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The mechanisms are multi-layered

J Am Coll Surg 235:894904 Abdelmoaty WF, Dunst CM, Filicori F, Zihni AM, Davila-Bradley D, Reavis KM, Swanstrom LL, DeMeester SR (2019) Combination of surgical technique and bioresorbable mesh reinforcement of the crural repair leads to low early hernia recurrence rates with laparoscopic paraesophageal hernia repair

Chronic stress also disrupts the delicate interplay between the nervous, endocrine, and immune systems, creating a feedback loop that can exacerbate hair follicle inflammation

Although the pathogenetic steps have not completely been explored, nowadays, research has highlighted the role of the intestinal microbiota in H