What are the indications for performing an endoscopy in patients with suspected hiatal hernias?

Indications for performing an endoscopy in patients with suspected hiatal hernias include:

• Presence of gastro-oesophageal symptoms that are non-responsive to treatment or unexplained after initial primary care assessment, warranting specialist referral and endoscopic evaluation to exclude complications or alternative diagnoses ¹.
• Before considering surgical intervention such as fundoplication, an upper GI endoscopy is recommended to confirm diagnosis and assess oesophageal mucosa, especially in children and young people but applicable in adults as well ³,¹.
• To evaluate for complications such as Barrett's oesophagus, which requires endoscopic confirmation and histopathology, particularly if there is chronic reflux or suspicion of metaplastic changes ¹,².
• In cases where there is suspicion of oesophageal adenocarcinoma or dysplasia, endoscopy with biopsies is indicated for diagnosis, staging, and surveillance ².