Clinical Relevance: Disorders of the Stomach
Gastro-Oesophageal Reflux Disease
This is a digestive disorder affecting the lower oesophageal sphincter. It refers to the movement of gastric acid and food into the oesophagus.
GORD is a common condition, affecting 5-7% of the population. Symptoms include dyspepsia, dysphagia, and an unpleasant sour taste in the mouth.
There are three main causes of reflux disease:
- Dysfunction of the lower oesophageal sphincter
- Delayed gastric emptying
- Hiatal hernia (see below)
Treatment involves lifestyle changes, medication such as a PPI to reduce stomach acid, and as a last resort, surgery.
Hiatus Hernia
A hiatus hernia occurs when a part of the stomach protrudes into the chest through the oesophageal hiatus in the diaphragm. There are two main types of hiatal hernias; sliding and rolling:
- Sliding hiatus hernia – The lower oesophageal sphincter slides superiorly. Reflux is a common complication, as the diaphragm is no longer reinforcing the sphincter.
- Rolling Hiatus Hernia – The lower oesophageal sphincter remains in place, but a part of the stomach herniates into the chest next to it. This type of hiatus hernia is more likely to require surgical correction to prevent strangulation of the herniated pouch.
By TeachMeSeries Ltd (2023)
Fig 6 – Classifications of hiatus hernias. is the normal anatomy, B is a pre-stage, C is a sliding hiatal hernia, and D is a rolling type.