Newly developing hiatus hernia: A survey in patients undergoing upper gastrointestinal endoscopy

Abstract

Data on the incidence of hiatus hernia are lacking. A cross-sectional study was performed in a large population of consecutive patients undergoing endoscopy in order to assess the yearly incidence of hiatus hernia in this population. Consecutive patients undergoing upper gastrointestinal endoscopy in whom no macroscopic abnormalities were seen and who, in addition, underwent a second endoscopy were included in the study. The presence of newly developed hiatus hernia was noted, as well as the time elapsed between both endoscopies. Over a period of 8 years, 12 122 endoscopies were performed in 9580 patients. Ninety patients developed a hiatus hernia; this was not the case in a control group of 353 patients. Patients who developed a hiatus hernia were significantly older than those who did not (P < 0.001). The number of women who developed hiatus hernia was higher than the number of men who developed hiatus hernia (P < 0.0001). The total time between both endoscopies in 443 patients was 897 patient years. Ninety patients (20.3%) developed a hiatus hernia. If these data are extrapolated to a yearly occurrence, then 35 of 176 patients will develop a hiatus hernia. It takes an average of 1.9 years for a hiatus hernia to develop. In the present study, it was calculated that 19.9% of the studied population would develop a hiatus hernia per year. Patients who developed a hiatus hernia were significantly older than patients who did not. The present study also shows that a hiatus hernia actually develops later in life.