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A 51-year-old man with moderate obesity is seen in consultation for heartburn

51 years old | Male

Vignette:

A 51-year-old man with moderate obesity (body mass index of 34 kg/m²) is seen in consultation for heartburn and regurgitation. He has a diagnosis of gastroesophageal reflux disease and has been treated with proton-pump inhibitors. His heartburn is less severe with the medication, but he still is bothered by regurgitation. His physical examination is unremarkable. A barium esophagram and upper endoscopy demonstrate a type I (sliding) hiatal hernia, with about one-third of the upper stomach in the chest. The patient has free reflux to the level of the cervical esophagus.

Summary:

obesity | heartburn | regurgitation | gastroesophageal reflux disease | proton-pump inhibitors

Dx:

Hiatus Hernia Hiatal hernia

Ref:

https://online.epocrates.com/diseases/73522/Hiatal-hernia/Common-Vignette

Rank

Disease

Weight
1 Barrett esophagus 280.0
2 Gastroesophageal reflux disease 242.0
3 Obstructive Sleep Apnea 198.0
4 Achalasia 174.0
5 Esophagitis 171.0
6 Erectile dysfunction 166.0
7 Hiatus hernia 158.0
8 Abnormal uterine bleeding 142.0
9 Peptic Ulcer 138.0
10 Stable ischemic heart disease 137.0
11 Bruxism 129.0
12 Acute peptic ulcer 124.0
13 Duodenal Ulcer 124.0
14 Gastric Ulcer 124.0
15 Migraine headache in adults 119.0
16 Papilledema 117.0
17 Colorectal cancer 115.0
18 Hepatocellular carcinoma 113.0
19 Primary sclerosing cholangitis 112.0
20 Hypertriglyceridemia 112.0
21 Non-alcoholic Fatty Liver Disease 108.0
22 Type 2 Diabetes mellitus 107.0
23 Systemic sclerosis 106.0
24 Achilles tendinopathy 106.0
25 Achilles tendon rupture 106.0
26 Thrombotic thrombocytopenic purpura 105.0
27 Primary biliary cirrhosis 104.0
28 Liver Cirrhosis 101.0
29 Biliary cirrhosis 101.0
30 Chronic atrial fibrillation 101.0
31 ST-elevation myocardial infarction 101.0
32 Non-ST-elevation myocardial infarction 101.0
33 Zollinger-Ellison Syndrome 99.0
34 Preeclampsia 98.0
35 Eclampsia 98.0
36 Gallstones 95.0
37 Systemic lupus erythematosus 95.0
38 Fibromyalgia 94.0
39 Asthma 89.0
40 Limited cutaneous systemic sclerosis 89.0
41 Gastric Volvulus 88.0
42 Choledocholithiasis 85.0
43 Kidney stones 83.0
44 Varicose veins 83.0
45 Gout 82.0
46 Osteoarthritis 80.0
47 Irritable Bowel Syndrome 78.0
48 Analgesic nephropathy 76.0
49 Rumination Syndrome 76.0
50 Endometrial cancer 64.0
51 Anaphylaxis 64.0
52 Cushing syndrome 62.0
53 pancreatic cancer 61.0
54 Leiomyomas 60.0
55 Hyperparathyroidism 60.0
56 Diabetic Ketoacidosis 58.0
57 Malt lymphoma 56.0
58 Food poisoning 56.0
59 Umbilical hernia 53.0
60 Celiac Disease 51.0
61 Hypothyroidism 51.0
62 Gallbladder cancer 50.0
63 Acute Pancreatitis 50.0
64 Gallstone pancreatitis 50.0
65 Diabetes Mellitus 50.0
66 Carpal Tunnel Syndrome 50.0
67 Rheumatoid Arthritis 50.0
68 Psoriasis 50.0
69 Balanitis 50.0
70 Deep venous thrombosis 50.0
71 Secondary hypogonadism 50.0
72 Dermatophyte infections 50.0
73 Osteomalacia 50.0
74 Primary hypogonadism 50.0
75 Cellulitis 50.0
76 Clostridium difficile infection 50.0
77 Diabetic Kidney Disease 50.0
78 Androgenetic alopecia 50.0
79 Multiple Myeloma 50.0
80 Osteoporosis 50.0
81 Acromegaly 49.0
82 Annular pancreas 48.0
83 Breast Cancer 45.0
84 Amphetamine use disorder 45.0
85 Menopause 44.0
86 COPD Exacerbation 42.0
87 Musculoskeletal lower back pain 41.0
88 Hypercalcemia 39.0
89 Hyperprolactinemia 38.0
90 Chronic Kidney Diseases 34.0
91 Renal Cell Carcinoma 34.0
92 Rotator Cuff Tears 34.0
93 Rosacea 34.0
94 Candidal intertrigo 34.0
95 Dyspepsia 34.0
96 Sarcoidosis 34.0
97 Malaria 33.0
