GOALS: To investigate whether there is a relationship between hiatus hernia (HH) and kyphosis or obesity in elderly Japanese persons. BACKGROUND: The causes of HH in the elderly are unclear. STUDY: We enrolled 147 consecutive patients aged over 50 years in this study. Endoscopic assessment of the size of HH was performed by using a modified Makuuchi classification with grades from 1 (no HH) to 4 (>3 cm). The gastroesophageal flap valve (GEFV) was also graded from I to IV. Kyphosis was evaluated from a lateral photograph by measuring the modified Cobb angle (CA) and calculating the kyphosis index (KI). Body mass index (BMI) was used to evaluate obesity. RESULTS: In women, there were significant differences of both the CA (analysis of variance, P<0.0001) and KI (Kruskal-Wallis test, P<0.01) between each grade of HH. Differences of the CA (P<0.001) and KI (P<0.001) were also seen between the grades of GEFV. None of these differences were detected in men. In women, the CA (r=0.556, P<0.0001) and KI (P<0.0001) were positively correlated with age, but this was not so in men. Neither sex showed an association between BMI and the grade of either HH or GEFV. However, there was a weak negative correlation between age and BMI in women (r=-0.223, P<0.05) and men (r=-0.334, P<0.05). CONCLUSIONS: The size of HH is associated with the severity of kyphosis, not with obesity, in elderly Japanese women. Age is a risk factor for both kyphosis and HH.
GOALS: To investigate whether there is a relationship between hiatus hernia (HH) and kyphosis or obesity in elderly Japanese persons. BACKGROUND: The causes of HH in the elderly are unclear. STUDY: We enrolled 147 consecutive patients aged over 50 years in this study. Endoscopic assessment of the size of HH was performed by using a modified Makuuchi classification with grades from 1 (no HH) to 4 (>3 cm). The gastroesophageal flap valve (GEFV) was also graded from I to IV. Kyphosis was evaluated from a lateral photograph by measuring the modified Cobb angle (CA) and calculating the kyphosis index (KI). Body mass index (BMI) was used to evaluate obesity. RESULTS: In women, there were significant differences of both the CA (analysis of variance, P<0.0001) and KI (Kruskal-Wallis test, P<0.01) between each grade of HH. Differences of the CA (P<0.001) and KI (P<0.001) were also seen between the grades of GEFV. None of these differences were detected in men. In women, the CA (r=0.556, P<0.0001) and KI (P<0.0001) were positively correlated with age, but this was not so in men. Neither sex showed an association between BMI and the grade of either HH or GEFV. However, there was a weak negative correlation between age and BMI in women (r=-0.223, P<0.05) and men (r=-0.334, P<0.05). CONCLUSIONS: The size of HH is associated with the severity of kyphosis, not with obesity, in elderly Japanese women. Age is a risk factor for both kyphosis and HH.
Authors: Matthew J Schuchert; Prasad S Adusumilli; Chris C Cook; Christos Colovos; Arman Kilic; Katie S Nason; Joshua P Landreneau; Thomas Zikos; Robert Jack; James D Luketich; Rodney J Landreneau Journal: J Gastrointest Surg Date: 2010-09-08 Impact factor: 3.452