Skip to main content
Gut logoLink to Gut
. 1995 Jun;36(6):809–812. doi: 10.1136/gut.36.6.809

Twenty to 40 year follow up of infantile hiatal hernia.

B T Johnston 1, I J Carré 1, P S Thomas 1, B J Collins 1
PMCID: PMC1382613  PMID: 7615264

Abstract

The aim of this study was to assess clinical and radiological findings of gastro-oesophageal reflux in adults who were diagnosed as having a hiatal hernia in infancy or early childhood. One hundred and eighteen patients with a minimum age of 20 who were diagnosed as having a hiatal hernia in childhood were interviewed; barium meal examination was performed in 96 of these cases. Ninety four patients had not required surgery for their hernia. The hiatal hernia persisted in 53% of these patients and 46% experienced heartburn at least monthly but in only three was this severe. Heartburn was significantly more common in patients in whom reflux was seen on barium meal. The consumption of antacids was significantly lower (20% v 46%) in patients who responded well to treatment as children. Eighteen of 24 patients who underwent surgery as children experienced heart-burn monthly but in only one patient was this severe. Two patients underwent endoscopy at their request because of symptoms during this follow up. Both had Barrett's oesophagus. In conclusion, despite the persistence of the hiatal hernia in half of the non-surgically treated patients, few complained of significant symptoms. Effective treatment in childhood was associated with a significant reduction in antacid consumption for heartburn as adults. The finding of Barrett's oesophagus in two patients high-lights a possible role for endoscopic screening in this patient group.

Full text

PDF
809

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Astley R., Carré I. J., Langmead-Smith R. A 20-year prospective follow-up of childhood hiatal hernia. Br J Radiol. 1977 Jun;50(594):400–403. doi: 10.1259/0007-1285-50-594-400. [DOI] [PubMed] [Google Scholar]
  2. CARRE I. J., ASTLEY R., SMELLIE J. M. Minor degrees of partial thoracic stomach in childhood; review of 112 cases. Lancet. 1952 Dec 13;2(6746):1150–1153. doi: 10.1016/s0140-6736(52)92286-1. [DOI] [PubMed] [Google Scholar]
  3. CARRE I. J. Postural treatment of children with a partial thoracic stomach ('hiatus hernia'). Arch Dis Child. 1960 Dec;35:569–580. doi: 10.1136/adc.35.184.569. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. CARRE I. J. The natural history of the partial thoracic stomach (hiatus hernia) in children. Arch Dis Child. 1959 Aug;34:344–353. doi: 10.1136/adc.34.176.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. CODE C. F., FYKE F. E., Jr, SCHLEGEL J. F. The gastroesophageal sphincter in healthy human beings. Gastroenterologia. 1956;86(3):135–150. doi: 10.1159/000200544. [DOI] [PubMed] [Google Scholar]
  6. Carré I. J. Management of gastro-oesophageal reflux. Arch Dis Child. 1985 Jan;60(1):71–75. doi: 10.1136/adc.60.1.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Carré S. J. Clinical significance of gastro-oesophageal reflux. Arch Dis Child. 1984 Oct;59(10):911–912. doi: 10.1136/adc.59.10.911. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Cohen S., Harris L. D. Does hiatus hernia affect competence of the gastroesophageal sphincter? N Engl J Med. 1971 May 13;284(19):1053–1056. doi: 10.1056/NEJM197105132841902. [DOI] [PubMed] [Google Scholar]
  9. Graham D. Y., Smith J. L., Patterson D. J. Why do apparently healthy people use antacid tablets? Am J Gastroenterol. 1983 May;78(5):257–260. [PubMed] [Google Scholar]
  10. HUSFELDT E., THOMSEN G., WAMBERG H. Hiatal hernia and short oesophagus in children. Thorax. 1951 Mar;6(1):56–70. doi: 10.1136/thx.6.1.56. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Mittal R. K., Lange R. C., McCallum R. W. Identification and mechanism of delayed esophageal acid clearance in subjects with hiatus hernia. Gastroenterology. 1987 Jan;92(1):130–135. doi: 10.1016/0016-5085(87)90849-3. [DOI] [PubMed] [Google Scholar]
  12. Nebel O. T., Fornes M. F., Castell D. O. Symptomatic gastroesophageal reflux: incidence and precipitating factors. Am J Dig Dis. 1976 Nov;21(11):953–956. doi: 10.1007/BF01071906. [DOI] [PubMed] [Google Scholar]
  13. Ruth M., Månsson I., Sandberg N. The prevalence of symptoms suggestive of esophageal disorders. Scand J Gastroenterol. 1991 Jan;26(1):73–81. doi: 10.3109/00365529108996486. [DOI] [PubMed] [Google Scholar]
  14. Sloan S., Kahrilas P. J. Impairment of esophageal emptying with hiatal hernia. Gastroenterology. 1991 Mar;100(3):596–605. doi: 10.1016/0016-5085(91)80003-r. [DOI] [PubMed] [Google Scholar]
  15. Sontag S. J., Schnell T. G., Miller T. Q., Nemchausky B., Serlovsky R., O'Connell S., Chejfec G., Seidel U. J., Brand L. The importance of hiatal hernia in reflux esophagitis compared with lower esophageal sphincter pressure or smoking. J Clin Gastroenterol. 1991 Dec;13(6):628–643. doi: 10.1097/00004836-199112000-00006. [DOI] [PubMed] [Google Scholar]
  16. Stewart R. J., Johnston B. T., Boston V. E., Dodge J. Role of hiatal hernia in delaying acid clearance. Arch Dis Child. 1993 May;68(5):662–664. doi: 10.1136/adc.68.5.662. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Thompson W. G., Heaton K. W. Heartburn and globus in apparently healthy people. Can Med Assoc J. 1982 Jan 1;126(1):46–48. [PMC free article] [PubMed] [Google Scholar]
  18. Werlin S. L., Dodds W. J., Hogan W. J., Arndorfer R. C. Mechanisms of gastroesophageal reflux in children. J Pediatr. 1980 Aug;97(2):244–249. doi: 10.1016/s0022-3476(80)80482-3. [DOI] [PubMed] [Google Scholar]

Articles from Gut are provided here courtesy of BMJ Publishing Group

RESOURCES