Of five patients who were receiving tricyclic antidepressants, two
experienced an aggravation of preexisting hiatus hernia, and three with
previously normal gastrointestinal X rays developed hiatal herination. The
author suggests that this group of drugs may exert an anticholinergic
effect on the esophageal sphincter and reduce the tone of the
esophagogastric sphincter, thus aggravating existing hiatus hernia or
causing its development.