[Hiatal hernia, gastroesophageal reflux and the lower esophageal sphincter. Manometric study with the "rapid...

Data obtained by means of rapid pull-through manometry in cases of hiatal hernia with or without gastro-oesophageal reflux are presented. Particular reference is made to lower oesophageal sphincter pressure in reflux symptomatologies irrespective of the presence of hiatal hernia. A relation between age and lower oesophageal pressure was noted. Hypotonia of the sphincter was observed in younger subjects, whose reflux symptoms are more marked and often unassociated with hiatal hernia. In the patients, sphincter dysfunction appears to be related to an error in the neurohormonal control mechanism of this functional complex. Stress is also laid on the rôle of pull-through manometry in the diagnostic, therapeutic and prognostic approach to diseases of this type.