageal hernias (PEH) are most common in older adults, particularly females, although they are increasingly seen in younger people and males. Consequently, PEHs are becoming increasingly common as the population ages. Kyphosis is a major risk factor, and these hernias are also more common in people with a history of other abdominal hernias such as inguinal, umbilical, or ventral hernias. […] Unlike sliding hiatal hernias, there is no medical management for PEH. Surgical treatment of PEH will be reviewed here. […] The four types of hiatal hernias can be distinguished by the hernia contents and the position of the gastroesophageal junction (GEJ). Sliding hernias are associated with gastroesophageal reflux disease (GERD), but only a PEH has the potential to develop acute hernia-related complications such as obstruction, ischemia, or perforation. When more than 50 percent of the stomach has herniated into the chest, a PEH is often referred to as a „giant” PEH.

• #23 Surgical management of paraesophageal hernia – UpToDate

  https://www.uptodate.com/contents/surgical-management-of-paraesophageal-hernia

  Paraesophageal hernias (PEH) are most common in older adults, particularly females, although they are increasingly seen in younger people and males. Consequently, PEHs are becoming increasingly common as the population ages. Kyphosis is a major risk factor, and these hernias are also more common in people with a history of other abdominal hernias such as inguinal, umbilical, or ventral hernias. […] Unlike sliding hiatal hernias, there is no medical management for PEH. Surgical treatment of PEH will be reviewed here. […] The four types of hiatal hernias can be distinguished by the hernia contents and the position of the gastroesophageal junction (GEJ). Sliding hernias are associated with gastroesophageal reflux disease (GERD), but only a PEH has the potential to develop acute hernia-related complications such as obstruction, ischemia, or perforation. When more than 50 percent of the stomach has herniated into the chest, a PEH is often referred to as a „giant” PEH.

• #24 The prevalence and risk factors for hiatal hernia among patients undergoing endoscopy

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10187740/

  The prevalence of HH was 29.8% among all patients and 48.6% among those who underwent EGD for gastroesophageal reflux disease-related indications. […] The prevalence of HH was 28.9% based on this large endoscopy-based population. We found no association between HH and gender, age, or BMI. […] The prevalence of HH was 29.8% among patients who underwent EGD for any indication and 48.7% among those who underwent EGD for GERD-related indications. […] Although several factors are associated with the risk of developing HH, we could not establish a relationship between HH and gender, age, or BMI. […] In our study, the prevalence of HH was similar in men (28.6%) and women (30.5%). […] In the present study, no association was observed between obesity, as defined by BMI, and HH, which resembles what has been reported in other studies. […] In conclusion, the prevalence of HH in the Saudi population was 28.9% in this large endoscopy-based population. We found no association between HH and gender, age, or BMI.

• #25 The prevalence and risk factors for hiatal hernia among patients undergoing endoscopy | Saudi Medical Journal

  https://smj.org.sa/content/44/5/509

  Objectives: To determine the prevalence of hiatal hernia (HH) and its association with age, gender, and body mass index (BMI). […] The prevalence of HH was 29.8% among all patients and 48.6% among those who underwent EGD for gastroesophageal reflux disease-related indications. […] The prevalence of HH was 28.9% based on this large endoscopy-based population. […] Although several factors are associated with the risk of developing HH, we could not establish a relationship between HH and gender, age, or BMI. […] In conclusion, the prevalence of HH in the Saudi population was 28.9% in this large endoscopy-based population. We found no association between HH and gender, age, or BMI.

• #26 Hiatal hernia – epidemiology, pathogenesis, diagnostic • Postępy Nauk Medycznych 5/2018 • Czytelnia Medyczna BORGIS

  https://www.czytelniamedyczna.pl/6473,hiatal-hernia-epidemiology-pathogenesis-diagnostic.html

  Hiatal hernia epidemiology, pathogenesis, diagnostic Przepukliny przeponowe epidemiologia, patogeneza, diagnostyka Przeanalizowano epidemiologi wystpowania przepuklin rozworu przeykowego, ich patogenez, symptomatologi, najczciej stosowane metody diagnostyczne oraz moliwoci terapeutyczne. Epidemiology The frequency of occurrence of hiatal hernia increases along with age. Actual frequency of occurrence of hiatal hernia may only be estimated due to the fact that it brings only mild or no symptoms, and diagnostic criteria may differ. Clinical estimations report that approximately 50-60% of patients over 50 years old suffer from hiatal hernia. The frequency of occurrence of symptomatic cases of hiatal hernia is strictly connected with the recognition of gastroesophageal reflux disease (GERD) due to the fact that both those conditions are strongly correlated. Approximately 9% of hiatal hernias are symptomatic. Sliding hiatal hernia (type I) are significantly more frequent and consist of 90-95% of cases, esophageal type (type II) consists of only 5% where LES remains below the diaphragm and the stomach is relocated to the thorax. Hiatal hernias occur the most frequently in highly developed countries of Northern America and Western Europe, and the most rarely in African and Eastern populations.

