The evaluation of a hiatal hernia starts with a history and physical exam.

Physical findings in someone with a hiatal hernia may include:

• Abdominal tenderness:
• Upper middle part of the abdomen

Testing may be necessary to make the diagnosis of hiatal hernia.

Tests that may be used to evaluate a hiatal hernia include:

• Complete blood count
• Serum gastrin levels:
• Can detect Zollinger-Ellison syndrome
• Tests for Helicobacter pylori infection:
• Helicobacter pylori breath test
• Helicobacter pylori blood test
• Helicobacter pylori biopsy test
• Helicobacter pylori stool test
• Stool guaiac tests for intestinal bleeding
• Upper GI series:
• A barium x-ray study of the stomach and upper intestines
• Upper GI endoscopy:
• Allows direct inspection of the stomach and duodenum