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The first visit for the symptoms of hiatal hernia may warrant tests to rule out more serious or life-threatening causes first, such as heart disease.

A thorough history will be taken to determine associated symptoms, circumstances, and risk factors for various diseases. Tell the doctor about foods or activities that help or worsen the symptoms.

A complete physical exam will focus on the digestive, pulmonary (lungs), and cardiovascular (heart) systems. A rectal exam and stool test for blood may be necessary to determine if there is bleeding from the digestive tract.

• Initial tests
  
  
  • Electrocardiogram (ECG) to look for electrical disturbances of the heart from disease
    
    
  • Chest x-ray to look for pneumonia, collapsed lung, or other problems in the chest
    
    
  • Blood tests to look for anemia, infection, or injury to the heart, pancreas, or liver
    
    
  • Other tests focusing on the cardiovascular and pulmonary organ systems if suspicion remains high for problems in these areas

• Possible follow-up tests
  
  
  • Barium swallow or upper GI x-ray series may be performed by a radiologist (you drinks some contrast material, and x-rays are taken).
    
    
  • Endoscopy may be performed by a gastroenterologist. A long fiberoptic scope is passed through the mouth and into the stomach looking for an ulcer, tumor, or other tissue damage. Sometimes a biopsy is needed.

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