Manometry, Reflux Testing and Endoscopy: How a Hiatal Hernia Repair Is Planned

The folder on the kitchen table holds four appointment letters. One is for a camera test, one for an X-ray with a chalky drink, one for a thin tube that measures pressure, and one for a day spent wearing a small recorder on the belt. The person reading them has a single hernia, the size of a plum, and a reasonable question: why does one small problem need four different hiatal hernia tests before surgery?

The honest answer is that the hernia itself is only half the story. A hiatal hernia is a gap in the diaphragm through which part of the stomach slides into the chest. Whether it needs fixing, and how, depends less on the gap than on what it does to the valve at the bottom of the esophagus and to the muscle above it.

Each test answers a different question. Put together, they let a surgical team plan an operation that fits the person, rather than the scan.

Why hiatal hernia tests before surgery matter more than the hernia's size

Here is a fact that surprises many people: most hiatal hernias cause no symptoms at all, and are discovered by accident during a scan ordered for something else. Mayo Clinic notes that small hernias are common and often need no treatment. The NHS adds that the condition becomes more frequent after the age of 50 and during pregnancy.

So the decision to operate is rarely about the hernia alone. Surgeons think in two columns. In the first column sits the anatomy: how much stomach has moved up, whether the junction between esophagus and stomach has slid upward (a sliding hernia) or whether part of the stomach has rolled up beside a normally placed junction (a paraesophageal hernia). In the second column sits function: does acid wash up into the esophagus, and can the esophagus push food down against the resistance a repair will add?

That second column is the reason for the extra appointments. A repair that tightens the valve in someone whose esophagus squeezes weakly can trade heartburn for trouble swallowing. A repair performed on someone whose chest pain comes from the heart, not from reflux, treats the wrong organ. The testing is not bureaucracy; it is the map the operation follows.

Think of it the way an engineer thinks about a bridge. You can see the cracked span from the road, but before rebuilding it you measure the load it carries, the strength of the supports, and the traffic that will cross it. Endoscopy and barium swallow show the span. Manometry measures the supports. pH monitoring counts the traffic. Only with all four does the plan become specific to the person sitting with that folder of letters.

What test is done for a hiatal hernia? The usual order of the workup

People searching this question usually want a single answer, and there isn’t one. There is, however, a fairly standard sequence that most gastroenterology and surgical teams follow, and knowing the order makes the appointments feel less random.

The first step is often an upper endoscopy. Endoscopy means passing a thin, flexible tube with a camera through the mouth into the esophagus and stomach. It shows the hernia from the inside and, just as importantly, shows the lining of the esophagus, where long-standing reflux can leave inflammation or changes in the cells.

The second step is usually a barium swallow, an X-ray study in which you drink a contrast liquid while images are taken. Where endoscopy gives a close-up, the barium swallow gives the wide shot: the size of the hernia, its shape, whether it reduces when you stand, and how smoothly liquid moves through.

If surgery is being seriously considered, the third and fourth steps come into play. Esophageal manometry measures the pressure waves of the esophageal muscle and the strength of the lower valve. Ambulatory pH monitoring measures how often, and for how long, acid actually reaches the esophagus during an ordinary day.

Not everyone needs all four. Someone with a large paraesophageal hernia that is causing obstruction may proceed on the basis of imaging alone, because the problem is mechanical rather than acid-related. Someone with classic heartburn and a small sliding hernia may be managed with lifestyle changes and acid-suppressing medicine first, and never reach the later tests. Mayo Clinic’s overview of diagnosis lists endoscopy, barium swallow and manometry as the core studies, with pH testing added when the reflux picture is unclear. The order can vary; the logic does not.

Upper endoscopy and barium swallow for hiatal hernia: seeing the anatomy two ways

The camera test comes with sedation, so most people remember little of it. What the endoscopist is doing in those minutes is methodical. They measure the distance from the teeth to the point where the pale esophageal lining meets the darker stomach lining, then the distance to the pinch of the diaphragm. The gap between those two points is the length of a sliding hernia. They look for redness, erosions or ulcers that signal esophagitis, inflammation of the esophageal lining from acid. They may take small tissue samples to check for Barrett’s esophagus, a change in the lining cells linked to years of reflux. They also bend the camera back on itself to view the valve from below, a maneuver called retroflexion, which shows whether the valve hugs the scope tightly or gapes open.

