Maximal acid output and oesophagitis in hiatus hernia.

It has been suggested (Casten, Bernhang, Nach, and Spinzia, 1963) that patients with symptomatic sliding hiatus hernia have a higher acid output than the normal patient, but this has recently been disputed by Williams, Lawrie, and Forrest (1967). These latter workers found that there is no significant increase in maximal acid output in patients with sliding hiatus hernia. Aylwin (1953) demonstrated a correlation between the degree of oesophagitis in sliding hiatus hernia and the enzyme activity of juices bathing the oesophagus at night, and suggested that this was the chief factor in the production of oesophagitis. In this study patients with hiatus hernia were investigated to see if there was any correlation between the degree of oesophagitis and the maximal acid output. The maximal acid output in patients with hiatus hernia was found not to differ significantly from normal, and the degree of oesophagitis in the patients with oesophageal reflux was not closely related to the maximal acid output.