Document Detail

The role of hiatus hernia in gastro-oesophageal reflux disease.
MedLine Citation:
PMID:  15316404     Owner:  NLM     Status:  MEDLINE    
This article gives an overview of the role of sliding hiatus hernia in gastro-oesophageal reflux disease (GORD). The crural diaphragm acts as an external sphincter of the anti-reflux barrier. Contractions of the crural diaphragm increase lower-oesophageal-sphincter (LOS) pressure during each inspiration and in situations of increased abdominal pressure, whereas these contractions are inhibited when gas and/or a bolus has to pass the gastro-oesophageal junction. A hiatus hernia is associated with GORD symptoms, increased oesophageal acid exposure, and oesophagitis and its severity. In patients with hiatus hernia, the incidence of reflux episodes is increased during periods with low LOS pressure, straining and swallowing. These findings underline the importance of the crural diaphragm, which, when surrounding the LOS, protects against gastro-oesophageal reflux.
Margot A van Herwaarden; Melvin Samsom; André J P M Smout
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European journal of gastroenterology & hepatology     Volume:  16     ISSN:  0954-691X     ISO Abbreviation:  Eur J Gastroenterol Hepatol     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-18     Completed Date:  2004-10-12     Revised Date:  2009-10-16    
Medline Journal Info:
Nlm Unique ID:  9000874     Medline TA:  Eur J Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  831-5     Citation Subset:  IM    
Gastrointestinal Research Unit, Department of Gastroenterology, University Medical Centre, Utrecht, the Netherlands.
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MeSH Terms
Diaphragm / physiopathology
Esophagitis / etiology
Gastroesophageal Reflux / etiology*,  physiopathology
Hernia, Hiatal / complications*

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