• #27 Hiatus hernia epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Hiatus_hernia_epidemiology_and_demographics

  Hiatus hernias affect around 1 to 20% of the population. Out of this 9 % are symptomatic, depending on the ability of the lower esophageal sphincter (LES). Approximately 95% of these categorize under „sliding” hiatus hernias, in which the lower esophageal sphincter protrudes above the diaphragm along with the stomach, and only 5% is the „rolling” type (paraesophageal), in which the lower esophageal sphincter (LES) remains stationary but the stomach protrudes above the diaphragm. A hiatus hernia is more common in older people. […] It is estimated that greater than 95 percent of hiatus hernias are type I (sliding) hiatus hernia. […] Approximately 5 percent of the hiatus hernias are with type II, III, and IV (paraesophageal) hernias. […] Hiatus hernias commonly affects individuals older than 50 years of age. […] There is no racial predilection to hiatus hernia. […] Women are more commonly affected by Hiatus hernias than men.

• #28 Hiatal Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562200/

  The incidence of hiatal hernias increases with age. Approximately 55% to 60% of individuals older than 50 have a hiatal hernia. However, only about 9% have symptoms, with the manifestations depending on the type and competence of the LES. The vast majority of these hernias are type I sliding hiatal hernias. Type II paraesophageal hernias only comprise about 5% of hiatal hernias where the LES remains stationary, but the stomach protrudes above the diaphragm. The condition’s prevalence is also increased in women, which may be attributed to elevated intraabdominal pressure during pregnancy. Hiatal hernias are most common in Western Europe and North America and are rare in rural Africa. […] Managing hiatal hernias and reflux requires an interprofessional team approach. The team should include primary care clinicians, radiologists, gastroenterologists, and surgeons. Diagnostic studies are required for both diagnosis and operative planning. The workup typically includes endoscopy, pH monitoring, esophagography, and coordinated efforts between multiple teams. The interprofessional approach ultimately results in more accurate diagnoses, better surgical outcomes, and more patient satisfaction.

• #29 Hiatal hernia – Wikipedia

  https://en.wikipedia.org/wiki/Hiatal_hernia

  Incidence of hiatal hernias increases with age; approximately 60% of individuals aged 50 or older have a hiatal hernia. Of these, 9% are symptomatic, depending on the competence of the lower esophageal sphincter (LES). 95% of these are „sliding” hiatal hernias, in which the LES protrudes above the diaphragm along with the stomach, and only 5% are the „rolling” type (paraesophageal), in which the LES remains stationary, but the stomach protrudes above the diaphragm. […] Hiatal hernias are most common in North America and Western Europe and rare in rural African communities. Some have proposed that insufficient dietary fiber and the use of a high sitting position for defecation may increase the risk.

• #30 Literature Review: A Surgeon’s View of Recurrent Hiatal Hernia

  http://www.scielo.org.co/scielo.php?pid=S0120-99572015000400008&script=sci_arttext&tlng=en

  Recurrent hiatal hernias are a common pathology that generate a diagnostic and therapeutic challenge for surgeons and gastroenterologists. […] More than 95% of primary hiatal hernias are Type I sliding hernias. Types II, III and IV are grouped as para-esophageal hernias. Of these, over 90% are type III. Type II is the least common. […] The incidence of recurrence of hiatal hernia after repair of a primary sliding hiatal hernia in patients with gastroesophageal reflux is difficult to determine since not all patients who have undergone anti-reflux surgery have had esophagograms prior to the procedure, and since sometimes patients develop sliding hiatal hernias as the result of the release of attachments during surgery. […] Rates from 2% to 42% have been reported for recurrence of para-esophageal hiatal hernias, but the types of procedures performed and the follow-up times vary widely. […] These studies suggest a high rate of relapse with a direct relationship to the length of time after the original procedure, but also suggest that very few patients require a new procedure.

• #31 Hiatal hernia prevalence and natural history on non-contrast CT in the Multi-Ethnic Study of Atherosclerosis (MESA) | BMJ Open Gastroenterology

  https://bmjopengastro.bmj.com/content/8/1/e000565

  Hiatal hernia (HH) prevalence and natural history on non-contrast CT in the Multi-Ethnic Study of Atherosclerosis (MESA) […] To determine the prevalence, risk factors and natural history of hiatal hernia (HH) on CT in the general population. […] Among 316 HH identified (prevalence=9.9%), 223 (71%) were type I and 93 (29%) were type III. HH prevalence increased with age, from 2.4% in 6th decade to 16.6% in 9th decade (unadjusted prevalence ratio (PR)=1.1 (95% CI 1.04 to 1.1)). HH prevalence was greater in women (12.7%) than men (7.0%) (unadjusted PR=1.8 (95% CI 1.5 to 2.3)) and associated with proton pump inhibitor use (p0.001). […] HH on non-contrast CT is prevalent in the general population, increasing with age, female gender and BMI. Its association with proton pump inhibitor use confirms a role in gastro-oesophageal reflux disease and HH progression is associated with increased BMI.

• #32 Giant Hiatus Hernia and Association with Gastro-Oesophageal Reflux: A Review

  https://clinmedjournals.org/articles/jcgt/journal-of-clinical-gastroenterology-and-treatment-jcgt-3-045.php?jid=jcgt

  Gastro-oesophageal reflux is a common problem worldwide with an estimated prevalence of 10-20% in the Western world. […] The precise incidence of GORD in patients with HH of any size is difficult to know and has been variably reported to be between 8-80%. The incidence of GORD in patients with GHH is similarly divergent being reported between 43% and 87%. […] Overall GHH are reported to represent 0.3-15% of all HH and are either Type III or IV, with Type III being the most common.