The barium swallow for hiatal hernia answers questions the camera cannot. Because it is taken in real time, often with you lying flat and then standing, it shows whether the hernia slides back and forth or is fixed in the chest. It reveals the twist of a paraesophageal hernia, which can be hard to appreciate through a camera. It also gives a first impression of movement: whether the contrast pools, or whether the esophagus clears it in a few swallows. MedlinePlus describes the barium study as an X-ray examination of the esophagus and stomach after drinking contrast, usually performed without sedation.

Neither test is painful in the ordinary sense. Endoscopy can leave a scratchy throat for a day. Barium can cause pale stools and mild constipation until it passes. Both involve fasting beforehand for a period your team will specify, and the sedation for endoscopy means you will need someone to take you home.

Esophageal manometry before hiatal hernia surgery: the test that shapes the wrap

If one test deserves the most explanation, it is this one, because it is the least familiar and the most influential. Esophageal manometry measures pressure inside the esophagus using a thin catheter passed through the nose, with sensors along its length. You swallow small sips of water while the sensors record each wave of muscle contraction from top to bottom, along with the resting squeeze of the lower esophageal sphincter, the ring of muscle that acts as the valve above the stomach. Mayo Clinic reports that the test typically takes about 30 minutes and is done without sedation, since you need to swallow on command.

Why does a surgeon care about pressure waves? Because the most common repair, a fundoplication, wraps the top of the stomach around the lower esophagus to rebuild the valve. Any wrap adds resistance. A healthy esophagus pushes food through that resistance without noticing. A weak or poorly coordinated esophagus may not, and the result can be food sticking, chest discomfort after meals, and regurgitation of a different kind.

Manometry also rules out conditions that mimic reflux. Achalasia, a disorder in which the lower valve fails to relax and the esophagus loses its coordinated squeeze, can cause heartburn-like symptoms and regurgitation, yet a fundoplication would make it markedly worse. Spasm disorders can produce chest pain that sounds like acid but is not.

In practice, many surgical teams use manometry results to choose between a full wrap, which circles the esophagus completely, and a partial wrap, which covers only part of the circumference and offers less resistance. The test does not make the decision by itself. It gives the surgeon a measured reason for the choice, which is exactly what a person about to have an operation should want.

pH monitoring for hiatal hernia: proving the reflux is really there

Heartburn is a feeling. Reflux is a measurement. The two overlap often, but not always, and that gap is why pH monitoring exists.

Ambulatory pH monitoring records the acidity of the lower esophagus over an ordinary day. In the traditional version, a very fine tube passes through the nose and sits just above the valve, connected to a recorder worn on a belt; MedlinePlus describes a monitoring period of 24 hours. A capsule version attaches a small sensor to the esophageal wall during endoscopy and transmits wirelessly for a longer stretch, with no tube in the nose. Some teams combine pH with impedance, which detects any liquid or gas moving up the esophagus, acidic or not, so that non-acid reflux is counted too.

During the recording you press a button when symptoms occur, note meals, and record when you lie down. The report then shows the percentage of time the esophagus was exposed to acid and, crucially, whether your symptoms lined up with reflux events. That symptom correlation is the part surgeons read most carefully. A person whose chest pain happens during measured reflux episodes is likely to benefit from a repair that stops those episodes. A person whose pain occurs when the esophagus is quiet probably has another explanation, and an operation would not address it.

Teams usually ask people to pause acid-suppressing medicines for a period before the study, so that the recording reflects the untreated state. That instruction comes from the prescribing clinician, with a specific timeline, and is not something to decide alone. If you are also on medicines for other conditions, mention them; some can affect how the esophagus moves or how acidic the stomach is.

The point of all this is not to doubt anyone’s symptoms. It is to make sure the planned operation targets the thing causing them.

The four tests side by side: what each one answers

Seen together, the studies stop looking like repetition and start looking like a division of labor. Each has a specific question it answers well and a blind spot that another test covers.

