Hiatal hernia size is the dominant determinant of esophagitis presence and severity in gastroesophageal reflux disease

Colin Howden, James M. Henning, Bidan Huang, Nancy Lukasik, James W. Freston

Research output: Contribution to journalArticle

156 Citations (Scopus)

Abstract

OBJECTIVE: Although reflux esophagitis is a multifactorial disease, the relative importance of these pathogenetic factors has not been clearly established. In this study, regression analysis was used to model the major determinants of esophagitis in patients with symptomatic gastroesophageal reflux disease (GERD). METHODS: Sixty-six GERD patients and 16 asymptomatic controls were evaluated. All patients underwent upper endoscopy, esophageal manometry, and 24-h pH monitoring. Esophagrams were performed in 38 of the GERD patients and all controls. Stepwise regression was performed using esophagitis severity as the dependent variable. Logistic regression was performed grouping subjects as controls, non-erosive GERD, or erosive esophagitis. RESULTS: Hiatal hernia size, lower esophageal sphincter pressure, esophageal acid exposure, and number of reflux episodes >5 min significantly correlated with esophagitis severity. Stepwise regression identified hiatal hernia size (p = 0.0001) and lower esophageal sphincter pressure (p = 0.0024) as significant predictors of esophagitis. Logistic regression also identified hiatal hernia size (X2 = 17.07, p < 0.0001) and lower esophageal sphincter pressure (X2 = 5.97, p = 0.0146) as significant predictors of erosive esophagitis. CONCLUSION: Esophagitis severity is best predicted by hiatal hernia size and lower esophageal sphincter pressure. Of these, hiatal hernia size is the strongest predictor.

Original languageEnglish (US)
Pages (from-to)1711-1717
Number of pages7
JournalAmerican Journal of Gastroenterology
Volume96
Issue number6
DOIs
StatePublished - Jul 3 2001
Externally publishedYes

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Hiatal Hernia
Esophagitis
Gastroesophageal Reflux
Lower Esophageal Sphincter
Pressure
Logistic Models
Peptic Esophagitis
Manometry
Endoscopy
Regression Analysis
Acids

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Hiatal hernia size is the dominant determinant of esophagitis presence and severity in gastroesophageal reflux disease. / Howden, Colin; Henning, James M.; Huang, Bidan; Lukasik, Nancy; Freston, James W.

In: American Journal of Gastroenterology, Vol. 96, No. 6, 03.07.2001, p. 1711-1717.

Research output: Contribution to journalArticle

Howden, Colin ; Henning, James M. ; Huang, Bidan ; Lukasik, Nancy ; Freston, James W. / Hiatal hernia size is the dominant determinant of esophagitis presence and severity in gastroesophageal reflux disease. In: American Journal of Gastroenterology. 2001 ; Vol. 96, No. 6. pp. 1711-1717.
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