Hi, I would initially like to describe you about hiatus hernia, Gerd, IBS hiatus hernia- hernia is defined as an area of weakness or disruption of the fibromuscular tissues of the body wall. There are different types of hiatus hernia based on displacement of the different structures like displacement of the gastrooesophageal junction or displacement of fundus of stomach with the ge junction and esophagus in to the mediastinum through the hiatus. There are 3 types of hiatus hernia: 1. sliding hernia 2. rolling hernia 3. combined these hernias present with symptoms like features of Gerd like pain and burning sensation in retro sternal area referred to shoulder, neck, arm, heart burn, dysphagia, abdominal pain, chest pain, regurgitation, post prandial bloating. Hiatus hernia diagnosed by plain X-ray, barium meal, CT scan treatment by surgery by mesh repair. GERD occurs due to reflux of acidic gastric content, it can be seen in patients with hiatus hernia. Diagnosis made by barium meal X-ray, gastrostomy, biopsy. Treatment done with antacids, H2 blockers, ppi, prokinetics. 1. IBS - irritable bowel syndrome - it occurs due to bowels becoming over sensitive and overreacting to mild stimulation. Patients present with diarrhea, constipation, constipation alternating with diarrhea, bellypains, cramps, lot of gas, bloating treatment of ibs include to modify dietary habits and lifestyle like to avoid caffeine. Add more fiber to your diet, like fruit, vegetables, whole grains and nuts, drink 4-5 glasses of water, limited cheese intake, medicines like antispasmodics, anti-diarrheals, bulking agents, antidepressants. prebiotic. In the above I am thinking patient is suffering from hernia which caused Gerd and the symptoms are due to the IBS and Gerd, hernia. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Pavani