Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Yes, symptoms of these two may be very similar and hiatal hernia usually presents with all signs of acid reflux. However, there may be also some additional symptoms such as breathing difficulties, sleeping disorder, or excessive bloating. Hiatal hernia happens when stomach is protruding through diaphragm muscle. It may cause breathing difficulties, nausea, swallowing difficulties, and irritation of stomach. It will also be aggravated by certain food or medications, stress and smoking. You need to avoid fried food, carbonated drinks, coffee, alcohol, and spicy food. You should eat more milk products, vegetables, and boiled food. Also, certain antacid medications may be required and as last option, it is possible to perform surgical repair of hernia especially, if there are progressive respiratory discomfort and dyspepsia. To diagnose it you should do gastroscopy or bariums contrast test. This will show you if there is hernia present or not. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Ivan R. Rommstein