What is the primary diagnostic method for a hiatal hernia?

The primary diagnostic method for a hiatal hernia is a chest radiograph or barium swallow. This approach is effective because it allows for visualization of the esophagus, stomach, and any potential herniation through the diaphragm. A barium swallow involves the patient ingesting a barium solution, which enhances the imaging of the upper gastrointestinal tract during X-rays, making it easier to identify anomalies such as a hiatal hernia.

While endoscopy is valuable for evaluating the esophagus and stomach lining, it may not always provide clear images of the anatomical structures related to a hiatal hernia. A CT scan can also be useful in certain cases but is typically reserved for more complex evaluations. Ultrasound is generally not effective in diagnosing hiatal hernias as it is more suited for evaluating soft tissues and abdominal organs, particularly in pediatric populations and conditions like gallstones. Therefore, the combination of chest radiography and barium swallow is the preferred first-line diagnostic technique for identifying a hiatal hernia.