Impact of Hiatal Hernia on Pediatric Gastroesophageal Reflux Disease
- *Corresponding Author:
- Wikrom Karnsakul, MD
Assistant Professor, Division of Pediatric Gastroenterology and Nutrition
Johns Hopkins University School of Medicine, CMSC-2
600 North Wolfe Street, Baltimore, MD. 21287, USA
E-mail: [email protected]
Received date: July 27, 2015 Accepted date: August 19, 2015 Published date: August 27, 2015
Citation: Au Yeung KJ, Cannon ML, Arkachaisri T, Gillespie S, Karnsakul W (2015) Impact of Hiatal Hernia on Pediatric Gastroesophageal Reflux Disease. J Gastrointest Dig Sys 5:330. doi:10.4172/2161-069X.1000330
Copyright: © 2015 Yeung KJA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objectives: To identify the frequency of hiatal hernia (HH) and the impact of HH size in children with gastroesophageal reflux disease (GERD). Methods: Outpatient records were retrospectively reviewed in children ages 0-17 years old, diagnosed clinically with GERD. HH was diagnosed based on an upper gastrointestinal (UGI) series and HH body was characterized as either small (<2 cm) or large (≥2 cm). For patients who underwent an upper endoscopy, presence and severity of esophagitis was diagnosed with esophageal biopsies and correlated with size of HH. Results: There were 155 children diagnosed clinically with GERD who underwent an UGI. HH was diagnosed in 80 (51%) children via UGI (mean age 7.5 y, 32 female, 48 male). Small HH was observed in 60 children (75%; mean age 7 y, 25 female, 35 male) and large HH in 20 (25%; mean age 3.2 y, 7 female, 13 male). Erosive esophagitis was uncommon in children with HH. Abdominal pain, chest pain and heartburn were commonly reported chief complaints in children (age >5yr) with a large HH. Children with large HH were more frequently found to fail medications and require Nissen fundoplication than those with a small HH (p=0.032). Conclusions: Children with GERD had high frequency of HH based on UGI. Children with large HH required significantly more anti-reflux surgery than those with small HH. A larger scale longitudinal prospective study is needed to further investigate the impact of HH on GERD complications and the effects of therapy.