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

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Revision as of 20:15, 7 February 2018

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

Overvie

The symptoms of 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, [#]% of patients with hiatus hernia may progress to develop strangulation, esophageal adenocarcinoma and gastric volvulus. Prognosis is generally excellent and recovery after surgery in large hernia is approximately 90%. The disease is well controlled with medical therapy but not cured.

Natural History, Complications, and Prognosis

Natural History

The symptoms of 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, [#]% of patients with hiatus hernia may progress to develop strangulation, esophageal adenocarcinoma and gastric volvulus.

Complications

Common complications of hiatus hernia include:
- Esophageal adenocarcinoma^[1]
- Gastric volvulus and perforation in paraesopahgeal type^[2]
- Strangulation in paraesophageal hernia

Prognosis

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

References

↑ 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.
↑ Hennessey D, Convie L, Barry M, Aremu M (2012). "Paraoesophageal hernia: an overview". Br J Hosp Med (Lond). 73 (8): 437–40. PMID 22875520.

[pmid12942560-1] 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.

[pmid22875520-2] Hennessey D, Convie L, Barry M, Aremu M (2012). "Paraoesophageal hernia: an overview". Br J Hosp Med (Lond). 73 (8): 437–40. PMID 22875520.

[1]

[2]

@@ Line 4: / Line 4: @@
 ==Overvie==
-The symptoms of 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, [#]% of patients with hiatus hernia may progress to develop strangulation, esophageal adenocarcinoma and gastric volvulus.
+The symptoms of 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, [#]% of patients with hiatus hernia may progress to develop strangulation, esophageal adenocarcinoma and gastric volvulus. Prognosis is generally excellent and recovery after surgery in large hernia is approximately 90%. The disease is well controlled with medical therapy but not cured.
 ==Natural History, Complications, and Prognosis==
@@ Line 19: / Line 19: @@
 ===Prognosis===
-*Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
+*Prognosis is generally excellent and recovery after surgery in large hernia is approximately 90%.
-*Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
+*The disease is well controlled with medical therapy but not cured.
-*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
-*[Subtype of disease/malignancy] is associated with the most favorable prognosis.
-*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
-==Complications==
-. 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.
-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]].
-Another severe complication, although very rare, is a large herniation that can restrict the inflation of a [[lung]], causing pain and breathing problems.
 ==References==