The incidence of hiatal hernia, reflux esophagitis and Barrett's esophagus between 2003 and 2005

Introduction: It has been suggested that hiatus hernia (HH) is an important etiological factor for gastro-esophageal reflux disease (GERD).

Aims: To evaluate the prevalence of HH and its correlation with the presence of reflux esophagitis, Barrett's esophagus and the severity of esophagus.

Patients/Methods: The results of upper gastrointestinal endoscopies performed between 2003 and 2005 were evaluated retrospectively. The presence or absence of HH, its correlation with the presence of esophagitis and Barrett's esophagus and the severity of esophagitis (according to Los-Angeles classification) were evaluated. The distribution of HH by age and gender was also assessed.

Results: Of 6845 patients undergoing upper endoscopy, 3685 (53.8%) had reflux esophagitis. Barrett's esophagus was present in 109 patients (2.9%). HH was confirmed endoscopically in 2027 cases (29.6%). HH was found in 40.2% of patients with esophagitis, in 37.6% with Barrett's esophagus, and in 15.2% of patients with no esophagitis. HH was significantly associated with the presence of more severe (Los-Angeles C/D) esophagitis (p<0.05). HH patients belonged to an older age group, but no definite gender effect was observed.

Conclusions: HH correlated with the presence of reflux esophagitis and Barrett's esophagus. HH should be considered as a marker for severe disease in GERD patients.