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Exam Contradicts Previous Hiatal Hernia Diagnoses

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I just had a colonoscopy and endoscopy in Toronto, and the nurse told me everything looks perfectly fine. This is surprising because I experience reflux and indigestion almost daily, which also cause breathing problems. I know reflux is the culprit because Miracid always alleviates my symptoms, including the breathing issues.
What's truly perplexing is that I was diagnosed with a hiatal hernia twice before, five and seven years ago, at two different hospitals in Thailand (Vejthani and Medpark, respectively). How is it possible that two separate hospitals in Thailand made the exact same diagnosis, yet the Toronto endoscopy center found nothing?

 

Moreover I was also diagnosed with mild gastritis also twice, but that's  gone too.

 

Somehow I'm very suspicious of "findings" that found nothing. Maybe canadian healthcare IS ****

 

@Sheryl I would appreciate some input from you and our esteemed members.
 

Gallstones can cause all those symptoms, often missed by Thai hospitals.

Diagnosed by ultrasound scan.

2 hours ago, Celsius said:


I just had a colonoscopy and endoscopy in Toronto, and the nurse told me everything looks perfectly fine. This is surprising because I experience reflux and indigestion almost daily, which also cause breathing problems. I know reflux is the culprit because Miracid always alleviates my symptoms, including the breathing issues.
What's truly perplexing is that I was diagnosed with a hiatal hernia twice before, five and seven years ago, at two different hospitals in Thailand (Vejthani and Medpark, respectively). How is it possible that two separate hospitals in Thailand made the exact same diagnosis, yet the Toronto endoscopy center found nothing?

 

Moreover I was also diagnosed with mild gastritis also twice, but that's  gone too.

 

Somehow I'm very suspicious of "findings" that found nothing. Maybe canadian healthcare IS ****

 

@Sheryl I would appreciate some input from you and our esteemed members.
 

 

Medicine works like this, unfortunately. 

I had some gastrointestinal stricture diagnosed by various hospitals in Thailand and in Europe, by x-ray, by CT scan and clinically.

Endoscopy in Europe found absolutely nothing.

 I was very frustrated because I really wanted that surgery. I went home happy because I really don't like surgery, and endoscopy is the gold standard.

If endoscopy finds nothing then there is nothing.

 

How was your hernia diagnosed in Thailand? By endoscopy?

 

There may be functional problems that endoscopy didn't see, and you certainly would find a surgeon willing to cut into these problems.

Thanks, but no thanks.

I stick to conservative treatment: for a stricture, don't eat big pieces of steak without chewing. For a  "hernia", take miracid.

  • Author
2 hours ago, Lorry said:

How was your hernia diagnosed in Thailand? By endoscopy?

 

Yes, both times by endoscopy. 

 

 

31 minutes ago, Celsius said:

 

Yes, both times by endoscopy. 

 

 

Interesting.

How much time has passed between the Thai endoscopies and the Canadian one?

Errors by doctors are possible. Especially if there is profit involved  - by far the best diagnostics for any hernia is done in a public hospital,  wherever. 

A paraesophageal hernia is difficult to diagnose by endoscopy. 

Or see my last paragraph.

Gastritis is not a permament condition so  nothing surprising  in having had it in the past and not having it now.

 

Re the HH   I suggest you get a copy of the actual report of the endoscopy you just had. It will have far more detail than the  verbal nurse report. You might well find that it mentions a small HH.

 

Often a verbal "everything's fine" just means "we didn't find anything serious/anything needing immediate treatment".

 

I'vd had tests that showed small sliding HH and no one mentioned it, I just know from getting copy if the actual full report.

 

Most HH do not require any treatment other than some life style adjustments ( weight loss, elevate head of bed etc) to reduce reflux and, if these don't suffice, medications to reduce the acidity of the stomach contents.  (Of which Miracid is one). There are surgeries to correct HH but pretty major so done only in severe cases  

 

The import thing with reflux is to check for damage/ pre-cancerous changes to the lining of the esophagus. Presumably they did not find any but do get the full report to read yourself. 

 

 

  • Author
25 minutes ago, Sheryl said:

Re the HH   I suggest you get a copy of the actual report of the endoscopy you just had. It will have far more detail than the  verbal nurse report. You might well find that it mentions a small HH.