• #33 Surgical management of paraesophageal hernia – UpToDate

  https://www.uptodate.com/contents/surgical-management-of-paraesophageal-hernia

  Paraesophageal hernias (PEH) are most common in older adults, particularly females, although they are increasingly seen in younger people and males. Consequently, PEHs are becoming increasingly common as the population ages. Kyphosis is a major risk factor, and these hernias are also more common in people with a history of other abdominal hernias such as inguinal, umbilical, or ventral hernias. […] Unlike sliding hiatal hernias, there is no medical management for PEH. Surgical treatment of PEH will be reviewed here. […] The four types of hiatal hernias can be distinguished by the hernia contents and the position of the gastroesophageal junction (GEJ). Sliding hernias are associated with gastroesophageal reflux disease (GERD), but only a PEH has the potential to develop acute hernia-related complications such as obstruction, ischemia, or perforation. When more than 50 percent of the stomach has herniated into the chest, a PEH is often referred to as a „giant” PEH.

• #34 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?volume=5&number=3&spage=267

  The relationship between hiatal hernias and gastroesophageal reflux disease (GERD) has been greatly debated over the past decades, with the importance of hiatal hernias first being overemphasized and then later being nearly neglected. […] It is now understood that both the anatomical (hiatal hernia) and the physiological (lower esophageal sphincter) features of the gastroesophageal junction play important, but independent, roles in the pathogenesis of GERD, constituting the widely accepted „two-sphincter hypothesis.” […] The gastroesophageal junction becomes incompetent and esophageal acid clearance is compromised in patients with hiatal hernia, which facilitates the development of GERD. […] Of the different types of hiatal hernias (types I, II, III, and IV), type I (sliding) hiatal hernias are closely associated with GERD.

• #35 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?volume=5&number=3&spage=267

  The relationship between hiatal hernias and gastroesophageal reflux disease (GERD) has been greatly debated over the past decades, with the importance of hiatal hernias first being overemphasized and then later being nearly neglected. […] It is now understood that both the anatomical (hiatal hernia) and the physiological (lower esophageal sphincter) features of the gastroesophageal junction play important, but independent, roles in the pathogenesis of GERD, constituting the widely accepted „two-sphincter hypothesis.” […] The gastroesophageal junction becomes incompetent and esophageal acid clearance is compromised in patients with hiatal hernia, which facilitates the development of GERD. […] Of the different types of hiatal hernias (types I, II, III, and IV), type I (sliding) hiatal hernias are closely associated with GERD.

• #36 Atypical and typical manifestations of the hiatal hernia – Goodwin – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/6254/html

  Hiatal hernias may present in variety of ways, both typical and atypical. Manifestations are dependent on the type and size of the hernia. Gastrointestinal manifestations are the most common, predominately with GERD and associated syndromes. The true incidence and prevalence of hiatal hernia is difficult to quantify, as many patients remain asymptomatic and undiagnosed from the hernia. The presence of a hiatal hernia is closely related to reflux symptoms and associated complications. Patients with a hiatal hernia are significantly more likely to present with GERD symptoms compared to those without a hiatal hernia. GERD remains the most common presentation of a hiatal hernia. The prevalence of GERD in the United States (US) ranges from 18.1-27.8% with a slightly lower 10-20% prevalence in Western Europe. GERD symptoms are more common in Type 1 hiatal hernias, and the size of the hernia can impact symptom severity. The strong association between hiatal hernia and GERD syndromes implies that many of the atypical presentations of GERD may manifest in a hiatal hernia. Hiatal hernias can present with non-gastrointestinal symptoms, obscuring the diagnosis in such patients on initial presentation. Typical pulmonary symptoms with hiatal hernia include dyspnea and atelectasis as a result of pulmonary compression. In a large population-based study, hiatal hernias were associated with an increased prevalence of atrial fibrillation.

• #37 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?volume=5&number=3&spage=267

  Hiatal hernias can be diagnosed radiographically, endoscopically or manometrically, with each modality having its own limitations, especially in the diagnosis of hiatal hernias less than 2 cm in length. […] In the future, high resolution manometry should be a promising method for accurately assessing the association between hiatal hernias and GERD. […] The treatment of a hiatal hernia is similar to the management of GERD and should be reserved for those with symptoms attributable to this condition. […] Many studies have demonstrated that hiatal hernia is closely related to reflux symptoms, reflux esophagitis, Barrett’s esophagus and esophageal adenocarcinoma. […] Patients with hiatal hernia are significantly more likely to present with GERD symptoms than those without hiatal hernia, and symptomatic GERD patients are more likely to have hiatal hernias compared to those without symptoms.

• #38 Epidemiology – GPnotebook

  https://gpnotebook.com/pages/gastroenterology/sliding-hiatus-hernia/epidemiology

  The exact prevalence of hiatus hernia is unclear due to the differences in diagnostic criteria (1). […] in the adult population in North America, the prevalence rate varies between 10% to 80% […] prevalence is also thought to be increasing with age […] 30% of the population over 50 yrs are thought to have a hiatus hernia. (1,2,3) […] Frequency of hiatus hernia is reported to be higher in Western population e.g. in Norway 16.6% of 670 subjects, in USA 22% of 293 subjects, and in Sweden 14.5% of 1000 subjects who underwent upper gastro intestinal endoscopy were found to have hiatus hernia (3) […] 90% of patients with marked oesophagitis have a hiatus hernia.

