Large hiatal hernia in patients with iron deficiency anaemia: a prospective study on prevalence and treatment
Open Access
- 11 March 2004
- journal article
- clinical trial
- Published by Wiley in Alimentary Pharmacology & Therapeutics
- Vol. 19 (6), 663-670
- https://doi.org/10.1111/j.1365-2036.2004.01894.x
Abstract
Background : Although large hiatal hernia may cause bleeding from Cameron erosions, its role in iron deficiency anaemia has been debated, and no data are available on the treatment of these patients with proton pump inhibitors. Aims : To determine the prevalence of large hiatal hernia in out‐patients with iron deficiency anaemia and the role of proton pump inhibitors in the prevention of recurrence of anaemia. Methods : Two hundred and twenty‐eight out‐patients underwent upper/lower endoscopy. Those with large hiatal hernia were given an oesophagogram, discontinued iron supplementation and received proton pump inhibitor treatment with (group 1) or without (group 2) surgery. Anaemia was re‐assessed during 1 year of follow‐up. Results : Large hiatal hernia was the likely cause of anaemia in 21 patients (9.2%). The median haemoglobin and ferritin values at the diagnosis of anaemia were 7.9 g/dL and 6 µg/L, respectively. Cameron erosions were found in 33% of patients. Ten and eleven patients were included in groups 1 and 2, respectively. Haemoglobin values were 13.8 g/dL and 13.4 g/dL at 3 months of follow‐up, and 13.4 g/dL and 13.8 g/dL at 1 year of follow‐up, in groups 1 and 2, respectively. Conclusions : Large hiatal hernia may cause iron deficiency anaemia, even without Cameron erosions. Surgery in combination with proton pump inhibitor therapy is no better than proton pump inhibitor therapy alone in preventing the recurrence of anaemia.This publication has 23 references indexed in Scilit:
- Guidelines for the management of iron deficiency anaemiaGut, 2000
- Cure of Helicobacter pylori infection in atrophic body gastritis patients does not improve mucosal atrophy but reduces hypergastrinemia and its related effects on body ECL‐cell hyperplasiaAlimentary Pharmacology & Therapeutics, 2000
- Disorders of Iron MetabolismThe New England Journal of Medicine, 1999
- Iron absorption in patients with Zollinger–Ellison syndrome treated with long‐term gastric acid antisecretory therapyAlimentary Pharmacology & Therapeutics, 1998
- Prospective evaluation of gastrointestinal tract in patients with iron-deficiency anemiaDigestive Diseases and Sciences, 1995
- Evaluation of the Gastrointestinal Tract in Patients with Iron-Deficiency AnemiaThe New England Journal of Medicine, 1993
- Gluten, major histocompatibility complex, and the small intestineGastroenterology, 1992
- Healing and relapse of severe peptic esophagitis after treatment with omeprazoleGastroenterology, 1988
- You see what you look forGastroenterology, 1986
- Anaemia and hiatus hernia: experience in 450 patients.Thorax, 1967