Best Hiatal Hernia Diagnosis – CT Scan vs. Ultrasound vs Endoscopy

Hiatal Hernia Diagnosis

Any time that one part of the body moves or is pushed into an area that it does not belong; it is referred to as a hernia. There are many different types of hernias, however when the stomach is the part that becomes herniated, it is referred to as a hiatal hernia. This is because part of the stomach is pushed through or moves through an opening in the diaphragm called the hiatus. In many people, the condition produces no symptoms whatsoever. In others, acid reflux related discomfort comes along with the condition. For people with no symptoms, a hiatal hernia diagnosis is often accidental and comes with routine procedures or tests. For those with hiatal hernia symptoms, there are numerous different tools available for doctors to use in order to obtain a hiatal hernia diagnosis. When the condition is suspected, most commonly a barium swallow test follows. This test involves a specialized x-ray where the stomach and esophagus are highlighted and easier to see thanks to ingested liquids. However, this is not the only diagnostic tool available and it is not the best in all cases. Understanding just what is a hiatal hernia and how and when it produces symptoms can help determine which procedure is the best for obtaining a hiatal hernia diagnosis.

Burning, painful discomfort and sensations of fullness and bloat are common symptoms of a hiatal hernia presence. However, they do not exist for everyone. This is why many times, the condition is found by default when an individual undergoes a procedure such as a CT scan. However, this test is not considered practical as a standalone tool for developing a hiatal hernia diagnosis. Obviously there is a fair amount of radiation risk involved, and the procedure is enormously expensive. However, a CT scan might be used inadvertently to identify a hiatal hernia. The condition’s acid related symptoms are sometimes referred to as “the great mimic” and some people may experience hiatal hernia chest pain and discomfort that can seem similar to a heart attack when symptoms are at their worst. In these instances, a CT scan could prove useful in a hiatal hernia diagnosis. However, it is neither a reasonable nor practical approach and there are many other less expensive and invasive ways to identify the condition.

Perhaps a better tool is an ultrasound. While it lacks the ability to emphasize the esophagus and stomach the way barium swallow does, there are some benefits to using an abdominal ultrasound to identify a hiatal hernia. The benefits to this type of procedure are that if there are other conditions present, such as those involving the gallbladder, an abdominal ultrasound will be able to indicate them. This tool is not only therefore useful in making a hiatal hernia diagnosis, but also developing a clearer picture of the function of many things in the abdomen so that if there is something wrong somewhere else, it can also be addressed. The test is quite popular in younger individuals who are presenting possible hiatal hernia symptoms because it allows medical professionals to rule out a great number of other potential causes.

The most popular test for making a hiatal hernia diagnosis, however, remains to be endoscopy. This procedure refers to the insertion of a long and thin tube that gives a doctor a very good look at the esophagus and stomach. Surprisingly, while considered the best procedure for making a hiatal hernia diagnosis, it may not be ideal for identifying a sliding hiatal hernia. However, endoscopy is a fabulous tool for examining the lining of the stomach, which can provide key information about symptoms as they present.

All of these tools are equally important in making a diagnosis so that treatment for hiatal hernia symptoms, if present, can begin. In most cases, medications like proton pump inhibitors and H2 receptor blockers are used and they both may help by reducing the amount of acid that the stomach produces. In addition, dietary and lifestyle changes as well as natural and herbal remedies may provide some symptom relief as well.

Diagnostic tools are also important because they can help to identify complications of a hiatal hernia if present. For most people, having a hiatal hernia is rather inconsequential although some have acid reflux related symptoms. But, some hiatal hernias can be very serious and even lead to life threatening conditions, especially if the hernia is large. These complications might mean that a hiatal hernia repair via surgery is required in order to either reduce symptoms or prevent the risk of strangulation, a condition in which the blood supply to the stomach is cut off due to the hernia. A hiatal hernia repair surgery for symptom relief can be a simple, laparoscopic procedure. However, an emergency surgery to stop or prevent strangulation can be a major and intensely invasive treatment.

Another reason that diagnostic tools are important is related to the causes of hiatal hernia damage. In some cases, an injury resulting from pulling, lifting or pushing may be present. These types of causes may mean that other injury related damage is present, and if so, a hiatal hernia diagnosis might help to reveal them. Other causes include difficult bowel movements and even coughing, so thorough diagnosis is even more important for these reasons.

The most common tools used to obtain a hiatal hernia diagnosis are barium swallow x-rays and endoscopic procedures. Both have their positives and negatives, and may not be the most comprehensive way to diagnose the condition. However, while CT scans are obviously effective, they may be overkill and can be dangerous and expensive. An interesting alternative option is the abdominal ultrasound which can be hugely beneficial and provide an in depth look at the digestive system and identify other issues which might contribute to symptoms.

References:
https://my.clevelandclinic.org/health/diseases/8098-hiatal-hernia
http://www.markfuscomd.com/peh.htm