Hiatal hernia in patients with achalasia

The occurrence of hiatal hernia and achalasia in the same patient is considered to be extremely rare. There have been very few reports regarding this association. An extensive review of achalasia cases at the Cleveland Clinic is presented, with emphasis on the frequency of concomitant hiatal hernia. Our results indicate that the presence of a hiatal hernia makes the diagnosis of achalasia unlikely in patients presenting with esophageal symptoms. However, it does not completely exclude coexistence of this esophageal motility disorder, as the present study reveals that these two entities are infrequently found together.