Journal of Neurogastroenterology and Motility 2020; 26(1): 4-5
Find Out the Differences by Types of Hiatal Hernia!
Ra Ri Cha
Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Changwon, Gyeongsangnam-do, Korea
Correspondence to: Ra Ri Cha, MD
Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, 11 Samjeongja-ro, Seongsan-gu, Changwon, Gyeongsangnam-do 51472, Korea
Tel: +82-55-214-3715, Fax: +82-55-214-3250, E-mail:
Received: December 3, 2019; Accepted: December 8, 2019; Published online: January 30, 2020
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Hiatal hernia is a status that some upper part of the stomach bulges up into the thorax through that opening.1 It is known as hiatal hernia is asymptomatic. However, hiatal hernia may allow gastric contents to reflux into the distal esophagus more easily, is closely related with gastroesophageal reflux disease development and aggravation.2

Traditionally, hiatal hernias is divided into 2 types: sliding and paraesophageal hernia. In a sliding hiatal hernia, the stomach and the section of the esophagus that joins the stomach slide up into the chest through the hiatus. This is the more common type of hernia. The paraesophageal hernia is less common, but is more cause for concern. The esophagus and stomach stay in their normal locations, but part of the stomach squeezes through the hiatus, landing it next to the esophagus.

Mittal et al3 divided the hiatal hernia to 3 types, type 1 (sliding hiatal hernia) is when the esophagogastric junction (EGJ) and stomach is located above the diaphragmatic hiatus and the EGJ is located above the gastric fundus, type 2 (paraesophageal hiatal hernia) is when the EGJ is located at or below the level of diaphragmatic hiatus and part of the stomach alongside the esophagus (> 2 cm), above the diaphragm. Type 3 (mixed, sliding, and paraesophageal hiatal hernia) is the EGJ and stomach is located above the diaphragm and 2 cm or more of the fundus is located cephalad to the lower esophageal sphincter and esophagus.3

Hiatal hernia types were compared with the data of clinical basic characteristics, high-resolution manometry (HRM) findings, and CT findings. The results of CT scan images gave the anatomical differences, of HRM findings and HRM findings show the functional differences, even the clinical data did not provide the different results.

Although this article is not a masterpiece of research in this research field, it suggests a new scientific approach methodology to hiatal hernia with gastroesophageal reflux disease studies and is expected to serve as a flint for future research.


Financial support: None.

Conflicts of interest: None.

  1. Liao D, Lottrup C, Fynne L, et al. Axial movements and length changes of the human lower esophageal sphincter during respiration and distension-induced secondary peristalsis using functional luminal imaging probe. J Neurogastroenterol Motil 2018;24:255-267.
    Pubmed KoreaMed CrossRef
  2. Rerych K, Kurek J, Klimacka-Nawrot E, Błońska-Fajfrowska B, Stadnicki A. High-resolution manometry in patients with gastroesophageal reflux disease before and after fundoplication. J Neurogastroenterol Motil 2017;23:55-63.
    Pubmed KoreaMed CrossRef
  3. Kumar D, Zifan A, Ghahremani G, Kunkel DC, Horgan S, Mittal RK. Morphology of the esophageal hiatus: is it different in 3 types of hiatus hernias?. J Neurogastroenterol Motil 2020;26:51-60.
    Pubmed CrossRef

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