Gastro-oesophageal reflux disease - Hiatus hernia Factor
General information
More than half the elderly population of the western world would have some degree of hiatus hernia if submitted to a barium meal examination. Most (greater than 85%) hiatal hernias are of the sliding type. The lower oesophageal sphincter and a portion of the stomach in the sliding type of hiatal hernia moves into the chest, above the diaphragmatic hiatus.
Establishing the presence of an hiatus hernia
Most patients are asymptomatic unless the hernia becomes incarcerated or strangulated in which case there is acute chest pain, dysphagia and a mediastinal mass, requiring prompt operative treatment.
The presence of an hiatus hernia is demonstrated by radiography or endoscopy. However, doctors' and hospitals' records may have been destroyed or can no longer be obtained.
Therefore, a statement that an hiatus hernia was demonstrated at a particular time will generally be accepted, unless there is contradictory evidence. You may wish to seek medical advice.
Last reviewed for CCPS 18 July 2005.
Preliminary questions [6484]
6539 the veteran has had hiatus hernia at some time.
32357 the veteran has established the causal connection between the hiatus hernia and VEA service for gastro-oesophageal reflux disease.
6541 the veteran had a hiatus hernia at the time of the clinical onset of the condition under consideration.
6540 the veteran has established the causal connection between the hiatus hernia and VEA service for the clinical onset of gastro-oesophageal reflux disease.
6545 the veteran has established the causal connection between the hiatus hernia and operational service for the clinical onset of gastro-oesophageal reflux disease.
or
6546 the veteran has established the causal connection between the hiatus hernia and eligible service for the clinical onset of gastro-oesophageal reflux disease.
or
7334 the clinical onset of the condition under consideration occurred after the end of the veteran's last period of VEA service.
7335 the condition under consideration permanently worsened.
32358 the veteran had a hiatus hernia at the time of the clinical worsening of the condition under consideration.
32359 the veteran has established the causal connection between the hiatus hernia and VEA service for the clinical worsening of gastro-oesophageal reflux disease.
32360 the veteran has established the causal connection between the hiatus hernia and operational service for the clinical worsening of gastro-oesophageal reflux disease.
or
32362 the veteran has established the causal connection between the hiatus hernia and eligible service for the clinical worsening of gastro-oesophageal reflux disease.
Clinical onset and operational service [6545]
6549 the hiatus hernia is causally related to operational service.
Clinical onset and eligible service [6546]
6550 the hiatus hernia is causally related to eligible service.
Clinical worsening and operational service [32360]
6549 the hiatus hernia is causally related to operational service.
32363 the clinical onset of the condition under consideration occurred prior to that part of operational service to which the hiatus hernia is causally related.
Clinical worsening and eligible service [32362]
6550 the hiatus hernia is causally related to eligible service.
32364 the clinical onset of the condition under consideration occurred prior to that part of eligible service to which the hiatus hernia is causally related.