[Hiatal hernia in asthmatic patients: prevalence and its association with gastroesophageal reflux].
BACKGROUND
Evidence of a high prevalence of hiatal hernia (HH) and gastroesophageal reflux (GER) in asthmatic patients has been found. However, the relationship between these entities has not been studied in our country.


OBJECTIVE
1) To inform the prevalence of hiatal hernia in asthmatic patients, 2) To compare the prevalence of hiatal hernia in asthmatic vs. non-asthmatic patients, 3) To establish a possible association between hiatal hernia and GER in asthmatic patients.


METHODS
In order to detect and to compare the prevalence of hiatal hernia in asthmatic and non-asthmatic patients, upper gastrointestinal endoscopy was performed. To establish the association between asthma and GER, data obtained from a gastrointestinal symptoms questionnaire, an esophageal manometry and an ambulatory pH recording in asthmatics with or without hiatal hernia were compared.


RESULTS
Hiatal hernia was more frequently observed in asthmatics than in non-asthmatics (62% vs. 34%, p = 0.02). The frequency of typical symptoms of GER was similar in both asthmatics with or without hiatal hernia (54 vs. 43%, p = 0.3). Lower esophageal sphincter incompetence was similar in asthmatics with hiatal hernia (35%) vs. asthmatics without hiatal hernia (22%), as detected by manometry. Pathological GER was diagnosed by pH recording in 81% of the asthmatics with hiatal hernia and in 65% of asthmatics without hiatal hernia (p = 0.1).


CONCLUSIONS
There is a high prevalence of hiatal hernia in asthmatics, which in turn results to be greater than in non-asthmatic patients. The presence of hiatal hernia does not correlate with the detection of pathological GER as determined by pH recording in this group of patients.
Carmona-Sánchez
R
R
Departamento de Gastroenterología, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Valdovinos-Díaz
M A
MA
Facha
M T
MT
Aguilar
L
L
Cachafeiro
M
M
Solana
S
S
Carrillo
G
G
Chapela
R
R
Mejía
M
M
Pérez-Chavira
R
R
Salas
J
J
D000328:Adult; D000368:Aged; D001249:Asthma / Q000453:epidemiology / Q000209:etiology*; D015897:Comorbidity; D004943:Esophagogastric Junction / Q000503:physiopathology; D005260:Female; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000453:epidemiology; D005773:Gastroscopy; D006551:Hernia, Hiatal / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D008297:Male; D008365:Manometry; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011795:Surveys and Questionnaires