Oh dear that sounds awful and it sounds exactly like my cough except my hernia is smaller. So far. I’m always afraid that my wracking will enlarge it! It really does translate into a quality of life thing. I’ve avoided the procedures you’re talking about and instead watch my food intake and take 10mg Omeprazole every morning, Pepcid before dinner. I will still cough til I gag often and it is exhausting but the diet modifications and not eating for hours before bed helps a bit. Others here have done that 24hour test. Hope someone here can ease your mind about it. Good luck.