 

I specifically asked the nurse about a hiatal hernia, and she said there wasn't one. When I mentioned that I'd previously been diagnosed with one in Thailand, she rolled her eyes and took me to the person who performed the endoscopy. The endoscopist also confirmed that no hiatal hernia was found. I brought up my prior diagnosis in Thailand again, noting that the two diagnoses were seven years apart and came from modern hospitals (I know I shouldn't have gone there). The endoscopist again insisted there was no hernia but then said, "Maybe the hernia is so small I can't see it?"

 

Ridiculous. 
 

  • Author
12 hours ago, Lorry said:

How much time has passed between the Thai endoscopies and the Canadian one?

 

3 years maybe.

 

The only thing I can think of is that after drinking 4 liters of Peglyte and not eating for almost 2 days the small hernia became somehow became invisible.

12 minutes ago, Celsius said:

 

I specifically asked the nurse about a hiatal hernia, and she said there wasn't one. When I mentioned that I'd previously been diagnosed with one in Thailand, she rolled her eyes and took me to the person who performed the endoscopy. The endoscopist also confirmed that no hiatal hernia was found. I brought up my prior diagnosis in Thailand again, noting that the two diagnoses were seven years apart and came from modern hospitals (I know I shouldn't have gone there). The endoscopist again insisted there was no hernia but then said, "Maybe the hernia is so small I can't see it?"

 

Ridiculous. 
 

Small HHs are often missed on endoscopy, especially small sliding HHs ,   this is true.  Barium swallow is actually better for diagnosis of this.

 

You should still get the full report. In particular you want to see the description of the esophageal mucosa.

 

Whether or not you have an HH is far less important than whether or not your reflux is causing changes to the esophageal lining.  

On 7/31/2025 at 8:39 AM, Celsius said:


I just had a colonoscopy and endoscopy in Toronto, and the nurse told me everything looks perfectly fine. This is surprising because I experience reflux and indigestion almost daily, which also cause breathing problems. I know reflux is the culprit because Miracid always alleviates my symptoms, including the breathing issues.
What's truly perplexing is that I was diagnosed with a hiatal hernia twice before, five and seven years ago, at two different hospitals in Thailand (Vejthani and Medpark, respectively). How is it possible that two separate hospitals in Thailand made the exact same diagnosis, yet the Toronto endoscopy center found nothing?

 

Moreover I was also diagnosed with mild gastritis also twice, but that's  gone too.

 

Somehow I'm very suspicious of "findings" that found nothing. Maybe canadian healthcare IS ****

 

@Sheryl I would appreciate some input from you and our esteemed members.
 

How was the hiatal hernia being diagnosed? Ultrasound? CT?

Same for LES? How it was diagnosed?

What about your habits? Drinking, eating, smoking, food?

How about you weight, height, exercises?

Without those readings NO advices possible.

 

 

 

I found sleeping on my left side the reflex went away by itself try sleeping on your left side I know it sounds crazy but it worked for me TIT

Hiatal hernia and refluxoesophagitis are two different diagnoses. There different possibilities.

1. reluxoesophagitis without hi the slingatal herniass

2, refluxoesophagitis with hiatal hernia

3. sliding hiatal hernia with or without endoscopic signs of esophagitis.

4, reflux complaints without endoscopic abnormalities: diagnosis made by 24 hr pH measurement.

 

The sliding hiatal hernia could be intermittent, when a lot of air is inflated during de endoscopy the hiatal hernia will disappear.

 

Gastritis is not an endoscopic diagnosis. The so called red stomach at endoscopy has no meaning. The diagnosis gastritis can only be made by microscopic examination of gastric biopsies. (often in combination with culture of H.Pylori).

 

DikW,  MD,PhD; retired gastroenterologist

 

2 hours ago, DikW said:

Hiatal hernia and refluxoesophagitis are two different diagnoses. There different possibilities.

1. reluxoesophagitis without hi the slingatal herniass

2, refluxoesophagitis with hiatal hernia

3. sliding hiatal hernia with or without endoscopic signs of esophagitis.

4, reflux complaints without endoscopic abnormalities: diagnosis made by 24 hr pH measurement.

 

The sliding hiatal hernia could be intermittent, when a lot of air is inflated during de endoscopy the hiatal hernia will disappear.

 

Gastritis is not an endoscopic diagnosis. The so called red stomach at endoscopy has no meaning. The diagnosis gastritis can only be made by microscopic examination of gastric biopsies. (often in combination with culture of H.Pylori).

