{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T21:32:57Z","timestamp":1771536777135,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2006,2,27]],"date-time":"2006-02-27T00:00:00Z","timestamp":1140998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2006,3]]},"abstract":"<jats:sec><jats:title>Summary<\/jats:title><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Proximal acid reflux is common in gastro\u2010oesophageal reflux disease and is a determinant of symptoms. Patients with hiatal hernia complain of more symptoms than those without and are less responsive to proton\u2010pump inhibitors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the role of hiatal hernia on spatiotemporal characteristics of acid reflux.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty seven consecutive gastro\u2010oesophageal reflux disease patients underwent endoscopy, videofluoroscopy, manometry and multichannel 24\u2010h pH test. Data were compared with those of 15 asymptomatic controls. Multivariate linear regression was used for statistical analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At videofluoroscopy, hiatal hernia was found in 16 of 37 patients. The mean size of hiatal hernia was 3.4\u2003cm. Patients showed significantly prolonged acid clearance time, both at proximal and distal oesophagus, compared with controls. Hiatal hernia patients showed a significantly delayed acid clearance, along the oesophageal body, compared with non\u2010hiatal hernia patients. The prolonged acid exposure was maintained during upright and supine position. The presence of hiatal hernia significantly predicted acid clearance delay in the distal and proximal oesophagus [at 10\u2003cm below upper oesophageal sphincter: \u0394\u2003+\u20032.5\u2003min (95% confidence interval: 0.4\u20134.5); <jats:italic>P<\/jats:italic>\u2003&lt;\u20030.02].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The presence of hiatal hernia is a strong predictor of more prolonged proximal oesophageal acid exposure and clearance. Hiatal hernia is likely to play a role in the pathophysiology of gastro\u2010oesophageal reflux disease symptoms, and should be taken into greater consideration in the treatment strategies of the disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2036.2006.02816.x","type":"journal-article","created":{"date-parts":[[2006,2,27]],"date-time":"2006-02-27T17:05:56Z","timestamp":1141059956000},"page":"751-757","source":"Crossref","is-referenced-by-count":38,"title":["Effect of hiatal hernia on proximal oesophageal acid clearance in gastro\u2010oesophageal reflux disease patients"],"prefix":"10.1111","volume":"23","author":[{"given":"S.","family":"EMERENZIANI","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. 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