{"id":5375,"date":"2025-12-08T21:24:54","date_gmt":"2025-12-09T02:24:54","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&p=5375"},"modified":"2026-01-12T18:38:38","modified_gmt":"2026-01-12T23:38:38","slug":"hiatal-hernia-gerd-and-barretts-esophagus","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/hiatal-hernia-gerd-and-barretts-esophagus\/","title":{"raw":"10p11 Hiatal Hernia, GERD, and Barrett\u2019s Esophagus","rendered":"10p11 Hiatal Hernia, GERD, and Barrett\u2019s Esophagus"},"content":{"raw":"Gastroesophageal Conditions:\u00a0 Hiatal Hernia, GERD, & Barrett\u2019s Esophagus<\/strong>\r\n

Hiatal Hernia<\/strong><\/h1>\r\n
    \r\n \t
  • Definition:<\/strong>\u00a0Part of the stomach protrudes into the\u00a0thoracic cavity<\/strong>\u00a0through the\u00a0hiatus<\/strong>\u00a0(opening in the diaphragm).<\/li>\r\n \t
  • Types:<\/strong>\r\n
      \r\n \t
    • Sliding hiatal hernia:<\/strong>\u00a0The\u00a0gastroesophageal junction<\/strong>\u00a0and part of the stomach slide up into the thoracic cavity, especially when lying down.<\/li>\r\n \t
    • Para-esophageal hernia:<\/strong>\u00a0Part of the stomach forms a\u00a0sac beside the esophagus<\/strong>\u00a0and may get trapped.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t
    • Causes:<\/strong>\u00a0Weakness in the diaphragm, increased\u00a0abdominal pressure<\/strong>\u00a0(e.g., pregnancy).<\/li>\r\n \t
    • Consequences:<\/strong>\u00a0Acid\u00a0reflux<\/strong>\u00a0into the esophagus, leading to\u00a0damage<\/strong>.<\/li>\r\n \t
    • Management:<\/strong>\u00a0Avoid lying down immediately after eating, smaller meals, surgical correction if severe.<\/li>\r\n<\/ul>\r\n

      Gastroesophageal Reflux Disease (GERD)<\/strong><\/h1>\r\n
        \r\n \t
      • Definition:<\/strong>\u00a0Acid reflux\u00a0into the esophagus<\/strong>\u00a0causing\u00a0heartburn<\/strong>.<\/li>\r\n \t
      • Cause:<\/strong>\u00a0Weak\u00a0lower esophageal sphincter (LES)<\/strong>\u00a0or\u00a0excess acid<\/strong>.<\/li>\r\n \t
      • Symptoms:<\/strong>\u00a0Heartburn (30-60 min after eating), cough, chest pain.<\/li>\r\n \t
      • Risks:<\/strong>\u00a0Damage to esophageal lining (erosion<\/strong>,\u00a0fibrosis<\/strong>,\u00a0strictures<\/strong>).<\/li>\r\n \t
      • Complication:<\/strong>\u00a0Barrett\u2019s esophagus<\/strong>\u00a0(metaplasia) \u2014 replacement of squamous cells with\u00a0columnar<\/strong>\u00a0cells, increasing cancer risk.<\/li>\r\n<\/ul>\r\nDiagnosis<\/strong>\r\n
          \r\n \t
        • Imaging:<\/strong>\u00a0Barium swallow, endoscopy.<\/li>\r\n \t
        • pH Monitoring:<\/strong>\u00a0Detects acid levels in the esophagus.<\/li>\r\n \t
        • Manometry:<\/strong>\u00a0Measures LES pressure.<\/li>\r\n<\/ul>\r\nTreatment<\/strong>\r\n
            \r\n \t
          • Lifestyle:\r\n
              \r\n \t
            • Small, frequent meals.<\/li>\r\n \t
            • Avoid caffeine, alcohol, spicy, fatty foods.<\/li>\r\n \t
            • Do not lie down after meals.<\/li>\r\n \t
            • Quit smoking.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t
            • Pharmacologic:\r\n
                \r\n \t
              • Antacids<\/strong>.<\/li>\r\n \t
              • Histamine receptor blockers<\/strong>.<\/li>\r\n \t
              • Proton pump inhibitors (PPIs)<\/strong>.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t
              • Surgical:\r\n
                  \r\n \t
                • Fundoplication to strengthen LES.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n

                  Barrett\u2019s Esophagus<\/strong><\/h1>\r\n
                    \r\n \t
                  • Metaplasia:<\/strong>\u00a0Stratified squamous epithelium replaced with\u00a0simple columnar<\/strong>\u00a0epithelium.<\/li>\r\n \t
                  • Risks:<\/strong>\u00a0Precancerous, potential progression to\u00a0dysplasia<\/strong>\u00a0and\u00a0esophageal adenocarcinoma<\/strong>.<\/li>\r\n \t
                  • Prevalence:<\/strong>\u00a0800,000 Canadians affected; half are unaware.<\/li>\r\n \t
                  • Management:<\/strong>\u00a0Acid suppression, regular surveillance, lifestyle modifications.<\/li>\r\n<\/ul>\r\nVisuals<\/strong>\r\n
                      \r\n \t
                    • Normal vs. damaged esophagus.<\/li>\r\n \t
                    • Damage from chronic reflux shows\u00a0metaplasia<\/strong>\u00a0and\u00a0inflammation<\/strong>.<\/li>\r\n \t
                    • Prevention:<\/strong>\u00a0Healthy weight, smaller meals, avoiding irritants, stopping smoking.<\/li>\r\n<\/ul>","rendered":"