 

DikW,  MD,PhD; retired gastroenterologist

 

 While we have an expert onboard (rare thing here), someone can have gastritis without H.Pylori? i have intermittent gastritis but the breath test was negative

19 hours ago, TheFishman1 said:

I found sleeping on my left side the reflex went away by itself try sleeping on your left side I know it sounds crazy but it worked for me TIT


It doesn't sound crazy at all. When laying on the left side, the esophagus is positioned above the stomach, allowing gravity to help keep stomach acid from flowing back up. 
 

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On 8/6/2025 at 6:00 AM, scubascuba3 said:

 While we have an expert onboard (rare thing here), someone can have gastritis without H.Pylori? i have intermittent gastritis but the breath test was negative

Yes, it is possible to have gastritis without h. Pylori.

 

It is also very  possible to get a false negative on breath test. Especially if PPIs (omeprazole etc) were taken within 2 weeks prior. Certain other medications also  interfere including antibiotics and bidmuth preparations (includes Gaviscon and Pepto Bismol)   https://www.ncbi.nlm.nih.gov/books/NBK542286/

 

But what exactly do you mean by "intermittent gastritis"  and how was diagnosis made? 

6 hours ago, Sheryl said:

Yes, it is possible to have gastritis without h. Pylori.

 

It is also very  possible to get a false negative on breath test. Especially if PPIs (omeprazole etc) were taken within 2 weeks prior. Certain other medications also  interfere including antibiotics and bidmuth preparations (includes Gaviscon and Pepto Bismol)   https://www.ncbi.nlm.nih.gov/books/NBK542286/

 

But what exactly do you mean by "intermittent gastritis"  and how was diagnosis made? 

A few years ago i went to RSH in Bangkok and did the breathtest (no PPIs etc), it was negative, Dr indicated probably gastritis and symptoms gastritis like, anyway it comes and goes, for a few weeks then gone, currently on omeprazole for a few months then I'll stop and see how it feels, usually i only do for around a month then stop. i haven't bothered with an endoscopy yet, in the future maybe if it gets worse

  • Author
1 hour ago, scubascuba3 said:

A few years ago i went to RSH in Bangkok and did the breathtest (no PPIs etc), it was negative, Dr indicated probably gastritis and symptoms gastritis like, anyway it comes and goes, for a few weeks then gone, currently on omeprazole for a few months then I'll stop and see how it feels, usually i only do for around a month then stop. i haven't bothered with an endoscopy yet, in the future maybe if it gets worse

 

You should go if you are of certain age.

 

My wife went for endo\colon combo before we left for canada. Surprisingly they cound 2 polyps in her esophagus and zero 8n her colon. Usually its the other way around.

On 7/31/2025 at 8:39 AM, Celsius said:


I just had a colonoscopy and endoscopy in Toronto, and the nurse told me everything looks perfectly fine. This is surprising because I experience reflux and indigestion almost daily, which also cause breathing problems. I know reflux is the culprit because Miracid always alleviates my symptoms, including the breathing issues.
What's truly perplexing is that I was diagnosed with a hiatal hernia twice before, five and seven years ago, at two different hospitals in Thailand (Vejthani and Medpark, respectively). How is it possible that two separate hospitals in Thailand made the exact same diagnosis, yet the Toronto endoscopy center found nothing?

 

Moreover I was also diagnosed with mild gastritis also twice, but that's  gone too.

 

Somehow I'm very suspicious of "findings" that found nothing. Maybe canadian healthcare IS ****

 

@Sheryl I would appreciate some input from you and our esteemed members.
 

I have what they call 'mild' hiatal hernia, and have had acid reflux since my 20s. I take the proton pump inhibitors (PPIs) like Nexium. Only way to daignose it for sure is with the endoscopy, and any other doctor is just guessing from your symptoms. PPIs are risky though. A lot of mounting evidence that they weaken your stomach/small intestine's ability to absorb vitamins (over many years) - but doctors still hand them out like candy because they do work to get rid of the reflux. (BTW - you can have acid reflux without a hiatus hernia).

  • Author
1 hour ago, ronnie50 said:

I have what they call 'mild' hiatal hernia, and have had acid reflux since my 20s. I take the proton pump inhibitors (PPIs) like Nexium. Only way to daignose it for sure is with the endoscopy, and any other doctor is just guessing from your symptoms. 

 

As I mentioned many times before I had endoscopy at 2 different thai hospitals years apart and they both had the same diagnosis.

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