Test	What it involves	Main question it answers	What it cannot tell you
Upper endoscopy	Camera on a flexible tube, under sedation, through the mouth	Is the lining damaged by acid? How long is the hernia from the inside? Is Barrett’s present?	How the hernia behaves when you move; how strongly the esophagus squeezes
Barium swallow	X-ray images taken while drinking contrast, lying and standing	How large is the hernia, is it sliding or paraesophageal, is there a twist or obstruction?	Whether the lining is inflamed; how much acid is present
Esophageal manometry	Thin pressure catheter through the nose, swallows of water, about 30 minutes	Can the esophagus push against a wrap? Is there a motility disorder masquerading as reflux?	Whether acid is actually refluxing during daily life
Ambulatory pH (with or without impedance)	Nasal probe or attached capsule recording over at least 24 hours	How much acid reaches the esophagus, and do symptoms match reflux events?	The size or anatomy of the hernia

A useful way to read the table: the top two rows describe structure, the bottom two describe function. A surgeon planning a repair wants both halves. The timeline figures come from Mayo Clinic’s description of manometry and MedlinePlus’s description of pH monitoring; your own appointments may run shorter or longer.

Some people are also asked for a gastric emptying study, which times how quickly the stomach releases a test meal, or an electrocardiogram and other heart tests if chest pain is part of the picture. These are not hernia tests in the strict sense, but they protect against treating the wrong problem.

Who is usually offered a hiatal hernia repair, and who is usually asked to wait

Surgery is a tool, not a reward for completing the tests. The results determine whether it is the right tool, and for a meaningful share of people the answer is that it is not, or not yet.

Repair is most often discussed in three situations. The first is a paraesophageal hernia that is causing symptoms: difficulty swallowing, chest pressure after meals, vomiting, shortness of breath, or anemia from slow bleeding where the stomach rubs against the diaphragm. Cleveland Clinic notes that this type carries a risk of the stomach twisting or becoming trapped, which is why symptomatic cases are taken seriously. The second is reflux that is proven on testing and persists despite a proper course of acid-suppressing medicine and lifestyle change. The third is reflux that is controlled by medicine but is causing complications, such as repeated esophagitis or narrowing, or where long-term medicine is not tolerated.

People are usually asked to wait, or offered another path, when the pH study shows little acid exposure and symptoms do not correlate with reflux events; when manometry reveals a motility disorder that needs different treatment; when a small sliding hernia is found by chance and causes nothing; or when heart or lung disease makes general anesthesia a higher risk than the hernia itself. Pregnancy is another reason to defer. Obesity is not a bar to surgery, but some teams discuss whether weight-related treatment should come first, because higher abdominal pressure increases the chance that a hernia returns after repair.

None of this is a verdict on how real the symptoms are. It is a judgment about whether this operation will help them. Mayo Clinic’s guidance is that surgery is typically reserved for people whose symptoms are not relieved by medicine or who have a complication. That decision rests with the treating team, who can see the whole picture, including the parts a test report cannot capture.

How to prepare for hiatal hernia surgery: the weeks before the operation

Once the plan is set, preparation becomes practical, and much of it is in your hands. The aim is to arrive at the operation with the lungs, heart and tissues in the best shape they can be.

Smoking is the single modifiable factor surgeons raise most often. It worsens reflux, slows healing and increases lung complications after any operation under general anesthesia. Stopping even a few weeks ahead helps, and your team can point you to support. Alcohol relaxes the lower esophageal valve and interferes with healing, so cutting back beforehand is also commonly advised.

Medicines need a review rather than a self-edit. Blood thinners, some diabetes medicines, and certain supplements affect bleeding or anesthesia and may need to be paused or adjusted, but only on the instruction of the prescribing clinician. Acid-suppressing medicine is often continued up to surgery unless a repeat pH study is planned. Bring a complete list, including anything bought over the counter.

Fitness matters in a modest, realistic way. A daily walk in the weeks before surgery improves breathing and makes the early post-operative walks easier. If you have been losing weight for health reasons, continue; if you have not, this is not the moment for a crash diet that leaves you short of protein.

Expect a pre-admission visit. Blood tests, an electrocardiogram and sometimes a chest X-ray are standard; the anesthesia team will ask about sleep apnea, previous reactions to anesthesia, and loose teeth. You will be given fasting instructions for the night before, usually involving no solid food for a set number of hours and clear fluids up to a specified time.

At home, prepare for the first week: soft foods in the freezer, a pillow wedge for sleeping with the head raised, loose clothing without a tight waistband, and someone who can drive you back and stay the first night.

What actually happens during a hiatal hernia repair

The operation has three parts, and understanding them makes the test results click into place.

