Reflux esophagitis and its relationship to hiatal hernia

We performed this study to evaluate the prevalence of reflux esophagitis an d/or hiatal hernia in patients referred to a medical center and to examine the relationship between endoscopic reflux esophagitis and hiatal hernia. T he study was carried out in 1,010 patients referred to Yong Dong Severance Hospital for upper gastrointestinal endoscopy because of symptoms related t o the gastrointestinal tract from September 1994 to March 1996, The presenc e of hiatal hernia was defined as a circular extension of the gastric mucos a of 2 cm or more above the diaphragmatic hiatus. Reflux esophagitis was fo und in 5.3% of patients, hiatal hernia in 4.1%, duodenal ulcer in 7.2% and gastric ulcer in 8.2%. The prevalence rates of reflux esophagitis and hiata l hernia in males were significantly higher than those in females. Thirty-t wo percent of patients with reflux esophagitis had hiatal hernia. In patien ts without reflux esophagitis, hiatal hernia was found in only 2.5% (p<0.01 ). There was no significant association between the presence of hiatal hern ia and the degree of esophagitis on endoscopy, Duodenal ulcer was the secon d most common endoscopic abnormality found in patients with reflux esophagi tis. The prevalence rate of reflux esophagitis and/or hiatal hernia at a me dical center is relatively low compared to peptic ulcer disease and other r eports from the Western countries. Our study confirms the close association between reflux esophagitis and hiatal hernia.