Table 1: Basic demographic data of obese patients. (n=690)
Study Data
|
N (%)
|
Age group
|
|
|
182 (26.4%)
|
|
234 (33.9%)
|
|
155 (22.5%)
|
|
119 (17.2%)
|
Gender
|
|
|
296 (42.9%)
|
|
394 (57.1%)
|
Nationality
|
|
|
686 (99.4%)
|
|
04 (0.60%)
|
BMI Level
|
|
|
146 (21.2%)
|
|
373 (54.1%)
|
|
171 (24.8%)
|
Use of PPI
|
|
|
12 (01.7%)
|
|
678 (98.3%)
|
The data from a total of 690 obese patients who had upper gastrointestinal screening from January 2017 to December 2019 were analyzed. Table 1 presents the basic demographic characteristics of our patients. The range of patients’ age was from 15 to 63 years old (mean: 33.9) with 26 – 35 years being the most common age group (33.9%). Females were slightly more prevalent (57.1%) than women (42.9%). Furthermore, nearly all patients were Saudis (99.4%). More than half of them (54.1%) were classified as morbidly obese. In addition, only 1.7% were using PPI medications.
Figure 1 shows the prevalence of HH among obese patients. The prevalence of HH among obese patients was 14.9% while the majority were negative from HH (85.1%).
In figure 2, the most commonly known symptom related to HH was nausea (15.7%) followed by vomiting and abdominal pain (both 15.5%, each respectively) while shortness of breath was the least frequent complaint (0.7%).
Figure 3 presents chronic diseases associated with obese patients. The most frequently cited chronic disease was diabetes (14.3%) followed by hypothyroidism (9.1%) and finally hypertension and asthma (both at 7% each, respectively).
Table 2: Relationship between HH among the basic demographic and associated diseases of obese patients and the symptoms related to HH. (n=690)
Factor
|
Hiatal Hernia
|
X2
|
P-value §
|
Present
N (%)
(n=103)
|
Absent
N (%)
(n=587)
|
Age group
|
|
|
|
|
|
66 (64.1%)
|
350 (59.6%)
|
0.726
|
0.394
|
|
37 (35.9%)
|
237 (40.4%)
|
Gender
|
|
|
|
|
|
50 (48.5%)
|
246 (41.9%)
|
1.575
|
0.209
|
|
53 (51.5%)
|
341 (58.1%)
|
Nationality
|
|
|
|
|
|
103 (100%)
|
583 (99.3%)
|
0.706
|
0.401
|
|
0
|
04 (0.70%)
|
BMI Level
|
|
|
|
|
|
24 (23.3%)
|
122 (20.8%)
|
2.126
|
0.345
|
|
49 (47.6%)
|
324 (55.2%)
|
|
30 (29.1%)
|
141 (24.0%)
|
Use of PPI
|
|
|
|
|
|
05 (04.9%)
|
07 (01.2%)
|
6.876
|
0.009 **
|
|
98 (95.1%)
|
580 (98.8%)
|
Chronic diseases *
|
|
|
|
|
|
04 (03.9%)
|
44 (07.5%)
|
1.766
|
0.184
|
|
09 (08.7%)
|
90 (15.3%)
|
3.101
|
0.078
|
|
04 (03.9%)
|
44 (07.5%)
|
1.766
|
0.184
|
|
07 (06.8%)
|
56 (09.5%)
|
0.795
|
0.373
|
Symptoms of Hiatal Hernia *
|
|
|
|
|
|
14 (13.6%)
|
68 (11.6%)
|
0.337
|
0.561
|
|
07 (06.8%)
|
21 (03.6%)
|
2.332
|
0.127
|
|
07 (06.8%)
|
21 (03.6%)
|
2.332
|
0.127
|
|
23 (22.3%)
|
86 (14.7%)
|
3.885
|
0.049 **
|
|
03 (02.9%)
|
02 (0.30%)
|
8.057
|
0.005 **
|
|
23 (22.3%)
|
84 (14.3%)
|
4.302
|
0.038 **
|
|
23 (22.3%)
|
85 (14.5%)
|
4.090
|
0.043 **
|
|
02 (01.9%)
|
02 (0.30%)
|
3.897
|
0.048 **
|
* Variable with multiple responses.
§ P-value has been calculated using Chi square test.
** Significant at p<0.05 level.
Chi-square tests were conducted in Table 2 to determine the relationship between HH among the basic demographic data, chronic diseases, and symptoms related to HH. The results show that the use of PPI (X2=6.876; p=0.009) and abdominal pain (X2=3.885; p=0.049), shortness of breath (X2=8.057; p=0.005), vomiting (X2=4.302; p=0.038), nausea (X2=4.090; p=0.043) and other HH symptoms (X2=3.897; p=0.048) have a significant relationship with the presence HH.
Table 3: Multivariate regression analysis to detect the independent significant predictor associated with hiatal hernia. (n=690)
Factor
|
AOR
|
95% CI
|
P-value
|
Use of PPI
|
|
|
|
|
0.237
|
0.074 – 0.760
|
0.023 **
|
|
Ref
|
|
|
Abdominal pain
|
|
|
|
|
1.587
|
0.920 – 2.739
|
0.097
|
|
Ref
|
|
|
Shortness of breath
|
|
|
|
|
4.987
|
0.739 – 33.664
|
0.099
|
|
Ref
|
|
|
Vomiting
|
|
|
|
|
1.722
|
1.025 – 2.890
|
0.040 **
|
|
Ref
|
|
|
Nausea
|
|
|
|
|
1.698
|
1.012 – 2.849
|
0.045 **
|
|
Ref
|
|
|
Other symptoms
|
|
|
|
|
6.666
|
0.925 – 48.049
|
0.060
|
|
Ref
|
|
|
AOR – Adjusted Odds Ratio; CI – Confidence Interval.
** Significant at p<0.05 level.
Multivariate regression estimates (Table 3) showed the independent significant factor associated with HH. The risk of having HH was likely to decrease as much as 80% for those patients who were using PPI medication (AOR=0.237; CI=0.074 – 0.760; p=0.023). Patients with vomiting were nearly two-fold more likely to have HH (AOR=1.722; CI=1.025 – 2.890; p=0.040) while patients with nausea had 1.6-fold higher risk (AOR=1.698; CI=1.012 – 2.849; p=0.045).