A physical exam cannot tell whether you have a hiatal hernia, and this could also pose health risks if you do have one.

A hiatal hernia occurs when the upper part of the stomach moves into the chest cavity through the diaphragm.

In a 2023 article, researchers said that older adults experience muscle weakness and loss of flexibility, making them more prone to having a hiatal hernia.

It can also happen when there’s elevated intra-abdominal pressure, which mostly affects people with obesity, chronic constipation, and those who are pregnant.

Doctors may use different tests to check if you have a hiatal hernia, but it’s not possible to self-diagnose with a physical exam.

It’s not possible to check yourself for a hiatal hernia, and you may not be aware that you have the condition, as symptoms do not always appear.

A doctor may suspect that you have a hernia if you have severe acid reflux that has not improved with antacid medications.

You may have read about a technique called the hiatal hernia finger test, which involves placing your fingers on your upper abdomen below your sternum and inhaling deeply so that you feel your abs expand. If you have a hernia, it supposedly restricts your diaphragm’s movement. But there’s no research that supports this diagnostic method. Medical professionals do not use this method to diagnose hiatal hernias.

Large hiatal hernias can cause electrical changes that doctors can spot on an electrocardiogram (ECG or EKG), according to a 2021 study. This probably happens because the hernia adds extra pressure on the heart. It may also increase your chance of developing:

A large hiatal hernia can also cause gastric obstruction. The finger test may not be helpful for self-diagnosis, as you may unintentionally move your stomach contents into the lungs if a hernia is present.

The best way to tell that you may have a hiatal hernia is to recognize its symptoms. These may be similar to other conditions, but you can speak with a doctor who can assess your symptoms and provide a diagnosis and a treatment plan.

People with a hiatal hernia do not always have symptoms and only receive a diagnosis when they get tested for other conditions.

Hiatal hernia symptoms may occur as a result of stomach acid or bile. These may include the following:


Heartburn is a burning sensation that you feel in your chest when stomach acid travels upward to your throat. This is known as acid reflux.

Stomach acid can also cause:

  • an unpleasant taste in your mouth
  • a hoarse voice
  • bad breath
  • bloating

Heartburn can worsen if you have a hiatal hernia or are under stress. It can also worsen during pregnancy.

Chest pain

A hiatal hernia can affect your respiratory and cardiovascular areas, which can increase your risk of chest pain.

A large hernia uses more space and causes parts of your lungs to collapse as it compresses your arteries. You may develop chest tightness, shortness of breath, and breathing difficulties.

One study notes that it’s also possible that it adds extra pressure to the heart, causing it to compress and making you prone to developing chest discomfort.

Swallowing difficulties

Swallowing difficulties can happen if you’re unable to swallow food or liquids or experience pain when swallowing. This can make it difficult to get enough calories and nutrients.

Experiencing swallowing difficulties is common among older adults and can occur in those with cerebral palsy or Parkinson’s disease.

Also, you may have increased difficulty swallowing if your hernia grows or you have inflammation of the mucous membranes that line your mouth and your gastrointestinal tract (mucosal inflammation) that leads to obstruction.


Belching or burping happens when swallowed air accumulates in your stomach.

Risk factors include swallowing a lot of air, drinking carbonated beverages, and having irritable bowel syndrome (IBS).

It’s recommended you see a doctor if you have symptoms of hiatal hernia or your symptoms have not improved with treatment.

Getting medical care is also helpful if you have indigestion, acid reflux, or are experiencing:

  • swallowing difficulties
  • frequent vomiting
  • unexplained weight loss
  • upper abdominal pain

You may undergo different diagnostic tests for a doctor to confirm a diagnosis. These include:

An X-ray may also help healthcare professionals check if you have a hiatal hernia if you do not have symptoms and also test for other conditions, such as gastroesophageal reflux disease (GERD), heartburn, or chest pain.

It’s not possible to self-diagnose a hiatal hernia. It’s important to contact a doctor if you have symptoms like heartburn, chest pain, or swallowing difficulties. These may be signs of a hiatal hernia, but they may also appear if you have other conditions.

X-rays, barium swallows, and CT scans can help healthcare professionals confirm the diagnosis.