Tag Archives: hiatal hernia

Comparative study of Clinical Characteristics in Patients with Mild and Severe Reflux Esophagitis

DOI: 10.2478/amma-2020-0002

Objective: This study aims to determine the correlation between risk factors and erosive esophagitis development. Methods: We conducted a retrospective observational study on a consecutive series of 19.672 patients who underwent upper gastrointestinal endoscopy between 01.01.2011-31.12.2017. A total of 3005 patients, diagnosed with erosive esophagitis, were included in the present study and stratified according to Los Angeles classification. Results: During the studied period we found 3005 patients with erosive esophagitis, sex ratio male to female was 1.3/1, the most common forms of esophagitis being grade A and B: 74.54% patients with esophagitis grade A, 14.80% patients with grade B; 5.29% patients were with grade C and 5.35% patients with esophagitis grade D. In severe esophagitis the male predominance was more prevalent (249 males, 71 female), with a sex ratio 3.50/1. The correlation of male gender with severe esophagitis was highly statistically significant (p < 0.0001, OR 2.97; 95% CI 2.25-3.91). Hiatal hernia was diagnosed in 1171 patients, the presence of large hiatal hernias, being an important predictor, with statistical significance (p < 0.0001, OR 3.41; 95% CI 2.22-5.21), for severe esophagitis development. Incidence of Helicobacter pylori infection was 11.51%, in the entire study group, with no statistical significant difference between patients with mild or severe esophagitis (12.02% vs 7.18%). Conclusion: Erosive esophagitis is a frequent disease, the most common forms being grade A and B. Male gender and the presence of hiatal hernia are the most important risk factors for erosive esophagitis development, in our study group.

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Correlation Between Helicobacter pylori, Hiatal Hernia and Barrett’s Esophagus

Background: The incidence of adenocarcinoma of the esophagus has dramatically increased during the last 2 decades and so has the incidence of Barrett’s esophagus, one of the most important risk factors for esophageal adenocarcinoma.
Aim: The aim of this study was to determine whether infection with Helicobacter pylori is associated with a lower risk of Barrett’s esophagus development in our area, and if there is a direct correlation between hiatal hernia and Barrett’s esophagus.
Material and method: We studied a series of 4359 patients who were investigated by upper endoscopy in the Gastroenterology and Endoscopy Unit of Targu Mures County Clinical Emergency Hospital between the 1st of January 2009 and 31st of December 2009. Barrett’s esophagus was defined as the presence of specialized columnar epithelium with goblet cells in the esophagus. We compared the patients with Barrett’s esophagus with a similar serie with patients without reflux disease.
Results: In 33 patients a diagnosis of Barrett’s esophagus was established. There was a strong predominance of males. The mean age at diagnosis was 64.18 years. Helicobacter pylori was present in 17 cases (51.51%) in the control patients compared to 42.42% in patients with Barrett’s esophagus (p 0.622, Odds Ratio: 0.69 95% CI: 0.26-1.83). Hiatal hernia was present in patients with Barrett’s esophagus in 21 cases (63.63%), and in patients without reflux disease only in 5 cases (15.15%) (p<0.001, Odds Ratio: 9.8: 95% CI: 2.99-32.18).
Conclusions: A significant correlation between hiatal hernia and Barrett’s esophagus was demonstrated in our study (p<0.001).

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