World Journal of Advanced Research and Reviews, 2020, 05(03), 163–169 World Journal of Advanced Research and Reviews e-ISSN: 2581-9615, Cross Ref DOI: 10.30574/wjarr Journal homepage: https://www.wjarr.com  Corresponding author: Ray-Offor Emeka Copyright © 2020 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0. (R ESEARCH A RTICLE ) Hiatus hernia and erosive oesophagitis at endoscopy in Nigerian patients Ray-Offor Emeka 1, 2, * and Falase Bode 3 1 Digestive Disease Unit, Oak Endoscopy Centre Port Harcourt, Rivers State, Nigeria. 2 Department of Surgery, University of Port Harcourt Teaching Hospital Port Harcourt, Rivers State, Nigeria. 3 Cardio-Thoracic Surgery Division, Department of Surgery, Lagos State University Teaching Hospital Ikeja, Lagos State, Nigeria. Publication history: Received on 17 March 2020; revised on 26 March 2020; accepted on 28 March 2020 Article DOI: https://doi.org/10.30574/wjarr.2020.5.3.0066 Abstract Hiatus hernia is an extramural factor in the integrity of the lower oesophageal sphincter (LOS) complex. An incompetence of this complex is the crux in pathogenesis of gastroesophageal reflux disease. This paper aims to study hiatus hernia and its association with erosive oesophagitis in Nigerian patients. It is a cross-sectional and retrospective study of patients undergoing upper gastrointestinal (GI) endoscopy with diagnosis of hiatus hernia made at a referral endoscopy facility located in Port Harcourt metropolis, Niger delta region of Nigeria, from February 2014 to September 2019. The variables collated included demographics, presence/severity of hiatus hernia, and oesophagitis. Statistical analysis was performed using SPSS version 21. A total of 442 upper GI endoscopies were performed with 89 patients included in the study. The age range of study patients was from 11 years to 88 years; mean age of 50.4 ± 18.5 years. Of these, 49 (55.1%) were females and 40 (44.9%) males. Erosive oesophagitis was seen in 19 (21.3%) cases. The age of patients in study population was statistically significant for the size of hernia (p value = 0.027). Two (0.5%) cases of short segment Barret’s oesophagus with low grade dysplasia were recorded and no paraoesophageal hernia seen. Erosive oesophagitis and increasing size of hiatus hernia are common with aging. Barret’s oesophagus and paraoesophageal hernia are rare. Keywords: Hiatus hernia; Erosive oesophagitis; Endoscopy 1. Introduction The earliest report from world literature on hiatus hernia (HH) was published in mid-nineteenth century and diagnosis by x-ray was made years later [1]. Clinical estimations report that approximately 50-60% of patients over the age of 50 years suffer from hiatus hernia [2]. However, hiatus hernia is reported as a rarity in Africans [3]. In Nigeria, an earlier prevalence report of 0.39% for hiatus hernia was made using barium meal [4]. More recently, endoscopy-based studies on prevalence of hiatus hernia from symptomatic patients report 3.3% to 28.0% however marred by uniformity in method of diagnosis [5, 6]. Hiatus hernia is closely related to reflux disease. Gastro-oesophageal reflux disease (GORD) is a condition which develops when the reflux of stomach contents causes troubling symptoms and/or complications [7]. The prevalence of GORD ranges from 2.5% to 7.8% in East Asia, 8.8% to 25.9% in Europe, 8.7% to 33.1% in the Middle East, 11.6% in Australia, 23.0% in South America and 18.1% to 27.8% in North America [8]. Hiatus hernia may be congenital or acquired; the acquired variety being either traumatic or non-traumatic in origin. Acquired non-traumatic hernias are typically classified into four subtypes: sliding - type I (90-95%) and paraoesophageal -type II. The mixed type with coexisting features of sliding and paraoesophageal hernia observed as type III and type IV as hiatal hernia associated with short esophagus [9]. Hiatus hernia reduces lower oesophageal sphincter length and pressure while impairing the augmenting effects of the diaphragmatic crus. Also, it is associated with decrease in oesophageal peristalsis, an increase in cross-sectional area of the gastroesophageal junction (GOJ), and