Abou Khalil Michel, Hamadeh Khalil, Fakhry Mario, Chebly Elissa, Riachy Moussa, Eid Hind, Aoun Bacha Zeina
Faculty of Medicine, Saint Joseph University, Beirut 1107-2180, Lebanon.
Department of Pulmonary and Critical Care Medicine, Hotel Dieu de France, Saint Joseph University, Beirut 1107-2180, Lebanon.
Med Int (Lond). 2024 Dec 2;5(1):10. doi: 10.3892/mi.2024.209. eCollection 2025 Jan-Feb.
Hiatal Hernia (HH) and gastroesophageal reflux disease (GERD) have been found to be associated with respiratory conditions, such as pulmonary fibrosis. However, their association with asthma remains ambiguous. Thus, the present cross-sectional, retrospective, monocentric study aimed to investigate the prevalence of asthma among patients with HH, evaluate its severity in these patients, and screen for associated respiratory symptoms. Additionally, the present study explored the association between the prevalence of asthma and various parameters, including sex, GERD medications and symptoms. For this purpose, a retrospective study, conducted at one central university medical center from January, 2020 to May, 2023, included patients with HH identified on a computed tomography scan. Patients were contacted and evaluated using structured questionnaires. Asthma-free patients underwent assessment for respiratory symptoms indicative of asthma using a validated questionnaire from the European Community Respiratory Health Survey. In patients with asthma, disease severity was assessed using the Global Initiative for Asthma symptom control criteria. The results revealed that out of 17,374 scans, 1,308 (7.53%) were positive for HH. Among the 453 cases eligible for analysis in the present study, 67 (14.79%) were diagnosed with asthma, of which 28 (41.79%) were diagnosed with uncontrolled asthma. Among the asthma-free patients, 136 (35.23%) reported at least one unspecified respiratory symptom. In the patients with HH, sex and GERD exhibited showed no association with asthma (P=0.07 and P=0.11, respectively). However, patients taking GERD medications exhibited a higher prevalence of asthma (P=0.03). On the whole, the present study demonstrates that the prevalence of asthma in patients with HH appears to be elevated. Hence, an ambivalence arises as regards the presence of a HH potentially associated with poorly controlled asthma and GERD medication potentially exacerbating asthma.
食管裂孔疝（HH）与胃食管反流病（GERD）已被发现与呼吸系统疾病相关，如肺纤维化。然而，它们与哮喘的关联仍不明确。因此，本横断面、回顾性、单中心研究旨在调查HH患者中哮喘的患病率，评估这些患者中哮喘的严重程度，并筛查相关的呼吸道症状。此外，本研究还探讨了哮喘患病率与各种参数之间的关联，包括性别、GERD药物和症状。为此，在一所中央大学医学中心于2020年1月至2023年5月进行的一项回顾性研究纳入了通过计算机断层扫描确定的HH患者。通过结构化问卷对患者进行联系和评估。无哮喘患者使用来自欧洲共同体呼吸健康调查的经过验证的问卷接受哮喘指示性呼吸道症状的评估。对于哮喘患者，使用全球哮喘防治创议症状控制标准评估疾病严重程度。结果显示，在17374次扫描中，1308次（7.53%）HH呈阳性。在本研究中符合分析条件的453例病例中，67例（14.79%）被诊断为哮喘，其中28例（41.79%）被诊断为未控制的哮喘。在无哮喘患者中，136例（35.23%）报告至少有一种未明确的呼吸道症状。在HH患者中，性别和GERD与哮喘均无关联（P分别为0.07和0.11）。然而，服用GERD药物的患者哮喘患病率更高（P=0.03）。总体而言，本研究表明HH患者中哮喘的患病率似乎有所升高。因此，对于可能与哮喘控制不佳相关的HH的存在以及可能加重哮喘的GERD药物的使用存在矛盾之处。
