Hiatal hernia and Barrett’s oesophagus Impact on symptoms occurrence and complications
Authors:
M. Al-Tashi 1; S. Rejchrt 1; M. Kopáčová 1; V. Tyčová 2; M. Široký 1; R. Repák 1; I. Tachecí 1; T. Douda 1; J. Cyrany 1; T. Fejfar 1; P. Hůlek 1; J. Bukač 3; J. Bureš 1
Authors place of work:
Charles University in Praha, nd Department of Internal Medicine, Faculty of Medicine at Hradec Králové, University Teaching Hospital, Hradec Králové
1; Charles University in Praha, The Fingerland Department of Pathology, Faculty of Medicine at Hradec Králové, University Teaching Hospital, Hradec Králové
2; Charles University in Praha, Department of Medical Biophysics, Faculty of Medicine at Hradec Králové
3
Published in the journal:
Čas. Lék. čes. 2008; 147: 564-568
Category:
Original Article
Summary
The aim of the study was to evaluate the influence of sliding hiatal hernia over the Barrett’s oesophagus, including symptoms rate and complications.
Methods:
A total of 520 (4.6%) cases of Barrett’s oesophagus were found out of 18.276 upper gastrointestinal endoscopies, performed in 11.276 patients at a single tertiary centre in a period from 1994 to 2004.
Results:
Sliding hiatal hernia was found in 58% of patients with Barrett’s oesophagus, more frequently in men (60%). The association between hernia and some complications of Barrett’s oesophagus was significant (94% of Barrett’s ulcer, 77% of low-grade dysplasia with p < 0.01). However, there was no significant association with adenocarcinoma (54%; p > 0.05). The other complications of Barrett’s oesophagus (i.e. bleeding, stenosis, high-grade dysplasia) were identified in small number (less than 10), so they were not evaluated statistically. Association between the presence of hiatal hernia and occurrence of symptoms (reflux symptoms, dysphagia, odynophagia, dyspeptic and other symptoms) was significant with p < 0.01.
Conclusions:
Our study suggests that sliding hiatal hernia may play a significant role as a pathophysiologic factor in Barrett’s oesophagus. Complications rate of Barrett’s oesophagus were not equally frequent in particular cases with hiatal hernia. The occurrence of symptoms is getting more pronounced in those with sliding hiatal hernia.
Key words:
Barrett’s oesophagus, sliding hiatal hernia, symptoms, complications.
Zdroje
1. Sampliner, R. E: Practice Updated guidelines for the diagnosis, surveillance, and therapy of Barrett’s esophagus. Am. J. Gastroenterol., 2002, 97, s. 1888–1895.
2. Lukáš, K., Bureš, J., Drahoňovský, V. et al.: Gastro-oesophageal reflux disease. Guidelines of the Czech Society of Gastroenterology (in Czech). Čes. Slov. Gastroenterol. Hepatol., 2003, 57, s. 23–29.
3. Sharma, P.: Prevalence of Barrett’s oesophagus and metaplasia at the gastro-oesophageal junction. Aliment Pharmacol Ther 2004; 20 (Suppl 5), s. 48-54.
4. Dodds, W. J., Walter, B.: Cannon Lecture: Current concepts of esophageal motor function: clinical implications for radiology. Am. J. Roentgenol., 1977, 128, s. 549–561.
5. Mittal, R. K.: Hiatal hernia: myth or reality? Am. J. Med., 1997, 103, s. 33S–39S.
6. Kahrilas, P. J.: Hiatus hernia. UpToDate 2008, vol 16.2.
7. Kahrilas, P. J.: Hiatus hernia causes reflux: Fact or fiction? Gullet, 1993, 3 (Suppl.), s. 21.
8. Spechler, S. J.: Barrett’s esophagus. N. Engl. J. Med., 2002, 346, s. 836–842.
9. Stein, H. J, Hoeft, S, DeMeester, T. R.: Reflux and motility patterns in Barrett’s esophagus. Dis. Esophagus, 1992, 5, s. 21–28.
10. Gillen, P., Keeling, P., Byrne, P. J., Hennessy, T. P. J.: Barrett’s esophagus: pH profile. Br. J. Surg., 1987, 74, s. 774–776.
11. Campos, G. M., DeMeester, T. R., Peters, J. H. et al.: Predictive factors of Barrett’s esophagus: multivariate analysis of 502 patients with gastroesophageal reflux disease. Arch. Surg., 2001, 136, s. 1267–1273.
12. Weinstein, W., Leh, W., Lewin, K. et al.: How often is short segment Barrett’s esophagus proven histologically? A prospective study. Gastroenterology, 2002, 122 (Suppl.), s. A293.