• #39 Hiatus Hernia: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/hiatus-hernia-pro

  How common is hiatus hernia? (Epidemiology) The precise incidence of hiatus hernia is not known, as most studies have looked only at individuals who presented with symptoms of dyspepsia. However, it is estimated that 55-60% of over 50s have a hiatus hernia but that only 9% are symptomatic. Over half of people with reflux oesophagitis diagnosed either endoscopically or radiologically are found to have a hiatus hernia. Estimates for the general population vary enormously – from 10-80% of the adult population in North America, for example. It is more common amongst men. The incidence increases with age and with obesity. […] Hiatus hernias are often intermittent, so investigation may be unreliable. Investigation is needed to rule out sinister causes of symptoms and to exclude complications.

• #40 Atypical and typical manifestations of the hiatal hernia – Goodwin – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/6254/html

  Hiatal hernias may present in variety of ways, both typical and atypical. Manifestations are dependent on the type and size of the hernia. Gastrointestinal manifestations are the most common, predominately with GERD and associated syndromes. The true incidence and prevalence of hiatal hernia is difficult to quantify, as many patients remain asymptomatic and undiagnosed from the hernia. The presence of a hiatal hernia is closely related to reflux symptoms and associated complications. Patients with a hiatal hernia are significantly more likely to present with GERD symptoms compared to those without a hiatal hernia. GERD remains the most common presentation of a hiatal hernia. The prevalence of GERD in the United States (US) ranges from 18.1-27.8% with a slightly lower 10-20% prevalence in Western Europe. GERD symptoms are more common in Type 1 hiatal hernias, and the size of the hernia can impact symptom severity. The strong association between hiatal hernia and GERD syndromes implies that many of the atypical presentations of GERD may manifest in a hiatal hernia. Hiatal hernias can present with non-gastrointestinal symptoms, obscuring the diagnosis in such patients on initial presentation. Typical pulmonary symptoms with hiatal hernia include dyspnea and atelectasis as a result of pulmonary compression. In a large population-based study, hiatal hernias were associated with an increased prevalence of atrial fibrillation.

• #41 Giant Hiatus Hernia and Association with Gastro-Oesophageal Reflux: A Review

  https://clinmedjournals.org/articles/jcgt/journal-of-clinical-gastroenterology-and-treatment-jcgt-3-045.php?jid=jcgt

  Gastro-oesophageal reflux is a common problem worldwide with an estimated prevalence of 10-20% in the Western world. […] The precise incidence of GORD in patients with HH of any size is difficult to know and has been variably reported to be between 8-80%. The incidence of GORD in patients with GHH is similarly divergent being reported between 43% and 87%. […] Overall GHH are reported to represent 0.3-15% of all HH and are either Type III or IV, with Type III being the most common.

• #42 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?volume=5&number=3&spage=267

  The prevalence of hiatal hernia also increased with the length of Barrett’s esophagus and the size of hiatal hernia was larger in those with Barrett’s esophagus compared to those without. […] Moreover, it was shown that development and progression to Barrett’s esophagus with high-grade dysplasia or adenocarcinoma was significantly and independently related to the size of hiatal hernia. […] The presence of hiatal hernia more than doubled the risk of developing adenocarcinoma of the esophagus and gastric cardia. […] The presence of hiatal hernia per se is not an indication for treatment, and therapy should be given to those with symptoms attributable to this condition.

• #43 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?volume=5&number=3&spage=267

  The prevalence of hiatal hernia also increased with the length of Barrett’s esophagus and the size of hiatal hernia was larger in those with Barrett’s esophagus compared to those without. […] Moreover, it was shown that development and progression to Barrett’s esophagus with high-grade dysplasia or adenocarcinoma was significantly and independently related to the size of hiatal hernia. […] The presence of hiatal hernia more than doubled the risk of developing adenocarcinoma of the esophagus and gastric cardia. […] The presence of hiatal hernia per se is not an indication for treatment, and therapy should be given to those with symptoms attributable to this condition.

• #44 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?volume=5&number=3&spage=267

  The prevalence of hiatal hernia also increased with the length of Barrett’s esophagus and the size of hiatal hernia was larger in those with Barrett’s esophagus compared to those without. […] Moreover, it was shown that development and progression to Barrett’s esophagus with high-grade dysplasia or adenocarcinoma was significantly and independently related to the size of hiatal hernia. […] The presence of hiatal hernia more than doubled the risk of developing adenocarcinoma of the esophagus and gastric cardia. […] The presence of hiatal hernia per se is not an indication for treatment, and therapy should be given to those with symptoms attributable to this condition.

• #45 Hiatal Hernia Clinical Presentation: History and Physical Examination

  https://emedicine.medscape.com/article/178393-clinical

  Hiatal hernias are relatively common and, in themselves, do not cause symptoms. For this reason, most people with hiatal hernias are asymptomatic. […] The prevalence of large hiatal hernias in patients with iron deficiency anemia is 6%-7%. […] Certain conditions predispose to the development of hiatus hernia. These include obesity, pregnancy, and ascites.

• #46 Atypical and typical manifestations of the hiatal hernia – Goodwin – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/6254/html

  Hiatal hernias may present in variety of ways, both typical and atypical. Manifestations are dependent on the type and size of the hernia. Gastrointestinal manifestations are the most common, predominately with GERD and associated syndromes. The true incidence and prevalence of hiatal hernia is difficult to quantify, as many patients remain asymptomatic and undiagnosed from the hernia. The presence of a hiatal hernia is closely related to reflux symptoms and associated complications. Patients with a hiatal hernia are significantly more likely to present with GERD symptoms compared to those without a hiatal hernia. GERD remains the most common presentation of a hiatal hernia. The prevalence of GERD in the United States (US) ranges from 18.1-27.8% with a slightly lower 10-20% prevalence in Western Europe. GERD symptoms are more common in Type 1 hiatal hernias, and the size of the hernia can impact symptom severity. The strong association between hiatal hernia and GERD syndromes implies that many of the atypical presentations of GERD may manifest in a hiatal hernia. Hiatal hernias can present with non-gastrointestinal symptoms, obscuring the diagnosis in such patients on initial presentation. Typical pulmonary symptoms with hiatal hernia include dyspnea and atelectasis as a result of pulmonary compression. In a large population-based study, hiatal hernias were associated with an increased prevalence of atrial fibrillation.