Most repairs today are done laparoscopically, through several small incisions in the abdomen, with a camera and long instruments; the NHS describes keyhole surgery as the usual approach. Some surgeons use a robotic platform, which is still laparoscopy with a different set of controls. An open incision is reserved for complex or repeat cases.

The first part is reduction: the surgeon gently draws the stomach, and sometimes a portion of the lower esophagus, back down from the chest into the abdomen. With large paraesophageal hernias, the sac that has stretched up into the chest is dissected free so the stomach does not simply slide back up. The surgeon also checks that enough esophagus lies below the diaphragm without tension; a short esophagus, which the barium swallow may have hinted at, sometimes needs a lengthening step.

The second part is closing the gap. The two pillars of the diaphragm that form the hiatus are stitched together behind the esophagus so the opening is snug but not tight. In some cases a mesh patch reinforces the closure; whether to use mesh, and which kind, is a judgment the surgeon makes based on the size of the defect and the quality of the tissue.

The third part is the fundoplication, where manometry earns its keep. The fundus, the upper curve of the stomach, is wrapped around the lower esophagus and stitched in place to recreate a valve. A full wrap encircles the esophagus; a partial wrap covers roughly half to three-quarters of the circumference. A weaker esophagus on manometry generally steers the surgeon toward a partial wrap. The procedure takes a few hours under general anesthesia, and most people wake with a sore throat from the breathing tube and shoulder-tip discomfort from the gas used to inflate the abdomen.

What the days and weeks after a hiatal hernia repair usually look like

Recovery from this operation is less about the incisions and more about the swallow. The new valve is swollen at first, and the body needs time to learn its dimensions.

In the first day or two, most people are up and walking the ward, taking sips of water and then clear liquids. Shoulder pain from the laparoscopic gas is common and fades as the gas is absorbed. Many go home once they can keep fluids down and pain is managed with oral medicine; your team will give you the typical range they expect for your operation.

The first couple of weeks are usually a liquid and then soft-food phase. Mayo Clinic notes that eating may feel different after a fundoplication, and that food can feel slow to go down while swelling settles. Small, frequent meals, chewed thoroughly, go through more easily than large ones. Bread, dry meat and fizzy drinks are the usual troublemakers early on. A sensation of early fullness is expected; so is some bloating, since the new valve makes burping harder.

Over the following weeks the diet expands step by step. Lifting is typically restricted for a period to protect the diaphragm stitches, and walking is encouraged daily. Desk-based work often resumes before physical work; the NHS advises following your surgeon’s guidance on returning to activity rather than a fixed date.

Follow-up usually includes a clinic visit and, if swallowing remains difficult beyond the expected window, a repeat barium swallow to check the wrap’s position. Reflux symptoms that reappear months later are also investigated rather than assumed; a wrap can loosen or slip, and a hernia can recur, especially with heavy straining or significant weight gain.

Every one of these timelines is a typical range, not a promise. Bodies heal at their own pace, and the team that operated is the right judge of whether yours is on track.

Risks and alternatives, stated plainly

An honest conversation before surgery covers what can go wrong and what else could be done. Neither list is long, but both deserve plain language.

The specific risks of a hiatal hernia repair with fundoplication include difficulty swallowing that lasts longer than the early swelling, usually because the wrap or the hiatal closure is tighter than the esophagus can comfortably handle; gas-bloat, the combination of fullness, inability to burp and increased flatulence that follows some repairs; slipping or loosening of the wrap over time, which can bring reflux back; and recurrence of the hernia itself, more likely after very large paraesophageal repairs. Rarer events include injury to the esophagus or stomach during dissection, bleeding, injury to the vagus nerve affecting stomach emptying, and the general risks of any operation under anesthesia such as clots, infection and lung complications. Manometry and the choice of wrap reduce the swallowing risk; they do not eliminate it.

The alternatives depend on which problem is being treated. For reflux without a large hernia, long-term acid-suppressing medicine remains a reasonable path for many people. Proton pump inhibitors reduce the amount of acid the stomach makes; they do not stop the reflux itself, which is why regurgitation and cough may persist even when heartburn improves. Lifestyle measures, including raising the head of the bed, avoiding late meals, and managing weight, are not a consolation prize; the NHS lists them as first-line. Some centers offer endoscopic or magnetic valve-augmentation procedures for selected patients; their evidence base is shorter than that of fundoplication, and suitability is judged case by case.

