Epidemiology

The prevalence of hiatal hernia can only be estimated, because most of these hernias cause mild or no symptoms and diagnostic criteria may vary. One study used noncontrast computed tomography (CT) to identify hiatal hernias in a large sample of asymptomatic adults (ages 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 hiatal hernia is closely related to the diagnosis of gastroesophageal reflux disease (GERD), as these two conditions are closely (but not completely) correlated.​​[3][4]​​​​​ The precise incidence of treated cases of GERD in large populations is difficult to verify. According to one meta-analysis, the pooled global prevalence of GERD is about 14%, with significant regional variation.[5]

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

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