• #47 Achalasia and Hiatal Hernia: A Rare Association and a Therapeutic Challenge

  https://www.jnmjournal.org/journal/view.html?doi=10.5056/jnm22151

  Achalasia and hiatal hernia are rarely associated. […] The estimated prevalence of hiatal hernia in Western patients could reach 50%, and up to 90% in patients with erosive reflux-esophagitis. […] The presence of a hiatal hernia should not influence treatment decisions in patients with achalasia. […] We observed a 4% prevalence of hiatal hernia among patients with achalasia and did not record any specific clinical or manometric presentation, or treatment outcome pattern following various endoscopic treatment modalities in patients with achalasia and hiatal hernia. […] Depending on the diagnostic modality used, hiatal hernia can be associated to achalasia in 4% to 20% of the patients. […] In conclusion, hiatal hernia associated with achalasia occurred in 4% of cases. The finding of a hiatal hernia associated with achalasia should not affect the choice of the treatment, since therapeutic outcomes and gastroesophageal reflux symptoms are similar to patients without hiatal hernia.

• #48 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?volume=5&number=3&spage=267

  Hiatal hernias can be diagnosed radiographically, endoscopically or manometrically, with each modality having its own limitations, especially in the diagnosis of hiatal hernias less than 2 cm in length. […] In the future, high resolution manometry should be a promising method for accurately assessing the association between hiatal hernias and GERD. […] The treatment of a hiatal hernia is similar to the management of GERD and should be reserved for those with symptoms attributable to this condition. […] Many studies have demonstrated that hiatal hernia is closely related to reflux symptoms, reflux esophagitis, Barrett’s esophagus and esophageal adenocarcinoma. […] Patients with hiatal hernia are significantly more likely to present with GERD symptoms than those without hiatal hernia, and symptomatic GERD patients are more likely to have hiatal hernias compared to those without symptoms.

• #49 Hiatal Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562200/

  The incidence of hiatal hernias increases with age. Approximately 55% to 60% of individuals older than 50 have a hiatal hernia. However, only about 9% have symptoms, with the manifestations depending on the type and competence of the LES. The vast majority of these hernias are type I sliding hiatal hernias. Type II paraesophageal hernias only comprise about 5% of hiatal hernias where the LES remains stationary, but the stomach protrudes above the diaphragm. The condition’s prevalence is also increased in women, which may be attributed to elevated intraabdominal pressure during pregnancy. Hiatal hernias are most common in Western Europe and North America and are rare in rural Africa. […] Managing hiatal hernias and reflux requires an interprofessional team approach. The team should include primary care clinicians, radiologists, gastroenterologists, and surgeons. Diagnostic studies are required for both diagnosis and operative planning. The workup typically includes endoscopy, pH monitoring, esophagography, and coordinated efforts between multiple teams. The interprofessional approach ultimately results in more accurate diagnoses, better surgical outcomes, and more patient satisfaction.

• #50 Hiatal hernia

  https://www.epocrates.com/online/diseases/73523/Hiatal-hernia/Epidemiology

  Hiatal hernia may be asymptomatic or may present with heartburn, dysphagia, odynophagia, hoarseness, asthma, shortness of breath, chest pain, anemia or hematemesis, or a combination of these. […] Common risk factors are obesity and increased age. Other known risk factors include intra-abdominal pressure from various conditions, and a previous hiatal operation. […] An upper gastrointestinal fluoroscopy with oral contrast is the key investigation technique and aids the surgeon in characterizing any anatomic variation necessary for preoperative evaluation. […] The necessity for, and type of treatment, depends on the patient’s symptoms and the anatomic configuration of the hernia. […] Uncomplicated sliding hiatal hernias are treated symptomatically with medical therapy, although some patients may select surgical therapy. Complicated hiatal hernias (those with bleeding, volvulus, or obstruction) have a stronger indication for surgical repair.

• #51 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?volume=5&number=3&spage=267

  Hiatal hernias can be diagnosed radiographically, endoscopically or manometrically, with each modality having its own limitations, especially in the diagnosis of hiatal hernias less than 2 cm in length. […] In the future, high resolution manometry should be a promising method for accurately assessing the association between hiatal hernias and GERD. […] The treatment of a hiatal hernia is similar to the management of GERD and should be reserved for those with symptoms attributable to this condition. […] Many studies have demonstrated that hiatal hernia is closely related to reflux symptoms, reflux esophagitis, Barrett’s esophagus and esophageal adenocarcinoma. […] Patients with hiatal hernia are significantly more likely to present with GERD symptoms than those without hiatal hernia, and symptomatic GERD patients are more likely to have hiatal hernias compared to those without symptoms.

