Hiatal Hernia Self Test 

Take a self test to determine if you have the many influences that cause the symptoms of  a hiatal hernia? Please indicate by selecting from one of the following: 0 = none, 1 = occasionally, 2 = mild symptoms, 3 = moderate symptoms, 4 = severe, and 5 = debilitating

0 1 2 3 4 5    1. Do you have burning with acid reflux after you eat?

0 1 2 3 4 5    2. Do you have acid reflux several hours after eating? 

0 1 2 3 4 5    3. Do you take an antacid tablet to calm the burning down?

0 1 2 3 4 5    4. Do you feel you are not digesting your food adequately?

0 1 2 3 4 5    5. Do you have poor absorption symptoms?

0 1 2 3 4 5    6. Do you get sleepy after eating?

0 1 2 3 4 5    7. Does your blood sugar drop mid morning or mid afternoon?

0 1 2 3 4 5    8. Do you feel like you have a knot in your stomach?

0 1 2 3 4 5    9. Do you have an allergic reaction after eating?

0 1 2 3 4 5   10. Do you have gas after eating? 

0 1 2 3 4 5   11. Are you bloated after eating? 

0 1 2 3 4 5   12. Do you feel like you have a brick in your stomach after eating potatoes and meat? 

0 1 2 3 4 5   13. Do certain foods tend to produce more gas than others?

0 1 2 3 4 5   14. Are  your cholesterol and triglyceride's high? 

0 1 2 3 4 5   15. Do you have high blood pressure? 

0 1 2 3 4 5   16. Does your esophagus feel like it is closing off and preventing you from swallowing? 

0 1 2 3 4 5   17. Do you feel like there a lump in your throat?

0 1 2 3 4 5   18. Do you have unexplained severe chest pains you have checked and your heart is ok?? 

0 1 2 3 4 5   19. Are your ribs sore to the touch on the sides and front of the chest?

0 1 2 3 4 5   20.  Does you breast bone (sternum) stay sore?

0 1 2 3 4 5   21. Do your legs and feet get cold or stay cold?

0 1 2 3 4 5   22. Do your hands an arms stay cold?

0 1 2 3 4 5   23. Have you been in a car accident?

0 1 2 3 4 5   24. Were you wearing a seatbelt at the time of a car accident?

0 1 2 3 4 5   25. Did the airbag go off when you were in an accident?

0 1 2 3 4 5   26. Do you swell easily and hold fluids easily?

0 1 2 3 4 5   27. Are you constipated?

0 1 2 3 4 5   28. Do you have bowel movements every other day or less frequently? 

0 1 2 3 4 5   29. Have you had any falls on your tail bone recently? 

0 1 2 3 4 5   30. Have you banged you head or hit your head recently?

0 1 2 3 4 5   31. Have you been pregnant?

0 1 2 3 4 5   32. Did you gain weight that you couldn't loose after anyone of the pregnancies?

0 1 2 3 4 5   33. Did you experience digestive problems after your pregnancies?

0 1 2 3 4 5   34. Did you experience headaches or back pain after your pregnancies? 

If you answer "YES" which means 1,2,3,4 for level of severity, to more than ten questions, you have tendencies toward  hiatal hernia. This links to other systems in the body creating a network of deeper layers and causes. These causes link to prior injuries, poor blood supply to the abdomen and legs, lack of proper oxygen in the system, rib cage distortion, disturbances in the processing of fluids through the kidneys, adrenal dysfunction,  poor digestive patterns, cranial injuries, spinal injuries, hidden disc's injuries in the neck and upper back,  glandular disturbances,  and early primitive reflexes from early childhood, embryonic reflexes before birth. All this says is you have learned some very bad posture habits, trauma induced. This also means that there are hidden causes that have been left unresolved. 

To clarify this see hiatal hernia, frozen shoulder, functional endocrinology,  head injury, spine trauma, car accident trauma or you may wish to evaluate yourself with other self tests.

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 After taking the test above, send the results to us with the information below. We'll get back to you by E-mail within a week. We will give you an overview and a new perspective of what can be done. Or you can call our office for an appointment and consultation. 706-379-1225

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