Esophagitis manifested by epigastric pain and distress, retrosternal burning, belching, and dysphagia, and, in the more severe cases, esophagogastric ulceration with bleeding and cicatricial changes is oftenest due to esophageal hiatal hernia of the sliding type. Schmidt3 at the Mayo Clinic found that among 170 patients with benign regurgitant ulceration at the esophagogastric junction 158 had that type of hiatal hernia.
A 47-year-old housewife who was first seen with the complaint of epigastric and retrosternal distress of many years duration. Several years previously she had been diagnosed as having "stomach ulcer" and had received some help from an ulcer program. However, the symptoms continued to progress. Intake of food intensified the symptoms and caused belching and regurgitation, much to the annoyance of the patient and her associates. Temporary relief was afforded by the ingestion of a popular antacid dispensed at cigaret counters. When first seen, the patient was using