Background/Aims Achalasia and hiatal hernia are rarely associated. The aim of the current study is to explore the clinical and manometric findings in patients with achalasia and hiatal hernia, and to determine if the presence of a hiatal hernia should influence therapeutic management in patients with achalasia. Methods This retrospective single center analysis included a group of patients with achalasia and hiatal hernia (study group) and a group of matched patients with achalasia but no hiatal hernia (control group). We recorded demographic, clinical, endoscopic, and manometric parameters and compared initial presentation and treatment outcomes between the groups. Results Between 2015 and 2022, achalasia was diagnosed in 294/1513 (19.4%) patients. Concomitant hiatal hernia was identified in 13/294 (4.4%) patients. Compared to patients with achalasia and no hiatal hernia, patients in the study group had lower Eckardt scores at baseline (5.4 ± 2.0 vs 7.8 ± 2.4; P = 0.005) but similar integrated relaxation pressure. Following treatment, patients in the study and control group had similar clinical success and prevalence of gastroesophageal reflux symptoms. Conclusions Hiatal hernia is rarely associated with achalasia. The presence of a hiatal hernia should not influence treatment decisions in patients with achalasia.

中文翻译：

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贲门失弛缓症和食管裂孔疝：罕见的关联和治疗挑战。

背景/目的 贲门失弛缓症和食管裂孔疝很少相关。本研究的目的是探讨贲门失弛缓症和食管裂孔疝患者的临床和测压结果，并确定食管裂孔疝的存在是否会影响贲门失弛缓症患者的治疗管理。方法 这项回顾性单中心分析包括一组贲门失弛缓症和食管裂孔疝患者（研究组）和一组匹配的贲门失弛缓症但无食管裂孔疝患者（对照组）。我们记录了人口统计学、临床、内窥镜和测压参数，并比较了各组之间的初始表现和治疗结果。结果 2015 年至 2022 年间，294/1513 (19.4%) 名患者被诊断为贲门失弛缓症。13/294 (4.4%) 患者中发现伴有食管裂孔疝。与贲门失弛缓症且无食管裂孔疝的患者相比，研究组患者的基线 Eckardt 评分较低（5.4 ± 2.0 vs 7.8 ± 2.4；P = 0.005），但积分松弛压相似。治疗后，研究组和对照组患者的临床成功率和胃食管反流症状的发生率相似。结论 食管裂孔疝很少与贲门失弛缓症相关。食管裂孔疝的存在不应影响贲门失弛缓症患者的治疗决策。