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Hiatal Hernia Diagnosis

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  • Hiatal Hernia Diagnosis

    I have had what I can only describe as a hernia for the past 2 years. I get severe pain in upper left quadrant after a large meal and sometimes it pops out through the muscle and I can feel it pulsating (very painful). In addition, I have had shortness of breath (cardiac and pulmonary workup were negative). Saw a gastroenterologist and he sent me for an Upper GI series. The radiologist told me that I had severe reflux, however he did not see a hiatal hernia. He said, however, if the hernia is not acting up when the test is done sometimes it is missed.

    Does anyone know of a definitive test for a hiatal hernia? The GI has not returned 2 phone calls in 3 days so I can discuss my results with him. I am really at a loss to figure out what is going on ( and possible looking for a new GI if I can't reach him tomorrow).

    Thank you.

  • #2

    I don't know if there is a 'definitive' test. An upper GI and EGD are the most common. A 'sliding HH' is often hard to detect.



    • #3

      Hi There is no definitive test for a sliding hernia. An upper GI and endoscopy are the 2 tests primarily used. An endoscopy missed mine and so did an upper GI. A repeat upper GI eventually spotted my hiatal hernia.

      The technician sometimes does stomach manipulation to enable the hernia to be more visable during the upper GI.

      During the endoscopy, the GI may get the patient to sniff when the scope is in a certain area. This supposedly makes a hernia easier to see, if there is any question.

      A hiatal hernia does not pop out, it is an internal hernia that cannot be seen or felt on the outside. Some doctors really downplay the importance of the finding of a hiatal hernia, as many people have them and have no symptoms.

      You do not need a hiatal hernia to have GERD and the symptoms you described. Hiatal hernia is just one of the possible risk factors for GERD

      An upper GI isn't a great test for diagnosis of reflux either. There are false positives and negatives. You would need an endoscopy to diffinitively diagnose ( if you don't respond to treatment, and depending on your age and symptoms) or a ph test.