Can a hiatal hernia go away?

everything considered, i would get re-scoped by a different gastroenterologist, hopefully board certified. i've had a hiatal hernia with reflux for nearly 50 years.

Primula has the answer. Yes, a sliding hiatal hernia can be missed on scope. That's why I always recommend asking for a barium swallow.

The barium swallow is done while you're awake and using your stomach and esophagus. Who knows what the stomach does if you're asleep! Since they are both done on empty stomach it's possible to miss a small one that is not triggered into refluxing, reacting to stimulation.

A hernia where the stomach is always above the diaphragm is called a paraesophageal hiatal hernia. If it's large it's called giant paraesophageal hernia (GPEH). It's pretty obvious that these would "show."

Yes, it can be missed. Or even misdiagnosed. I had 8 endoscopies in the span of 5 years.

I had one gastro says it's a small para-esophageal hernia, other said it's a sliding one, 2 said there are just indirect signs of a hiatus hernia, one said there is no hernia.

I had surgeon do it too - he said yup, it's there and it's for surgery. I had some private issues and couldn't afford to be operated at that moment so I postponed for 6 months. The same surgeon does it again 6 months later - no, not for surgery. The only change I made in these 6 months - I reduced PPI from 40 to 20mg. I guess stomach gas had some role? Timing of the exam? Who knows...

One year later - yup - it's for surgery again.

Barium swallow scans are even worse. On more than half of them there was no visible hernia or reflux. On 2 it was visible both hernia and reflux.

It's scary actually. Such inconsistency with something that determines the most important decisions that are vital to your quality of life.

So, to summarize, in my experience and what I've learned and researched so far - it can be missed, but it can't "disappear" as in "cured" by itself or by manual manipulation often promised by some chiropractors. Part of the stomach goes up and down if there is extra room for that in the diaphragm opening , and it does that under certain conditions and depending on the size and position of that opening.

The only important questions are - how much symptoms it gives you and can you know if the symptoms are from hiatus hernia or something else, or it's the combination of hernia and something else. So if you figure what that something else is (like diet, some other lifestyle change, stress, sleep position...) and solve it, than hernia stops making you problems too...or at least does it less...