• #52 Hiatal hernia prevalence and natural history on non-contrast CT in the Multi-Ethnic Study of Atherosclerosis (MESA) | BMJ Open Gastroenterology

  https://bmjopengastro.bmj.com/content/8/1/e000565

  Non-contrast CT on 3200 Multi-Ethnic Study of Atherosclerosis subjects followed up over 10 years shows HH prevalence in the general population (aged 5394 years) increases with ageing from 2.4% in the sixth decade of life to 7.0%, 14.0% and 16.6% in seventh, eighth and ninth decades, respectively and is more common in women (PR=1.8) and in those with obesity (PR=1.1). […] Finding HH on chest CT raises the likelihood of gastro-oesophageal reflux disease and patients with high BMI have an association with HH progression. […] This MESA study involving 3179 subjects free of cardiovascular disease shows non-contrast chest CT is highly reproducible for detecting and typing HH and confirms that HH on CT is common in the general population increasing in prevalence with age, female gender and BMI. High BMI is further associated with increasing HH size over a 10-year follow-up.

• #53 Hiatal Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562200/

  The incidence of hiatal hernias increases with age. Approximately 55% to 60% of individuals older than 50 have a hiatal hernia. However, only about 9% have symptoms, with the manifestations depending on the type and competence of the LES. The vast majority of these hernias are type I sliding hiatal hernias. Type II paraesophageal hernias only comprise about 5% of hiatal hernias where the LES remains stationary, but the stomach protrudes above the diaphragm. The condition’s prevalence is also increased in women, which may be attributed to elevated intraabdominal pressure during pregnancy. Hiatal hernias are most common in Western Europe and North America and are rare in rural Africa. […] Managing hiatal hernias and reflux requires an interprofessional team approach. The team should include primary care clinicians, radiologists, gastroenterologists, and surgeons. Diagnostic studies are required for both diagnosis and operative planning. The workup typically includes endoscopy, pH monitoring, esophagography, and coordinated efforts between multiple teams. The interprofessional approach ultimately results in more accurate diagnoses, better surgical outcomes, and more patient satisfaction.

• #54 Hiatus Hernia: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/hiatus-hernia-pro

  How common is hiatus hernia? (Epidemiology) The precise incidence of hiatus hernia is not known, as most studies have looked only at individuals who presented with symptoms of dyspepsia. However, it is estimated that 55-60% of over 50s have a hiatus hernia but that only 9% are symptomatic. Over half of people with reflux oesophagitis diagnosed either endoscopically or radiologically are found to have a hiatus hernia. Estimates for the general population vary enormously – from 10-80% of the adult population in North America, for example. It is more common amongst men. The incidence increases with age and with obesity. […] Hiatus hernias are often intermittent, so investigation may be unreliable. Investigation is needed to rule out sinister causes of symptoms and to exclude complications.

• #55 Hiatal Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562200/

  The incidence of hiatal hernias increases with age. Approximately 55% to 60% of individuals older than 50 have a hiatal hernia. However, only about 9% have symptoms, with the manifestations depending on the type and competence of the LES. The vast majority of these hernias are type I sliding hiatal hernias. Type II paraesophageal hernias only comprise about 5% of hiatal hernias where the LES remains stationary, but the stomach protrudes above the diaphragm. The condition’s prevalence is also increased in women, which may be attributed to elevated intraabdominal pressure during pregnancy. Hiatal hernias are most common in Western Europe and North America and are rare in rural Africa. […] Managing hiatal hernias and reflux requires an interprofessional team approach. The team should include primary care clinicians, radiologists, gastroenterologists, and surgeons. Diagnostic studies are required for both diagnosis and operative planning. The workup typically includes endoscopy, pH monitoring, esophagography, and coordinated efforts between multiple teams. The interprofessional approach ultimately results in more accurate diagnoses, better surgical outcomes, and more patient satisfaction.

• #56 Hiatal Hernia: What It Is, Symptoms, Treatment & Surgery

  https://my.clevelandclinic.org/health/diseases/8098-hiatal-hernia

  Hiatal hernias are common, especially as you get older. In the U.S., they affect about 20% of the general population. They affect 50% over the age of 50, 60% over the age of 60 and 70% over the age of 70. […] Most arent serious. Most dont even cause symptoms. You may never know that you have one. But a larger hernia could eventually become serious. Youd probably have symptoms if you had a larger one. […] The most common problem that hiatal hernias cause is chronic acid reflux. Chronic acid reflux can do damage to your esophagus over time, if its severe and medications dont manage it well enough. […] Healthcare providers find hiatal hernias by looking at images of your esophagus and stomach. Sometimes, they find it accidentally while looking for something else. If theyre looking for it, its usually because you have symptoms of acid reflux.

• #57 Literature Review: A Surgeon’s View of Recurrent Hiatal Hernia

  http://www.scielo.org.co/scielo.php?pid=S0120-99572015000400008&script=sci_arttext&tlng=en

  Recurrent hiatal hernias are a common pathology that generate a diagnostic and therapeutic challenge for surgeons and gastroenterologists. […] More than 95% of primary hiatal hernias are Type I sliding hernias. Types II, III and IV are grouped as para-esophageal hernias. Of these, over 90% are type III. Type II is the least common. […] The incidence of recurrence of hiatal hernia after repair of a primary sliding hiatal hernia in patients with gastroesophageal reflux is difficult to determine since not all patients who have undergone anti-reflux surgery have had esophagograms prior to the procedure, and since sometimes patients develop sliding hiatal hernias as the result of the release of attachments during surgery. […] Rates from 2% to 42% have been reported for recurrence of para-esophageal hiatal hernias, but the types of procedures performed and the follow-up times vary widely. […] These studies suggest a high rate of relapse with a direct relationship to the length of time after the original procedure, but also suggest that very few patients require a new procedure.

