Hiatus hernia natural history, complications and prognosis: Difference between revisions

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==Complications==
==Overvie==
A hiatus hernia ''per se'' does not cause any symptoms. The condition promotes reflux of gastric contents (''via'' its direct and indirect actions on the anti-reflux mechanism) and thus is associated with [[gastroesophageal reflux disease]] (GERD). In this way a hiatus hernia is associated with all the potential consequences of GERD - [[heartburn]], [[esophagitis]], [[Barrett's esophagus]] and [[esophageal cancer]]. However the risk attributable to the hiatus hernia is difficult to quantify, and at most is low.  
The symptoms of a hiatus hernia usually develop in the first decade of life in children and start with symptoms such as [[vomiting]], [[heartburn]], [[regurgitation]], and [[dysphagia]]. If left untreated, patients with a hiatus hernia may progress to develop strangulation, esophageal adenocarcinoma, and [[gastric volvulus]]. Prognosis is generally excellent and recovery after surgery in a large hernia is approximately 90%. The disease is well controlled with medical therapy but not cured.


Besides discomfort from GERD and dysphagia, hiatal hernias can have severe consequences for patients if not treated.  While sliding hernias are primarily associated with gastroesophageal acid reflux, rolling hernias can [[strangulating|strangulate]] a portion of the stomach above the diaphragm.  This strangulation can result in esophageal or GI tract obstruction and the tissue even become [[ischemic]] and [[necrosis|necrose]].
==Natural History, Complications, and Prognosis==


Another severe complication, although very rare, is a large herniation that can restrict the inflation of a [[lung]], causing pain and breathing problems.
===Natural History===
*The symptoms of a hiatus hernia usually develop in the first decade of life in children and start with symptoms such as [[vomiting]], [[heartburn]], [[regurgitation]], and [[dysphagia]].<ref name="pmid21927653">{{cite journal| author=Hyun JJ, Bak YT| title=Clinical significance of hiatal hernia. | journal=Gut Liver | year= 2011 | volume= 5 | issue= 3 | pages= 267-77 | pmid=21927653 | doi=10.5009/gnl.2011.5.3.267 | pmc=3166665 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21927653  }} </ref>
*If left untreated, patients with a hiatus hernia may progress to develop [[strangulation]], esophageal [[adenocarcinoma]], and [[gastric volvulus]].<ref name="pmid12942560" />
 
===Complications===
*Common complications of hiatus hernia include:
**[[Anemia]] from bleeding from erosions caused by [[reflux esophagitis]]<ref name="NeumannPoulton1999">{{cite journal|last1=Neumann|first1=L.|last2=Poulton|first2=B.|last3=Ridley|first3=S.|title=Life-threatening complications of hiatus hernia|journal=Anaesthesia|volume=54|issue=1|year=1999|pages=93–94|issn=0003-2409|doi=10.1046/j.1365-2044.1999.0759o.x}}</ref>
**Esophageal [[adenocarcinoma]]<ref name="pmid12942560">{{cite journal |vauthors=Wu AH, Tseng CC, Bernstein L |title=Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma |journal=Cancer |volume=98 |issue=5 |pages=940–8 |year=2003 |pmid=12942560 |doi=10.1002/cncr.11568 |url=}}</ref>
**[[Gastric volvulus]] and perforation in paraesopahgeal type<ref name="pmid22875520">{{cite journal |vauthors=Hennessey D, Convie L, Barry M, Aremu M |title=Paraoesophageal hernia: an overview |journal=Br J Hosp Med (Lond) |volume=73 |issue=8 |pages=437–40 |year=2012 |pmid=22875520 |doi= |url=}}</ref>
**[[Strangulation]] in paraesophageal hernia
 
===Prognosis===
*Prognosis is generally excellent and recovery after surgery in a large hernia is approximately 90%.<ref>https://online.epocrates.com/diseases/73551/Hiatal-hernia/Prognosis</ref>
*The disease is well controlled with medical therapy but not cured.


==References==
==References==


{{Reflist|2}}
{{Reflist|2}}
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Latest revision as of 22:10, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amandeep Singh M.D.[2]

Overvie

The symptoms of a hiatus hernia usually develop in the first decade of life in children and start with symptoms such as vomiting, heartburn, regurgitation, and dysphagia. If left untreated, patients with a hiatus hernia may progress to develop strangulation, esophageal adenocarcinoma, and gastric volvulus. Prognosis is generally excellent and recovery after surgery in a large hernia is approximately 90%. The disease is well controlled with medical therapy but not cured.

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

  • Prognosis is generally excellent and recovery after surgery in a large hernia is approximately 90%.[5]
  • The disease is well controlled with medical therapy but not cured.

References

  1. ↑ Hyun JJ, Bak YT (2011). "Clinical significance of hiatal hernia". Gut Liver. 5 (3): 267–77. doi:10.5009/gnl.2011.5.3.267. PMC 3166665. PMID 21927653.
  2. ↑ 2.0 2.1 Wu AH, Tseng CC, Bernstein L (2003). "Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma". Cancer. 98 (5): 940–8. doi:10.1002/cncr.11568. PMID 12942560.
  3. ↑ Neumann, L.; Poulton, B.; Ridley, S. (1999). "Life-threatening complications of hiatus hernia". Anaesthesia. 54 (1): 93–94. doi:10.1046/j.1365-2044.1999.0759o.x. ISSN 0003-2409.
  4. ↑ Hennessey D, Convie L, Barry M, Aremu M (2012). "Paraoesophageal hernia: an overview". Br J Hosp Med (Lond). 73 (8): 437–40. PMID 22875520.
  5. ↑ https://online.epocrates.com/diseases/73551/Hiatal-hernia/Prognosis
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