Small hiatal hernias: clinical manifestations, sleep disorders and quality of life
https://doi.org/10.31146/1682-8658-ecg-200-4-59-64
Abstract
Purpose of the study: to identify the features of clinical manifestation, sleep disorders and quality of life in patients with small hiatal hernias in gastroesophageal (GER) and duodenogastroesophageal refl ux (DGER).
Materials and methods. 120 patients with small (1–2 degrees) hiatal hernias and grade I–III refl ux esophagitis on the basis of predominantly GER (35 people) and DGER (85 people) refl ux were examined. Sleep disorders were assessed using the Yu. A. Aleksandrovsky scale, violations of the quality of life — the KSC RAMS questionnaire.
Results. Small hiatal hernias in all cases occur with a pronounced refl ux syndrome in the form of combination of esophageal and extraesophageal manifestations, developing both on the basis of GER and DGER. Esophageal manifestations of refl ux syndrome predominate in the presence of DHER and are combined with biliary dyspepsia. Extraesophageal manifestations do not depend on the type of refl ux. Dyssomnia was noted in every second patient with hiatal hernia, primarily presomnic and intrasomnic disorders, which were most pronounced in patients with GER. In the majority of patients with small hiatal hernias, the main reasons for the decrease in the quality of life, regardless of the type of refl ux into the esophagus, were the need for treatment, adherence to a diet, instrumental studies, and restriction of physical activity.
About the Authors
G. S. Dzhulay
Tver State Medical University
Russian Federation
Russian Federation
Galina S. Dzhulay, MD, PhD, Head of the Department of Faculty Therapy
4, Sovetskaya St., Tver, 170100
I. A. Zyabreva
Tver State Medical University
Russian Federation
Russian Federation
Irina A. Zyabreva, PhD, Assistant of the Department of Faculty Therapy
4, Sovetskaya St., Tver, 170100
E. P. Dulneva
Tver State Medical University
Russian Federation
Russian Federation
Elizaveta P. Dulneva, Assistant of the Department of Faculty Therapy
4, Sovetskaya St., Tver, 170100
References
1. Puchkov K.V., Filimonov V. B. Hiatal hernias. Moscow. Medpraktika- M Publ., 2003, 172 P. (in Russ.)
2. Vostryakova T.V., Shleikova E. N., Pyshkin S. A. Th e frequency of detection of a hiatal hernia. Experimental and Clinical Gastroenterology. 2014; (11): 94. (in Russ.)
3. Yu H.X., Han C. S., Xue J. R., Han Z. F., Xin H. Esophageal hiatal hernia: risk, diagnosis and management. Expert Rev. Gastroenterol. Hepatol. 2018; 12 (4): 319–329. doi: 10.1080/17474124.2018.1441711
4. Vasilevsky D.I., Smirnov A. A. Diagnostics and surgical treatment of hiatal hernias. Experimental and Clinical Gastroenterology. 2017; 140 (4): 92–94. (in Russ.)
5. Coch O.O., KOhler G., Antoniou S. A., Pointer R. Diagnosis and surgical therapy of hiatal hernia. Zentralbl. Chir. 2014; 139 (4): 393–398. doi: 10.1055/s-0033–1360294
6. Stanak M., Erdos J., Hawlik K., Birsan T. Novel surgical treatments for gastroesophageal refl ux disease: systematic review of magnetic sphincter augmentation and electric stimulation therapy. Gastroenterology Res. 2018; 11 (3): 161–173. doi: 10.14740/gr1024w
7. Takeuchi T., Oota K., Yarada S., et al. Characteristics of refractory gastroesophageal refl ux disease (GERD) symptoms – is switching proton pump inhibitors based on the patient's CYP2C19 genotype an eff ective management strategy? Intern. Med. 2015; 54 (2): 97–105. doi: 10.2169/internalmedicine.54.3412
8. Kunseh S., Neesse A., Linhart T., Nell C., Gress T. M., Ellenrieder V. Prospective evaluation of duodenogastroesophageal refl ux in gastroesophageal refl ux disease patients refractory to proton pump inhibitor therapy. Digestion. 2012; 86 (4): 315–322. doi: 10.1159/000342234
9. Maev I.V., Gulenchenko Yu.S., Andreev D. N., Kazyulin A. N., Dicheva D. T. Duodenogastroesophageal refl ux: clinical signifi cance and approaches to therapy. Consilium Medicum. 2014; 16 (8): 5–8. (in Russ.)
10. Маев И. В., Гуленченко Ю. С., Андреев Д. Н., Казюлин А. Н., Дичева Д. Т. Дуоденогастроэзофагеальный рефлюкс: клиническое значение и подходы к терапии. Consilium Medicum. 2014; 16 (8): 5–8.
11. Lundell L. Borderline indication and selection of gastroesophageal refl ux disease patients: «Is surgery better than medical therapy?». Dig. Dis. 2014; 32 (1–2): 152–155. doi: 10.1159/000357182
12. Kashkina E.I., Lyakisheva R. V. Violations of the sleep-wake cycle as a criterion for predicting the next exacerbation of gastroesophageal refl ux disease. Saratov Journal of Medical Scientifi c Research. 2009; 5 (3): 355–357. (in Russ.)
13. Hung J.S., Lei W. Y., Yi C. H., Liu T. T., Chen C. L. Asso ciation between nocturnal acid refl ux and sleep disturbance in patients with gastroesophageal refl ux disease. Am. J. Med. Sci. 2016; 352 (2): 141–145. doi: 10.1016/j.amjms.2016.05.017
14. Iwakura N., Fujiwara Y., Shiba M., et al. Characteristics of sleep disturbances in patients with gastroesophageal refl ux disease. Intern. Med. 2016; 55 (12): 1511–1517. doi: 10.2169/internalmedicine.55.5454
15. Dronova O.B., Mironchev O. A. Anatomical and endoscopic features of the gastroesophageal junction and their clinical signifi cance. Reconstructive and plastic surgery issues. 2007; 3–4: 40–42. (in Russ.)
16. Styazhkina S.N., Galimova A. R., Bannikova V. A. Features of diagnosis and treatment of patients with hiatal hernia. Modern trends in the development of science and technology. 2016; 4–2: 100–103. (in Russ.)
Review
For citations:
Dzhulay G.S., Zyabreva I.A., Dulneva E.P. Small hiatal hernias: clinical manifestations, sleep disorders and quality of life. Experimental and Clinical Gastroenterology. 2022;(4):59-64. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-200-4-59-64
Views:
204
Email this article 