A New Type of Sliding Hiatus Hernia

Abstract

A series of patients showing a previously unrecognized type of sliding hiatus hernia is presented and analyzed. This type of hernia is characterized by reflux of the mucous membrane of the Hiss angle into the lumen of the esophagus. The occurrence of mucosal prolapse is a secondary phase of gastroesophageal reflux. The mucous plug prevents further reflux of the acid contents of the stomach into the esophagus and mouth. After the appearance of mucosal prolapse, the symptoms and signs of esophagitis disappear. The most characteristic complaint of the patients is retrosternal pain on lying and bending down. Endoscopy with provocative tests reveals the mucosal prolapse. Tooth erosions due to previous acid reflux into the mouth are diagnostic. The symptoms of this new subtype of sliding hiatus hernia were cured by the Nissen fundoplication.

Effects of gustatory stimulants of salivary secretion on salivary pH and flow: a randomized controlled trial

“…Its aetiology is multifactorial, and the various disease causes are grouped according to acid origin in intrinsic and extrinsic (Gandara and Truelove, 1999). Intrinsic causes include oral cavity exposure to gastric acids due to abnormalities in the gastrointestinal tract (Ismail‐Beigi et al , 1970; Eccles, 1978; Pope, 1982; Myllarniemi and Saario, 1985; Pace et al , 2008) or recurrent vomiting as a result of psychological disorders (Hellstrom, 1977; Knewitz and Drisko, 1988). Extrinsic factors include the unusual or abusive consumption of demineralizing acidic foods and beverages (Eccles and Jenkins, 1974; Smith and Knight, 1984; Asher and Read, 1987; Johansson, 2002; Dugmore and Rock, 2004) and some medicines such as aspirin, vitamin C (Eriksson and ngmar‐Mansson, 1986; Meurman and Murtomaa, 1986), iron tonics (James and Parfitt, 1953), acidic oral hygiene products or products with calcium chelators, as well as acidic salivary substitutes and salivary flow stimulants as potential erosive products (Zero, 1996).…”

Buffering effect of antacids in the mouth ‐ a new treatment of dental erosion?

“…Accepted for publication 12 March 1988. Dental erosion is, by definition, a chemical pulsion of gastric contents into the mouth destruction of tooth structure in a process (4,5). Our previous, restalts indicate that which does not involve bacteria (1).…”

The treatment of gastric mucosal prolapse syndrome with laparoscopic Nissen fundoplication

“…GMP has been depicted as a secondary phase of gastroesophageal reflux; it has also been identified as a new subtype of sliding hernia. Therefore, Nissen fundoplication has been found to be a successful means of treating this condition [10].…”

“…Nissen fundoplication [11] has been employed in the surgical treatment of this condition [10]. The goal of this procedure is to improve the competence of the lower esoph- Enderlen [4] Gastroesophageal prolapse at autopsy 1947…”