Gastroenterology and Hepatology from Bed to Bench

Abstract

Aim: This study aimed at determining the prevalence of hiatal hernia (HH) in patients with endoscopic erosive esophagitis (EE).

Background: Gastro-esophageal reflux disease (GERD) is one of the most common problems all over the world. This may lead to erosive esophagitis. Previous studies have demonstrated that HH has an important role in the pathogenesis of reflux disease. The rising prevalence of GERD among Iranians necessitates more comprehensive studies about the underlying etiologies. This study aimed at determining the prevalence of HH in patients with endoscopic erosive esophagitis (EE).

Patients and methods: In a case-control setting, 454 patients with gastrointestinal problems referred to the endoscopy unit of Tabriz Imam Hospital were evaluated during a 24-month period. Two hundred and twenty seven patients determined to have EE and 227 patient with non-ulcer dyspepsia (NUD) enrolled as the control group. The presence of HH was assessed during the endoscopic procedure. The possible risk factors for EE also elucidated.

Results: HH was confirmed in 94.3% of the case group comparing with the rate of 30% in the controls (OR=38.49, 95%CI: 20.55-72.11; p<0.001). The male patients were significantly dominant in the case group (130 patients vs. 92 patients; p<0.001). The presence of HH was an independent risk factor for the EE. The age of patients with EE and concurrent HH was significantly lower than that in the patients without it (42.13 years vs. 55.08 years; p=0.001). There was no significant relation between the presence of HH and the gender of patients with EE.

Conclusion: This study showed that HH is a common concomitant finding in patients suffering from heartburn due to EE. Thus considering this pathological entity is necessary, especially in younger patients.