For a large paraesophageal hernia that is obstructing or bleeding, the realistic alternative to repair is watchful waiting with a plan for urgent surgery if the stomach becomes trapped. The treating team weighs that trade-off with you, based on age, overall health and the specific findings on the tests described above.

What people often get wrong about hiatal hernia tests and surgery

A few misunderstandings come up in nearly every clinic, and clearing them early saves worry.

The first concerns the so-called three-finger test. This is a bedside maneuver for a groin hernia, where the examiner places fingers over the inguinal canal and asks the person to cough. It has nothing to do with a hiatal hernia, which sits deep inside the chest behind the breastbone and cannot be felt from outside. Nor can you diagnose one by pressing on your upper abdomen, drinking water, or any home maneuver. Imaging or endoscopy is the only way to see it.

The second is that a bigger hernia means more symptoms. It often does not. Small sliding hernias can cause fierce reflux; large paraesophageal hernias sometimes cause only vague fullness. This is precisely why function tests sit alongside anatomy tests.

The third is that a normal endoscopy rules out reflux. It does not. Many people with significant acid exposure have a lining that looks healthy through the camera. That is what pH monitoring is for.

The fourth is that heartburn medicine is a weaker option that surgery replaces. In fact, the two treat different things: medicine reduces acid, surgery restores the mechanical barrier. People whose main complaint is regurgitation or cough may find medicine disappointing for that reason, while people with pure heartburn may do well on it for years.

The fifth is that surgery fixes reflux for life. A repair can loosen, and a hernia can come back, particularly with heavy lifting, chronic cough or weight gain. Surgeons describe the repair as durable in many people, not permanent in all, and the honest counselling reflects that.

The last is that the tests are a formality. They are the opposite. Results change plans: a different wrap, a different operation, or no operation at all.

Questions to ask your care team before you agree to surgery

Good questions get good answers, and the pre-operative visit is the moment to ask them. Bring the list; nobody minds.

• Which type of hiatal hernia do I have, and how large is it on the barium swallow?
• What did my manometry show about how my esophagus squeezes, and how does that affect the wrap you are planning?
• Did my pH study confirm acid reflux, and did my symptoms line up with the reflux events?
• Did the endoscopy show esophagitis or Barrett’s esophagus, and does that change the follow-up I will need afterward?
• Are you planning a full or partial fundoplication, and why that choice for me?
• Will you use mesh to reinforce the diaphragm, and what are the trade-offs?
• What is the realistic range for my hospital stay and return to work, given my job?
• What swallowing difficulty or bloating should I expect in the early weeks, and what would be outside the normal range?
• Which of my current medicines should I continue, pause or adjust, and who will tell me exactly when?
• What is the plan if my symptoms come back months or years later?
• If I decided not to have surgery, what would my options be, and what would you watch for?

Write the answers down, or ask whether someone can come with you to take notes. Ask, too, who to contact after the operation if something feels wrong, and how to reach them outside clinic hours. The surgical consent form will list the risks; the conversation should explain which of them are most relevant to your particular findings. A team that has looked at four separate test results will have specific answers, and specific answers are what you are entitled to before any operation.

When to call your doctor

Before surgery, a hiatal hernia rarely becomes an emergency, but a paraesophageal hernia can, and the warning signs are worth knowing by heart. Seek urgent care if you have sudden, severe chest or upper abdominal pain together with vomiting or retching that produces nothing; if you cannot swallow your own saliva; if you vomit blood or material that looks like coffee grounds; if your stools turn black and tarry; or if you develop shortness of breath or a racing heart alongside upper abdominal pain. These can signal that the stomach has twisted or become trapped above the diaphragm, which needs assessment the same day.

Chest pain that spreads to the arm, jaw or back, or that comes with sweating, breathlessness or faintness, should be treated as a possible heart problem until proven otherwise. Reflux and heart pain can feel alike, and the safe assumption is the serious one.

After surgery, contact your surgical team promptly if you have a fever, spreading redness or discharge at any incision, worsening rather than easing abdominal pain, difficulty breathing, calf pain or swelling in one leg, or if you cannot keep down fluids for more than a day. Persistent inability to swallow solids beyond the window your team described deserves a call rather than silent endurance; it is usually treatable, and early review makes that easier.