                      Gastroesophageal Conditions:\u00a0 Hiatal Hernia, GERD, & Barrett\u2019s Esophagus<\/strong><\/p>\n

                      Hiatal Hernia<\/strong><\/h1>\n
                        \n
                      • Definition:<\/strong>\u00a0Part of the stomach protrudes into the\u00a0thoracic cavity<\/strong>\u00a0through the\u00a0hiatus<\/strong>\u00a0(opening in the diaphragm).<\/li>\n
                      • Types:<\/strong>\n
                          \n
                        • Sliding hiatal hernia:<\/strong>\u00a0The\u00a0gastroesophageal junction<\/strong>\u00a0and part of the stomach slide up into the thoracic cavity, especially when lying down.<\/li>\n
                        • Para-esophageal hernia:<\/strong>\u00a0Part of the stomach forms a\u00a0sac beside the esophagus<\/strong>\u00a0and may get trapped.<\/li>\n<\/ul>\n<\/li>\n
                        • Causes:<\/strong>\u00a0Weakness in the diaphragm, increased\u00a0abdominal pressure<\/strong>\u00a0(e.g., pregnancy).<\/li>\n
                        • Consequences:<\/strong>\u00a0Acid\u00a0reflux<\/strong>\u00a0into the esophagus, leading to\u00a0damage<\/strong>.<\/li>\n
                        • Management:<\/strong>\u00a0Avoid lying down immediately after eating, smaller meals, surgical correction if severe.<\/li>\n<\/ul>\n

                          Gastroesophageal Reflux Disease (GERD)<\/strong><\/h1>\n
                            \n
                          • Definition:<\/strong>\u00a0Acid reflux\u00a0into the esophagus<\/strong>\u00a0causing\u00a0heartburn<\/strong>.<\/li>\n
                          • Cause:<\/strong>\u00a0Weak\u00a0lower esophageal sphincter (LES)<\/strong>\u00a0or\u00a0excess acid<\/strong>.<\/li>\n
                          • Symptoms:<\/strong>\u00a0Heartburn (30-60 min after eating), cough, chest pain.<\/li>\n
                          • Risks:<\/strong>\u00a0Damage to esophageal lining (erosion<\/strong>,\u00a0fibrosis<\/strong>,\u00a0strictures<\/strong>).<\/li>\n
                          • Complication:<\/strong>\u00a0Barrett\u2019s esophagus<\/strong>\u00a0(metaplasia) \u2014 replacement of squamous cells with\u00a0columnar<\/strong>\u00a0cells, increasing cancer risk.<\/li>\n<\/ul>\n

                            Diagnosis<\/strong><\/p>\n

                              \n
                            • Imaging:<\/strong>\u00a0Barium swallow, endoscopy.<\/li>\n
                            • pH Monitoring:<\/strong>\u00a0Detects acid levels in the esophagus.<\/li>\n
                            • Manometry:<\/strong>\u00a0Measures LES pressure.<\/li>\n<\/ul>\n

                              Treatment<\/strong><\/p>\n

                                \n
                              • Lifestyle:\n
                                  \n
                                • Small, frequent meals.<\/li>\n
                                • Avoid caffeine, alcohol, spicy, fatty foods.<\/li>\n
                                • Do not lie down after meals.<\/li>\n
                                • Quit smoking.<\/li>\n<\/ul>\n<\/li>\n
                                • Pharmacologic:\n
                                    \n
                                  • Antacids<\/strong>.<\/li>\n
                                  • Histamine receptor blockers<\/strong>.<\/li>\n
                                  • Proton pump inhibitors (PPIs)<\/strong>.<\/li>\n<\/ul>\n<\/li>\n
                                  • Surgical:\n
                                      \n
                                    • Fundoplication to strengthen LES.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                                      Barrett\u2019s Esophagus<\/strong><\/h1>\n
                                        \n
                                      • Metaplasia:<\/strong>\u00a0Stratified squamous epithelium replaced with\u00a0simple columnar<\/strong>\u00a0epithelium.<\/li>\n
                                      • Risks:<\/strong>\u00a0Precancerous, potential progression to\u00a0dysplasia<\/strong>\u00a0and\u00a0esophageal adenocarcinoma<\/strong>.<\/li>\n
                                      • Prevalence:<\/strong>\u00a0800,000 Canadians affected; half are unaware.<\/li>\n
                                      • Management:<\/strong>\u00a0Acid suppression, regular surveillance, lifestyle modifications.<\/li>\n<\/ul>\n

                                        Visuals<\/strong><\/p>\n

                                          \n
                                        • Normal vs. damaged esophagus.<\/li>\n
                                        • Damage from chronic reflux shows\u00a0metaplasia<\/strong>\u00a0and\u00a0inflammation<\/strong>.<\/li>\n
                                        • Prevention:<\/strong>\u00a0Healthy weight, smaller meals, avoiding irritants, stopping smoking.<\/li>\n<\/ul>\n","protected":false},"author":1370,"menu_order":14,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-5375","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":67,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5375","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":2,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5375\/revisions"}],"predecessor-version":[{"id":5377,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5375\/revisions\/5377"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/67"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/5375\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=5375"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=5375"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=5375"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=5375"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}