Epidemiology

The prevalence of hiatus hernia can only be estimated, because most of these hernias cause mild or no symptoms and diagnostic criteria may vary. One study used non-contrast computed tomography (CT) to identify hiatal hernias in a large sample of asymptomatic adults (aged 53 to 94 years); they reported a prevalence of 9.9%, but noted CT may be insensitive to small, sliding hernias.[2]​ Higher rates are reported among symptomatic populations. In one retrospective study of patients who had undergone endoscopy at a tertiary care hospital, the prevalence of hiatal hernia was 28.9%.[3]​ The prevalence may be lower in Asian-Americans.[2]

The incidence of symptomatic cases of hiatus hernia is closely related to the diagnosis of gastro-oesophageal reflux disease (GORD), as these two conditions are closely (but not completely) correlated.​​[3][4]​​​​​ The precise incidence of treated cases of GORD in large populations is difficult to verify. According to one meta-analysis, the pooled global prevalence of GORD is about 14%, with significant regional variation.[5]

Among all hiatus hernias, the sliding type (type I) is by far the most common, accounting for 85% to 95% of cases. For para-oesophageal hernias (types II-IV), type III (mixed, para-oesophageal with a sliding component) is the most common.[1][6]

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