Hiatus hernia diagnostic study of choice

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]


When a patient is suspected for having a sliding hiatus hernia and symptoms of gastroesophageal reflux disease (GERD) which includes regurgitation, heartburn, and dysphagia epigastric pain or fullness, nausea, or vomiting. High resolution manometry with esophageal pressure topography (EPT) is the most sensitive test for the diagnosis of hiatal hernia.

Diagnostic Study of Choice

Study of choice:

The comparison table for diagnostic studies of choice for High resolution manometry and endoscopy.[4]

Test Sensitivity Specificity
High resolution manometry 92% 95%
Endoscopy  73% 73%


  1. Kahrilas PJ, Kim HC, Pandolfino JE (2008). "Approaches to the diagnosis and grading of hiatal hernia". Best Pract Res Clin Gastroenterol. 22 (4): 601–16. doi:10.1016/j.bpg.2007.12.007. PMC 2548324. PMID 18656819.
  2. Cho YK (October 2011). "High-resolution manometry for assessing hiatal hernia in a patient with severe reflux esophagitis". J Neurogastroenterol Motil. 17 (4): 421–2. doi:10.5056/jnm.2011.17.4.421. PMC 3228984. PMID 22148113.
  3. Khajanchee YS, Cassera MA, Swanström LL, Dunst CM (January 2013). "Diagnosis of Type-I hiatal hernia: a comparison of high-resolution manometry and endoscopy". Dis. Esophagus. 26 (1): 1–6. doi:10.1111/j.1442-2050.2011.01314.x. PMID 22320417.
  4. Weijenborg PW, van Hoeij FB, Smout AJ, Bredenoord AJ (February 2015). "Accuracy of hiatal hernia detection with esophageal high-resolution manometry". Neurogastroenterol. Motil. 27 (2): 293–9. doi:10.1111/nmo.12507. PMID 25620528.

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