{
  "abstract": "Background/Aims: The Lyon Consensus considers hiatal hernia (HH) as a supportive metric for the diagnosis of gastroesophageal reflux disease (GERD) when evidence is inconclusive; however, HH size is not taken into consideration. We aimed to correlate HH size with conclusive evidence of GERD from multichannel intraluminal impedance and pH monitoring (MII-pH) and upper endoscopy.\n\nMethods: We analyzed a retrospective consecutive cohort of patients with suspected GERD with and without HH on high-resolution manometry who also underwent upper endoscopy and MII-pH monitoring off therapy within a ≤6 month interval. HH was categorized as none, small (<3 cm), medium (3–5 cm), or large (>5 cm). Pathological acid exposure time (AET, >6%), endoscopic GERD findings, and adjunctive MII-pH metrics were compared and correlated between subsets based on the presence and size of HH.\n\nResults: Of the 456 included patients, 337 (73.9%) had HH as follows: small HH, 114; medium HH, 117; and large HH, 106. Pathological AET showed a stepwise increase from 19.3% in the no HH group to 41.2% in the small HH group, 51.3% in the medium HH group, and 83.0% in the large HH group (P < 0.001). The prevalence of erosive esophagitis increased similarly (7.6%, 14.9%, 17.9%, and 43.4%, respectively; P < 0.001). DeMeester score, total reflux episodes (TREs), and mean nocturnal baseline impedance (MNBI) showed similar findings (all P < 0.001), but the prevalence of peptic stricture (P = 0.263) and Barrett’s esophagus did not differ significantly (P = 0.108). HH size correlated positively with AET (rho = 0.49) and TRE (rho = 0.53) and negatively with MNBI (rho = -0.46; all P < 0.001).\n\nConclusions: Evidence for conclusive GERD increases with HH size, supporting its role as a key anatomical marker for GERD assessment using the Lyon Consensus 2.0 criteria.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, Pontificia Universidad Javeriana, Bogotá Dc Colombia",
    "Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá Dc Colombia",
    "Division of Gastroenterology, Hospital Universitario San Ignacio, Bogotá Dc Colombia",
    "Division of Gastroenterology, Washington University School of Medicine St Louis MO USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Juan S. Hernández",
      "orcid": "0000-0002-2614-127X"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Albis C. Hani",
      "orcid": "0000-0002-9219-4548"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Oscar M. Muñoz",
      "orcid": "0000-0001-5401-0018"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Juan P. Garcia",
      "orcid": "0000-0001-8615-2723"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Raúl A. Cañadas",
      "orcid": "0000-0003-2938-7731"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Freddy A. Ávila",
      "orcid": "0000-0003-4270-7146"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Ferney Arias",
      "orcid": "0009-0002-9784-4594"
    },
    {
      "affs": [
        3
      ],
      "name": "C. Prakash Gyawali",
      "orcid": "0000-0002-3388-0660"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1emh5ns2jtbv9.bib",
  "cited_by": 0,
  "doi": "10.5056/jnm26046",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13725379/",
  "id": "1emh5ns2jtbv9",
  "issns": [
    "2093-0879",
    "2093-0887"
  ],
  "landing_url": "https://doi.org/10.5056/jnm26046",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2715|Gastroesophageal reflux and treatments"
    ]
  ],
  "openalex": "W7224201981",
  "pdf_url": "https://www.jnmjournal.org/journal/download_pdf.php?doi=10.5056/jnm26046",
  "pmcid": "PMC13725379",
  "pmid": "42954007",
  "published": "2026-10-31",
  "publisher": "The Korean Society of Neurogastroenterology and Motility",
  "ris": "https://research.draconitic.com/paper/1emh5ns2jtbv9.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T12:23:47Z",
      "native_id": "PMC13725379",
      "source": "pmc",
      "url": "https://doi.org/10.5056/jnm26046"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2715|Gastroesophageal reflux and treatments",
      "subfield": "general"
    }
  ],
  "title": "Hiatal Hernia and Conclusive Gastroesophageal Reflux Disease: Size Matters",
  "title_text": "Hiatal Hernia and Conclusive Gastroesophageal Reflux Disease: Size Matters",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:21:39Z",
  "url": "https://research.draconitic.com/paper/1emh5ns2jtbv9",
  "venue": "Journal of Neurogastroenterology and Motility",
  "versions": []
}