98 Aortic Dissection 32.0
99 Amyloidosis 30.0
100 Acute atrial fibrillation 29.0
101 Ischemic stroke 28.0
102 Diabetic Amyotrophy 28.0
103 Acute Cholecystitis 28.0
104 Hepatic Encephalopathy 26.0
105 Chronic fatigue syndrome 24.0
106 Prinzmetal angina 23.0
107 Type 1 Diabetes mellitus 22.0
108 Cataract 22.0
109 Acne vulgaris 22.0
110 Acne fulminans 22.0
111 Acne conglobata 22.0
112 Gram-negative folliculitis 22.0
113 Excoriated acne 22.0
114 Chronic Hepatitis 22.0
115 Gastric cancer 22.0
116 Autosomal Recessive Polycystic Kidney Disease 21.0
117 Lactose intolerance 21.0
118 Giardiasis 21.0
119 Hyperthyroidism 21.0
120 Graves Disease 21.0
121 Endometriosis 21.0
122 Ulcerative Colitis 20.0
123 Anthrax 19.0
124 Ovarian and fallopian tube torsion 18.0
125 Mitral Stenosis 18.0
126 End Stage Renal Disease 18.0
127 Urinary Tract Obstruction 16.0
128 Acute intermittent porphyria 16.0
129 Adrenal Suppression 16.0
130 Pseudohypoparathyroidism 16.0
131 Gestational diabetes mellitus 15.0
132 Discogenic low back pain 15.0
133 Fibrocystic breasts 15.0
134 Male factor infertility 15.0
135 Secondary hyperparathyroidism 15.0
136 Emphysematous cholecystitis 15.0
137 Inflammatory Bowel Diseases 15.0
138 Crohn Disease 15.0
139 Gilbert syndrome 15.0
140 Laryngeal Cancer 15.0
141 Insomnia in adults 15.0
142 Prolactinoma 15.0
143 Adrenocortical carcinoma 14.0
144 Short bowel syndrome 14.0
145 Zenker diverticulum 14.0
146 Tuberculous Peritonitis 14.0
147 Medullary thyroid cancer 13.0
148 Multiple endocrine neoplasia 2B 13.0
149 Pneumonia 13.0
150 Influenza 13.0
151 Aortic coarctation 13.0
152 Aortic stenosis 13.0
153 Hemorrhagic stroke 13.0
154 Endometritis 13.0
155 Acute Liver Failure 12.0
156 Autosomal Dominant Polycystic Kidney Disease 12.0
157 Eosinophilic gastroenteritis 12.0
158 mucosal Eosinophilic gastroenteritis 12.0
159 Muscle Layer Eosinophilic gastroenteritis 12.0
160 subserosal eosinophilic gastroenteritis 12.0
161 Autoimmune hepatitis 12.0
162 Obstructive cervical goiters 12.0
163 Substernal goiter 12.0
164 Peyronie Disease 12.0
165 Heparin-induced thrombocytopenia 11.0
166 Simple kidney cyst 11.0
167 Multiple Sclerosis 11.0
168 Pulmonary Embolism 10.0
169 Hereditary Angioedema 10.0
170 Brucellosis 10.0
171 Ovarian Cancer 10.0
172 Multiple endocrine neoplasia 2A 9.0
173 Anemia of chronic disease 9.0
174 Churg-Strauss Syndrome 9.0
175 Pelvic inflammatory disease 9.0
176 Acute pelvic inflammatory disease 9.0
177 Chronic heart failure 8.0
178 Gastritis 8.0
179 Cystic Fibrosis 8.0
180 Chronic Myeloid Leukemia 8.0
181 Bed bugs 8.0
182 Mitral Valve Prolapse 8.0
183 Hereditary hemochromatosis 8.0
184 Toxic thyroid adenoma 8.0
185 Drowning 8.0
186 Familial Mediterranean fever 7.0
187 Chronic Mitral regurgitation 7.0
188 Transient ischemic attack 6.0
189 Acute fatty liver of pregnancy 5.0
190 Acute Myeloid Leukemia in adults 5.0
191 Chronic Clonorchiasis 5.0
192 Atopic dermatitis 5.0
193 Common cold(adults) 5.0
194 Allergic rhinitis 5.0
195 Phenylketonuria 5.0
196 Toxic multinodular goiter 5.0
197 Acute respiratory failure 5.0
198 Chronic Lymphocytic Leukemia 4.0
199 Psoriatic arthritis 4.0
200 Pheochromocytoma 4.0
201 Systemic vasculitis 4.0
202 Ankylosing spondylitis 4.0
203 Primary Myelofibrosis 2.0
204 Alopecia areata 2.0
205 Hyperaldosteronism 2.0
206 Mesenteric ischemia 1.0
207 Chronic Renal vein thrombosis 1.0
208 Guillain-Barre syndrome 1.0
209 COVID19 1.0
210 Acute pericarditis 1.0
211 Acute bacterial meningitis in children 1.0
212 Acute Lymphocytic Leukemia in Adults 0.0
213 Narcolepsy 0.0
214 Globus Sensation 0.0
215 Acute Bronchitis 0.0
216 Gallbladder Dyskinesia 0.0