MANY PATIENTS with hiatus hernia and reflux esophagitis have been found to have increased gastric acid secretion. Casten,4 studying nocturnal gastric secretion in patients with sliding hiatus hernia, found that the majority of patients with symptoms severe enough to require operative correction of the hernia had overnight secretion above 20 mEq. In the group of patients with minimal symptoms, where surgical repair of the hernia did not seem indicated, only a few were found to have gastric hypersecretion. The gastric acid secretion was highest in those patients with symptoms of reflux esophagitis and there was also good correlation between the size of the hernia and the magnitude of acid secretion. In addition, the authors noted that 23 of 47 patients with symptomatic hiatus hernia had a duodenal ulcer. The concept that hiatus hernia with esophagitis is related to ulcer disease is not a new one, and has been advanced
BAUE AE, LANDOR JH. Gastric Secretion in Experimental Hiatus Hernia. Arch Surg. 1965;90(1):57–59. doi:10.1001/archsurg.1965.01320070059012
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