13. Al-Tashi, M., Bureš, J., Rejchrt, S. et al.: Barrett’s oesophagus: prevalence and complications of disease between 1994 and 2003 (in Czech). Čes. Slov. Gastroenterol. Hepatol., 2005, 59, s. 62–65.
14. Mittal, R. K., Lange, R. C., McCallum, R. W.: Identification and mechanism of delayed acid clearance in subjects with hiatus hernia. Gastroenterology, 1987, 92, s. 130–135.
15. Sloan, S., Kahrilas, P. J.: Impairment of esophageal emptying with hiatal hernia. Gastroenterology, 1991, 100, s. 596-605.
16. Mittal, R. K., Balaban, D. H.: The esophagogastric junction. N. Engl. J. Med., 1997, 336, s. 924–932.
17. Sloan, S., Rademaker, A. W., Kahrilas, P. J.: Determinants of gastroesophageal junction incompetence: hiatal hernia, lower esophageal sphincter, or both? Ann. Intern. Med., 1992, 117, s. 977–982.
18. Fitzgerald, R. C., Omary, M. B., Triadafilopoulos, G.: Dynamic effects of acid on Barrett’s esophagus. An ex vivo proliferation and differentiation model. J. Clin. Invest., 1996, 98, s. 2120.
19. Fass, R., Hell, R. W., Garewal, H. S. et al.: Correlation of oesophageal acid exposure with Barrett’s oesophagus length. Gut, 2001, 48, s. 310.
20. Berstad, A., Weberg, R., Larsen, I. F. et al.: Relationship of hiatus hernia to reflux oesophagitis. A prospective study of coincidence, using endoscopy. Scand. J. Gastroenterol., 1986, 21, s. 55–58.
21. Wright, R. A., Hurwitz, A. L.: Relationship of hiatal hernia to endoscopy proven esophagitis. Dig. Dis. Sci., 1979, 24, s. 311–313.
22. Ténaiová, J., Tůma, L., Hrubant, K. et al.: Incidence of hiatal hernias in the current endoscopic praxis (in Czech). Čas. Lék. čes., 2007, 146, s. 74–76.
23. Cronstedt, J., Carling, L., Vestergaard, P., Berglund, J.: Oesophageal disease revealed by endoscopy in 1000 patients referred primarily for gastroscopy. Acta Med. Scand., 1978, 204, s. 413–416.
24. Cameron, A. J.: Barrett’s esophagus: prevalence and size of hiatal hernia. Am. J. Gastroenterol., 1999, 94, s. 2054–2059.
25. Patti, M. G., Goldberg, H. I., Arcerito, M. et al.: Hiatal hernia size affects lower esophageal sphincter function, esophageal acid exposure, and the degree of mucosal injury. Am. J. Surg., 1996, 171, s. 182–186.
26. Avidan, B., Sonnenberg, A., Schnell, T. G. et al.: Hiatal hernia size, Barrett’s length, and severity of acid reflux are all risk factors for esophageal adenocarcinoma. Am. J. Gastroenterol., 2002, 97, s. 1930–1936.
27. Avidan, B., Sonnenberg, A., Schnell, T. G., Sontag, S. J.: Hiatal hernia and acid reflux frequency predict presence and length of Barrett’s esophagus. Dig. Dis. Sci., 2002, 47, s. 256–264.
28. Frazzoni, M., De Micheli, E., Grisendi, A., Savarino, V.: Hiatal hernia is the key factor determining the lansoprazole dosage required for effective intra-oesophageal acid suppression. Aliment Pharmacol. Ther., 2002, 16, s. 881–886.
29. Petersen, H., Johannessen, T., Sandvik, A. K. et al.: Relationship between endoscopic hiatus hernia and gastroesophageal reflux symptoms. Scand. J. Gastroenterol., 1991, 26, s. 921–926.
30. Gerson, L. B., Schetler, K., Triadafilopoulos, G.: Prevalence of Barrett’s esophagus in asymptomatic individuals. Gastroenterology, 2002, 123, s. 461–467.
Štítky
Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistČlánok vyšiel v časopise
Journal of Czech Physicians
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
- Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
Najčítanejšie v tomto čísle
- Galectins in Squamous Cell Carcinomas of the Head and Neck Cancers
- Rationality and Irrationality in the Medicine and in the Life
- Hiatal hernia and Barrett’s oesophagus Impact on symptoms occurrence and complications
- Primary B-cell pituitary lymphoma of the Burkitt type: case report of the rare clinic entity with typical clinical presentation