Can a hiatal hernia be prsent even if it is not seen on the first EGD?

Long story short... I have been, and still am dealing with some acid reflux related issues. Medications do the job of eliminating the acid...if I skip a Nexium I can instantly tell there's acid and as long as I take it I don't get the burning sensation in my throat.

One of the things I have noticed is that what I eat does matter to a small degree, but that if I eat ANY food or even drink water in a large enough quantity (and that's not to say a very large quantity at all, I have been eating small meals etc.) Some of my "symptoms" come up (including lightheadedness, tightness in throat etc.) but I never really feel any acid or burning pain per se. after having many tests (gastric empyting normal, laryngoscope no irritation, CT scan of neck normal) it seems apparent that it isn't acid that is causing my problems however the problem is undoubtedly linked to meals and eating.

The thing is, I had an endoscopy and was told everything looked "normal" and there was no hiatal hernia. However I can only assume at this point that there is some mechanical dysfunction going on with my upper GI that is causing me distress where maybe circulation is being impaired since apparently there is no tissue damage being done.

So I guess my question is 2 parts:

1) I'm wondering if anyone has had a similar experience, where their acid seemed to be completely under control and yet eating anything but a very small meal would cause them lightheadedness/weakness and/or sinus/ear pressure headaches.

2) Has anyone had a hiatal hernia (or other abnormality) missed by an endoscopy and then found later?

And yes, I sleep with the head of my bed elevated 6 inches, I'm not very stressed out, I'm eating small low-fat meals without any irritants and basically following every possible recommended lifestyle change to the letter of the law

Hi Barnacle,
I had an endoscopy, and a hiatal hernia was never mentioned when I was given the results. The hernia was discovered when I did the barium swallow test. My family doctor was confident that I was getting a lot of "silent GERD" that I wasn't aware of. I did get periodic severe heartburn episodes (even on 40mg Protonix twice a day). My overriding symptom, though, was severe asthma, which was greatly improved after the Nissen Fundopication surgery.

I sure hope you get to the bottom of your problem. As Bea said, your quality of life can be greatly improved with the surgery, regardless of all the hysterical and unhappy posts you might read on the net. Selecting an eminently qualified (in the specific lap nissen surgery) is the most important thing.

Best of luck, and I'm glad you're posting here. There are lots of people who have experienced your symptoms, so you should get lots of support and advice.
Take care,
Denise

Hi.

I had two egd's which did not show hiatal hernia however when I had barium swallow test it shows I have a a hiatal hernia.

Hope things go well for you. Best of luck

Bethann

I am also interested as I have suffered similar symptoms daily for 17 years without any relief.

The lightheadedness is the part that doesn't seem to make sense.

I also have some lightheadedness and general unwell feeling when I reflux.

Just saw an ENT who was so uninformed, it was scary. I will post more about that.

Read the old posts in this thread. Scopes and scans often miss a sliding hernia that pops up after eating. You are told not to eat before the test. If you swallow barium a scan should pick a slider up. or ask for pH monitoring.

See a gastroenterologist or an ENT who specializes or at least has a lot of experience in these hernias.

I have never heard of an ENT treating a hiatal hernia. ENTs treat eats, nose and throat, not digestion issues. I have had relflex for 20+ years. My first Nissan was done about 22 years ago. It slipped around 12 years ago and I ended up with a huge paraesophageal hernia and had to have the Nissan redone. The only test that showed the actual size of the hernia was an upper GI, the endoscopy did not even show it.

I agree with Alcie, please see a gastro doctor.

Sharon