Uncommon cause of Iron Deficiency Anemia

Hiatal Hernia

With the obesity epidemic present in the United States, the presence of hiatal hernia ranges between 13-59% in those who have no symptoms of GERD. Those with symptoms of GERD, hiatal hernias are present in up to 94% of patients with reflux esophagitis. There are four main types of hiatal hernia. Type 3 and 4 are considered large hernias.

Studies have shown that up to 45% of patients with large hiatal hernias have iron deficiency anemia. This is in large part due to the presence of Cameron’s ulcers which are linear gastric erosions that occur due to mechanical trauma at the level of the diaphragm whereby the gastric folds rub against each other during respiration.

Treatment of these ulcers initially involves medical therapy and eradication of H.Pylori if present. Ongoing issues with anemia may require surgery to repair the hiatal hernia.

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