Most hernias can be diagnosed with a simple physical exam. Your doctor may ask you to stand and either cough or strain, revealing a hernia bulge. If your doctor cannot make a diagnosis from this activity, he or she may order an imaging test, such as an ultrasound, CT scan or MRI.
Hiatal hernias are treated a little differently because of their location between the esophagus and the stomach. If your doctor suspects you have a hiatal hernia, you may have a test called an esophagogastroduodenoscopy. During this test, a flexible tube with a camera on it will be fed gently down your throat to see your esophagus more clearly. You also may have an esophagram, an imaging study to visualize how your esophagus functions. These tests can reveal a hiatal hernia.