The diagnosis of hiatus hernia is suspected from talking to the patient.
Features such as:
- Excessive belching
- Regurgitation
- Heartburn
- Antacid usage
The diagnosis is confirmed by the examination of the oesophagus and stomach with a flexible endoscope:
The picture illustrates a hiatus hernia.
The endoscope has been manipulated to view itself passing into the stomach from below.
The "hole" is infact the stomach passing through the diaphragm.
The junction of the stomach and oesophagus is examined and the position of the
diaphragm in relation to its normal position determined, along with any evidence
of acid reflux or other resulting complication.
Any areas of concern will be biopsied at this time.
For patients contemplating surgery for their hiatus hernia the following tests are recommended:
- OGD
- Manometry
- pH studies
- Trial of medication
