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How is hiatal hernia diagnosed?
Most often, a hiatal hernia is found incidentally with gastrointestinal X-rays, EGD, and sometimes CT scan, since by itself, it causes no symptoms. Only when there are associated symptoms of GERD will the patient usually seek medical care. With symptoms of GERD, it is likely that a hiatal hernia is present since most patients with GERD have hiatal hernias.
Most often, the diagnosis is confirmed by a barium swallow or upper GI series, where a radiologist uses fluoroscopy to observe in real time as the swallowed barium outlines the esophagus, stomach and upper part of the small intestine. In addition to seeing the anatomy, the radiologist also can comment upon the movement of the muscles that work to propel the barium (and presumably) food through the esophagus into the stomach and beyond.
Endoscopy is a procedure performed under sedation by a gastroenterologist to look at the lining of the esophagus, stomach, and duodenum. A hiatal hernia may be diagnosed easily in this manner and more importantly, the physician may be able to see complications of GERD from the reflux of acid. Endoscopy is used to diagnose scarring with strictures (narrowing of the esophagus) and precancerous conditions like Barrett's esophagus. Biopsies or small tissue samples may be taken and examined under a microscope.
What is the treatment for hiatal hernia?
The treatment for hiatal hernia is really treatment for GERD and minimizing acid reflux. This includes decreasing acid secretion in the stomach, avoiding substances that are irritating to the stomach lining, and mechanical means to keep the remaining acid in the stomach where it belongs.