• #58 Literature Review: A Surgeon’s View of Recurrent Hiatal Hernia

  http://www.scielo.org.co/scielo.php?pid=S0120-99572015000400008&script=sci_arttext&tlng=en

  Recurrent hiatal hernias are a common pathology that generate a diagnostic and therapeutic challenge for surgeons and gastroenterologists. […] More than 95% of primary hiatal hernias are Type I sliding hernias. Types II, III and IV are grouped as para-esophageal hernias. Of these, over 90% are type III. Type II is the least common. […] The incidence of recurrence of hiatal hernia after repair of a primary sliding hiatal hernia in patients with gastroesophageal reflux is difficult to determine since not all patients who have undergone anti-reflux surgery have had esophagograms prior to the procedure, and since sometimes patients develop sliding hiatal hernias as the result of the release of attachments during surgery. […] Rates from 2% to 42% have been reported for recurrence of para-esophageal hiatal hernias, but the types of procedures performed and the follow-up times vary widely. […] These studies suggest a high rate of relapse with a direct relationship to the length of time after the original procedure, but also suggest that very few patients require a new procedure.

• #59 Surgical strategies for recurrent hiatal hernia: three-point fundoplication fixation | BMC Surgery | Full Text

  https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-025-02760-9

  According to a study of 307 patients, the incidence of symptomatic recurrence of hiatal hernia postoperatively was 20.8%. […] The recurrence of hiatal hernias is closely related to the size of the primary hernia defect. […] The pathophysiology of recurrent hiatal hernia may result from widening of the anterior and left lateral portions. […] We present several surgical strategies for addressing this issue. Fixation of the left and right sides of fundoplication with the phrenoesophageal ligament can effectively reduce the impact on the tissue around the hiatus hernia ring to reduce the incidence of recurrence as a form of additional phrenoesophageal membrane repair.

• #60 Surgical strategies for recurrent hiatal hernia: three-point fundoplication fixation | BMC Surgery | Full Text

  https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-025-02760-9

  The management of a recurrent (symptomatic) hiatal hernia remains controversial. This study aimed to review the outcomes of patients who underwent recurrent repair of hiatal hernias. […] The prevalence of GERD has now reached 13% worldwide. Hiatal hernia, a significant anatomic cause of GERD, has an incidence of up to 20%. […] However, the postoperative recurrence rate of hiatal hernias is high. It has been reported that the recurrence rates range from 25 to 42%, which may put patients at risk of reoperation. […] The results showed that fixation of the left and right sides of fundoplication with the phrenoesophageal ligament can effectively ameliorate patients symptoms and reduce the incidence of recurrence. […] Recurrence of hiatal hernia is the main cause of hiatal hernia reoperation, and it is also a challenge for surgeons.

• #61 Surgical strategies for recurrent hiatal hernia: three-point fundoplication fixation | BMC Surgery | Full Text

  https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-025-02760-9

  According to a study of 307 patients, the incidence of symptomatic recurrence of hiatal hernia postoperatively was 20.8%. […] The recurrence of hiatal hernias is closely related to the size of the primary hernia defect. […] The pathophysiology of recurrent hiatal hernia may result from widening of the anterior and left lateral portions. […] We present several surgical strategies for addressing this issue. Fixation of the left and right sides of fundoplication with the phrenoesophageal ligament can effectively reduce the impact on the tissue around the hiatus hernia ring to reduce the incidence of recurrence as a form of additional phrenoesophageal membrane repair.

• #62 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?volume=5&number=3&spage=267

  The prevalence of hiatal hernia also increased with the length of Barrett’s esophagus and the size of hiatal hernia was larger in those with Barrett’s esophagus compared to those without. […] Moreover, it was shown that development and progression to Barrett’s esophagus with high-grade dysplasia or adenocarcinoma was significantly and independently related to the size of hiatal hernia. […] The presence of hiatal hernia more than doubled the risk of developing adenocarcinoma of the esophagus and gastric cardia. […] The presence of hiatal hernia per se is not an indication for treatment, and therapy should be given to those with symptoms attributable to this condition.

• #63 Clinical Significance of Hiatal Hernia

  https://www.gutnliver.org/journal/view.html?pn=vol&uid=284&vmd=Full

  The prevalence of hiatal hernia also increased with the length of Barrett’s esophagus and the size of hiatal hernia was larger in those with Barrett’s esophagus compared to those without. […] Moreover, it was shown that development and progression to Barrett’s esophagus with high-grade dysplasia or adenocarcinoma was significantly and independently related to the size of hiatal hernia. […] The presence of hiatal hernia per se is not an indication for treatment, and therapy should be given to those with symptoms attributable to this condition.

• #64 Hiatus hernia – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/735

  Hiatus hernia may be asymptomatic or may present with heartburn, dysphagia, odynophagia, hoarseness, asthma, shortness of breath, chest pain, anaemia or haematemesis, or a combination of these. […] Common risk factors are obesity and increased age. Other known risk factors include intra-abdominal pressure from various conditions, and a previous hiatus operation. […] The necessity for, and type of treatment, depends on the patient’s symptoms and the anatomical configuration of the hernia. […] Uncomplicated sliding hiatus hernias are treated symptomatically with medical therapy, although some patients may select surgical therapy. Complicated hiatus hernias (those with bleeding, volvulus, or obstruction) have a stronger indication for surgical repair. […] Risk factors include obesity, increased age, previous gastro-oesophageal procedure, elevated intra-abdominal pressure, male sex, and incisional, umbilical, or inguinal hernia.

