An altered collagen I/III ratio has been discussed in conjunction with HH.50 Hiatus hernia might be a risk factor for developing GORD through a mechanism involving increased distensibility of the oesophagogastric junction, resulting in GORD as a secondary event.51 Moreover, HH formation may lead to delayed gastric emptying, increasing the clearance time for acid refluxes in the oesophagus.52 We suggest that that the associated alleles of COL3A1 are conferring increased susceptibility to both GORD and HH, respectively. Here, COL3A1 is linked to Hiatus hernia.