A sliding hiatus hernia may be suspected if you are experiencing the symptoms of heartburn or gastroesophageal reflux. The tests that may be used to investigate a possible sliding hiatus hernia are the same as those used to investigate gastroesophageal reflux disease.
Tests for diagnosing sliding hiatus hernia
- endoscopy (esophagogastroscopy): This test involves passing a small, lighted, flexible tube with a camera through your mouth into your esophagus and stomach. Your doctor will look for any abnormalities and small tissue samples may be taken (biopsy). Usually you will be given a sedative to make you sleepy and help you relax. This is the best test to check for Barrett's Esophagus, cancer of the esophagus, and esophagitis (an inflammation of the esophagus).
- upper GI series (barium swallow): For this test you will be asked to swallow a liquid barium mixture that is sometimes called a barium meal. Using a special type of X-ray, a doctor can watch the barium as it travels down your esophagus into your stomach. You will likely need to move into different positions on the X-ray table so the doctor can see what happens to the barium in your esophagus and stomach in different positions. This test is useful to examine the movement of the esophagus as it pushes food into the stomach and can detect any narrowing of the esophagus.
- Bernstein test: In this test a mild acid will be purposely put into your esophagus through a tube to see if this reproduces the symptoms that you are experiencing. If it does, your symptoms are likely due to reflux of acid from your stomach into your esophagus. If it doesn't cause the pain and symptoms you have been experiencing, your symptoms are not likely due to acid reflux. If your health care professional is uncertain about the cause of your symptoms, this is good test that should help in determining the cause.
- esophageal manometry: For this test a small, flexible tube will be placed in your esophagus and stomach and the different pressures in your esophagus and stomach will be measured over time. This helps to determine how well your esophagus and stomach are working.
- 24-hour pH monitoring: In this test a small, flexible tube is placed in your esophagus and stomach. The acidity (how much acid is present) in your esophagus and stomach is measured over time. This helps to determine the degree of acid refluxed into the esophagus from the stomach. You may be required to keep a diary of your symptoms while the monitoring is taking place so your health care professional can see if your symptoms occur when there is acid in your esophagus.
Another test that may be helpful in diagnosing either a sliding or paraesophageal hiatus hernia is a chest X-ray. An X-ray of the chest may reveal air in the stomach that is not in the normal position indicating that part of the stomach has moved into the chest.