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Achalasia associated with hiatal hernia: prevalence and potential implications
1Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1088.
Abdominal Imaging
|January 1, 1993
Summary
Hiatal hernia is uncommon in achalasia patients, occurring in only 8.3%. Its presence did not affect symptoms or manometry results and is not a contraindication for pneumatic dilatation treatment.
Area of Science:
- Gastroenterology
- Digestive Motility Disorders
Background:
- Hiatal hernia is common in the general population (40-50%).
- The prevalence and clinical significance of hiatal hernia in achalasia are not well understood.
Purpose of the Study:
- To determine the prevalence of hiatal hernia in patients diagnosed with achalasia.
- To evaluate the impact of hiatal hernia on the evaluation and management of achalasia.
Main Methods:
- Retrospective review of medical records and radiographic examinations.
- Analysis of 120 patients diagnosed with achalasia.
- Comparison of demographic, symptomatic, manometric, and treatment data between patients with and without hiatal hernia.
Main Results:
- Hiatal hernia was identified in 8.3% of achalasia patients.
- No significant differences were observed in age, sex, dysphagia, regurgitation, or lower esophageal sphincter pressure between groups.
- All five esophageal perforations during pneumatic dilatation occurred in patients without hiatal hernia.
Conclusions:
- Hiatal hernia is infrequently associated with achalasia.
- The presence of hiatal hernia does not appear to influence achalasia symptoms, manometric findings, or treatment outcomes.
- Hiatal hernia is not a contraindication for pneumatic dilatation therapy in achalasia patients.