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Pathophysiology

Contributing factors:

 Weight lifting
 Strenuous activity
 Constipation
 Pregnancy
 Tightening of clothes around abdomen

Permanent shortening of the esophagus Gastro-esophageal junction displacement

Reflux and regurgitation of stomach acid Decrease lower esophageal (LEL) pressure

Inflammation and scarring of esophagus Incompetent gastro-esophageal sphincter

Shortening of esophagus Large opening of esophageal hiatus

Stomach herniates through the hiatus into the chest

Clinical Manifestation

(Hearburn, Chestpain)

Hiatal hernia

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