Presence of vertebral fractures is highly associated with hiatal hernia and reflux esophagitis in Japanese elderly people

Objective Recent studies have shown the correlation between vertebral fractures (VFs) and gastrointestinal disorders in postmenopausal women. The aim of this study was to assess the association between VFs and hiatal hernia (HH) and/or reflux esophagitis (RE) in our patient population of both men and women. Methods We analyzed retrospective data of 280 patients aged 60 years or older (140 men and 140 women, mean +/- SD 73.5 years +/- 7.05) who had undergone upper gastrointestinal endoscopy and chest X-rays in our hospital from August 2005 to February 2006. We analyzed the correlation between the presence of VFs and the presence of HH and/or RE. Results The incidence of RE in this study was 13.9% (39/280) and that of HH was 30.0% (84/280). Among these patients, 12.1% (41/280) had VFs. The incidence of RE in patients with VFs was 24.4% (10/41) and without VFs was 12.1% (29/239), with the difference being significant between those with and without VFs (p<0.05). The incidence of HH in patients with VFs was 43.9% (18/41) and in those without VFs was 27.6% (66/239), p<0.05. We subdivided subjects into four groups: HH only group, RE only group, HH/RE group and neither condition present group. We compared the incidence of VFs among these groups. VFs were observed in 16.4% (11/67) of the HH only group, 13.6% (3/22) of the RE only group, 41.2% (7/17) of the HH/RE group and 11.5% (20/174) in the neither condition present group. There was a significant difference in the incidence of VFs between the HH/RE group and neither condition present group (p<0.05). Conclusion The presence of VFs was significantly associated with the presence of either RE or HH. This association became more significant when HH and RE were present together in elderly Japanese people.