Diagnostic and therapeutic strategies for hiatal hernia with dysphagia: Etiology-based classification and individualized treatment

doi:10.3877/cma.j.issn.1674-392X.2026.03.020

Abstract

Abstract:

Dysphagia is an important and complex manifestation of hiatal hernia and is not always caused by simple mechanical obstruction. It may also be related to esophageal motility disorders, reflux-related inflammatory strictures, esophageal diverticula, and connective tissue diseases. Based on the relevant literature and clinical practice, this article reviews the etiological mechanisms of hiatal hernia complicated by dysphagia, mainly summarizes the roles of gastroscopy, upper gastrointestinal contrast study, high-resolution esophageal manometry, 24-hour pH-impedance monitoring, and esophagogastric junction filling ultrasound contrast imaging in the integrated assessment of structure and function, and outlines etiology-oriented treatment strategies. We believe that for such patients, individualized management should be guided by accurate identification of the dominant mechanism so as to reasonably optimize the indications for dilation, anti-reflux therapy, hiatal hernia repair, and related functional procedures, thereby improving dysphagia and overall prognosis.

Key words: Hernia, hiatal, Dysphagia, Esophageal motility disorders, High-resolution esophageal manometry, Individualized treatment

Xingyu Wu, Haifeng Han, Jinghui Lu. Diagnostic and therapeutic strategies for hiatal hernia with dysphagia: Etiology-based classification and individualized treatment[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2026, 20(03): 351-356.

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References 33

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