The effect of diaphragmatic stressors on recurrent hiatal hernia

G. V. Kakarlapudi, Z. T. Awad, G. Haynatzki, T. Sampson, G. Stroup, C. J. Filipi

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Hiatal disruption is one of the common mechanisms of failure after Nissen fundoplication. We investigated the correlation between various diaphragm stressors and disruption of the diaphragmatic closure. Thirty-seven patients with a hiatal hernia recurrence of 2 cm or greater, as proven by esophagram, endoscopy, or operatie findings, were included. A retrospective analysis was conducted utilizing a standardized diaphragm stressor questionnaire for the study group and a control group of 50 patients without hiatal hernia recurrence. Logistic regression was used to determine the significant predictors of hiatal hernia recurrence. Three predictors emerged in the final model: weight lifting (P < 0.0174), vomiting (P < 0.0313) and hiccoughing (P < 0.2472). Of these, only vomiting and weight lifting were significant. The odds ratio for weight lifting is OR = 3.662 (95% CI: 1.256-10.676), and for vomiting it is OR = 4.938 (95% CI: 1.154-21.126). Vomiting or heavy weight lifting is a significant predictor of hiatal hernia recurrence.

Original languageEnglish (US)
Pages (from-to)163-166
Number of pages4
Issue number4
StatePublished - Dec 2002
Externally publishedYes


  • Diaphragm
  • Hernia
  • Hiatal
  • Recurrence
  • Stress factors

ASJC Scopus subject areas

  • Surgery


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