Between appointments, let your doctor know about unintended weight loss, new difficulty swallowing, food sticking, or anemia on a routine blood test, even if the hernia has been labelled small. These findings change the testing plan and sometimes the surgical one.

None of the information in this article replaces the judgment of the people who have examined you and read your results. If a symptom worries you, that worry is reason enough to ask.

Frequently asked questions

What test is done for a hiatal hernia?

The usual tests are an upper endoscopy, a barium swallow X-ray, esophageal manometry and ambulatory pH monitoring. Endoscopy shows the hernia and the lining from the inside, the barium study shows size and movement, manometry measures muscle strength, and pH monitoring confirms acid reflux. Not everyone needs all four; the treating team selects the tests that answer the questions relevant to the planned treatment.

Why is esophageal manometry done before hiatal hernia surgery?

Manometry checks whether the esophagus can push food through the added resistance of a surgical wrap. A weak or uncoordinated esophagus raises the risk of swallowing difficulty after a full fundoplication, so surgeons may choose a partial wrap instead. The test also detects conditions such as achalasia that mimic reflux but would be worsened by anti-reflux surgery.

Is pH monitoring for hiatal hernia always necessary?

Not always. If endoscopy shows clear acid damage such as esophagitis or Barrett’s esophagus, the reflux is already proven and pH monitoring may be skipped. It becomes important when the lining looks normal, when symptoms are unusual, or when the team wants to confirm that symptoms coincide with reflux events before committing to an operation.

What is the 3 finger test for a hernia?

The three-finger test is a physical examination for a groin (inguinal) hernia, where the examiner places fingers over the inguinal canal and asks the person to cough to feel a bulge. It does not apply to hiatal hernias, which sit inside the chest and cannot be felt from outside. A hiatal hernia is diagnosed with endoscopy or imaging, not by touch.

How do I prepare for hiatal hernia surgery?

Preparation usually involves stopping smoking, limiting alcohol, staying active with daily walks, and reviewing all medicines and supplements with the prescribing clinician so that anything affecting bleeding or anesthesia can be adjusted safely. You will receive fasting instructions and a pre-admission assessment. At home, stock soft foods, arrange a wedge pillow, loose clothing, and someone to drive you and stay the first night.

Can you tell me about some people who have had hiatal hernia surgery?

Individual stories vary too much to be a reliable guide, and no reputable source promises a particular outcome. What people commonly describe is a short hospital stay, shoulder-tip pain from laparoscopic gas, a period of liquid and soft foods, early fullness, and some bloating while the new valve settles. Some report lasting relief from reflux; others experience recurrence months or years later. Your surgeon can describe typical experiences for cases like yours.

Is a barium swallow for hiatal hernia uncomfortable?

Most people find it tolerable. You drink a thick, chalky contrast liquid while X-ray images are taken standing and lying down, with no sedation and no tube. The main after-effects are pale stools and mild constipation until the barium passes. It usually requires fasting beforehand, and it gives the surgeon a real-time view of the hernia’s size, shape and movement.

Does a normal endoscopy mean I do not have reflux?

No. Many people with significant acid exposure have an esophageal lining that looks healthy through the camera. Endoscopy is excellent at finding damage such as esophagitis or Barrett’s esophagus, but it is a snapshot of the lining, not a measure of how often acid rises. Ambulatory pH monitoring is the test that quantifies reflux over a full day.

What happens if the tests show I should not have surgery?

The team will explain what the results point to instead. That may mean continuing acid-suppressing medicine and lifestyle measures, treating a motility disorder that manometry uncovered, investigating the heart or lungs if symptoms do not match reflux, or simply monitoring a small hernia that causes nothing. A result that steers you away from an operation is a useful outcome, not a failed workup.

Can a hiatal hernia come back after repair?

Yes, recurrence is possible, especially after repair of large paraesophageal hernias, and a fundoplication wrap can loosen or slip over time. Heavy lifting, chronic cough, persistent vomiting and significant weight gain raise the chance. If reflux or swallowing symptoms return months or years later, the team typically repeats a barium swallow or endoscopy rather than assuming the cause.

References

• MedlinePlus: Esophageal pH monitoring
• MedlinePlus: Hiatal hernia
• NHS: Hiatus hernia
• Cleveland Clinic: Hiatal hernia

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.