• #65 Which hiatal hernia’s need to be fixed? Large, small or none? – Dunn – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5885/html

  Hiatal hernias are a common occurrence in the western population, with an estimated prevalence of 15% to 20%. […] The current body of literature is constantly expanding, with new evidence for and against aggressive repair of these hernias appearing on a monthly basis. […] The surgical management of hiatal hernia has evolved from open (transthoracic, transabdominal) procedures to laparoscopic procedures. […] Surgery is recommended for all acute symptomatic presentations of PEHs (obstruction or incarceration/strangulation). […] The management of type II-IV hiatal hernia is less clear. […] In recent years, however, some studies have found that the risk of catastrophic complications is much lower than these initial estimates. […] Few studies have looked at the natural history of paraesophageal hernias without surgical intervention, making it difficult to assess the risks of watchful waiting.

• #66 Hiatus hernia – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/735

  Hiatus hernia may be asymptomatic or may present with heartburn, dysphagia, odynophagia, hoarseness, asthma, shortness of breath, chest pain, anaemia or haematemesis, or a combination of these. […] Common risk factors are obesity and increased age. Other known risk factors include intra-abdominal pressure from various conditions, and a previous hiatus operation. […] The necessity for, and type of treatment, depends on the patient’s symptoms and the anatomical configuration of the hernia. […] Uncomplicated sliding hiatus hernias are treated symptomatically with medical therapy, although some patients may select surgical therapy. Complicated hiatus hernias (those with bleeding, volvulus, or obstruction) have a stronger indication for surgical repair. […] Risk factors include obesity, increased age, previous gastro-oesophageal procedure, elevated intra-abdominal pressure, male sex, and incisional, umbilical, or inguinal hernia.

• #67 Which hiatal hernia’s need to be fixed? Large, small or none? – Dunn – Annals of Laparoscopic and Endoscopic Surgery

  https://ales.amegroups.org/article/view/5885/html

  The results of this study highlight the poor outcomes of watchful waiting for symptomatic PEH. […] Current surgical techniques for elective PEH repair have documented low postoperative morbidity/mortality and favorable long-term symptomatic outcomes. […] These studies argue that elective surgery is safe and has favorable symptomatic outcomes. […] Together, the weight of evidence suggests that although part of the increased morbidity and mortality of emergency repair is explained by differences in comorbidities, there is also an independent risk associated with emergency repair. […] As such, we agree with the 2013 SAGES guidelines that decision-making for the asymptomatic patient should be conducted on a case-by-case basis after discussion of the risks and benefits with the patient.

• #68 Hiatal Hernia: What It Is, Symptoms, Treatment & Surgery

  https://my.clevelandclinic.org/health/diseases/8098-hiatal-hernia

  Hernias dont go away. They usually get worse over time. But that doesnt mean your hernia will cause problems for you. If your hiatal hernia never causes any symptoms, you might not need to treat it. But if it does, you can expect those symptoms to continue and possibly worsen. […] Hiatal hernia surgery has a 90% success rate. Most people are able to discontinue medications and enjoy life free of acid reflux after hiatal hernia surgery.

• #69 Hiatal Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562200/

  The incidence of hiatal hernias increases with age. Approximately 55% to 60% of individuals older than 50 have a hiatal hernia. However, only about 9% have symptoms, with the manifestations depending on the type and competence of the LES. The vast majority of these hernias are type I sliding hiatal hernias. Type II paraesophageal hernias only comprise about 5% of hiatal hernias where the LES remains stationary, but the stomach protrudes above the diaphragm. The condition’s prevalence is also increased in women, which may be attributed to elevated intraabdominal pressure during pregnancy. Hiatal hernias are most common in Western Europe and North America and are rare in rural Africa. […] Managing hiatal hernias and reflux requires an interprofessional team approach. The team should include primary care clinicians, radiologists, gastroenterologists, and surgeons. Diagnostic studies are required for both diagnosis and operative planning. The workup typically includes endoscopy, pH monitoring, esophagography, and coordinated efforts between multiple teams. The interprofessional approach ultimately results in more accurate diagnoses, better surgical outcomes, and more patient satisfaction.

• #70 Hiatal Hernia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562200/

  The incidence of hiatal hernias increases with age. Approximately 55% to 60% of individuals older than 50 have a hiatal hernia. However, only about 9% have symptoms, with the manifestations depending on the type and competence of the LES. The vast majority of these hernias are type I sliding hiatal hernias. Type II paraesophageal hernias only comprise about 5% of hiatal hernias where the LES remains stationary, but the stomach protrudes above the diaphragm. The condition’s prevalence is also increased in women, which may be attributed to elevated intraabdominal pressure during pregnancy. Hiatal hernias are most common in Western Europe and North America and are rare in rural Africa. […] Managing hiatal hernias and reflux requires an interprofessional team approach. The team should include primary care clinicians, radiologists, gastroenterologists, and surgeons. Diagnostic studies are required for both diagnosis and operative planning. The workup typically includes endoscopy, pH monitoring, esophagography, and coordinated efforts between multiple teams. The interprofessional approach ultimately results in more accurate diagnoses, better surgical outcomes, and more patient satisfaction.

Zobacz więcej