Hiatal incompetence and gastro-oesophageal reflux.

Gastro-oesophageal reflux and hiatal incompetence were analysed in 191 patients using a new radiographic contrast medium, polyiodostyrene, with the same density (1.0 g/cm3) as ordinary gastric contents, and correlated with supplementary oesophagoscopy and intraluminal pressure measurements. A normal hiatus seems to be an important protection against gastro-oesophageal reflux. An incompetent hiatus involves a real risk for oesophagitis. A low-density, low-viscosity contrast medium improves the roentgenologic diagnosis of gastro-oesophageal reflux.