A hiatal hernia occurs when a portion of the stomach protrudes through the diaphragm, the muscle that separates the chest and abdominal cavities. While many individuals with hiatal hernias experience no symptoms, others may suffer from heartburn, acid reflux, and other discomforts. A well-structured diet and specific lifestyle adjustments can significantly alleviate these symptoms and improve overall quality of life.
Understanding Hiatal Hernias and Their Symptoms
A hiatal hernia involves a part of your stomach extending or pushing through a small opening (hiatus) in your diaphragm. Researchers are not sure exactly why they develop, but hiatal hernias are common. When you have a hiatal hernia, it is easier for stomach acids to come up into the esophagus, the tube that carries food from your throat to your stomach. This causes a burning feeling in your throat and chest.
The primary symptom of a hiatal hernia is heartburn. The main symptom of a hiatal hernia is acid reflux, which is when acid and other stomach contents flow back up the food pipe. You may experience heartburn (burning sensation in the chest), sore throat, belching, and epigastric pain, among others. Chronic acid reflux may also lead to gastroesophageal reflux disease (GERD). Hiatal hernias are one of the leading causes of gastroesophageal reflux disease (GERD). This means that the recommended foods to eat are similar to those that help the symptoms of GERD.
Larger hiatal hernias may require surgery. Hiatal Hernia repair involves making a valve around the lower part of the esophagus to prevent reflux.
The Role of Diet in Managing Hiatal Hernia Symptoms
Diet may impact the frequency and severity of acid reflux symptoms related to hiatal hernia. What you eat may soothe or worsen these symptoms. In fact, dietary adjustments and other lifestyle changes are often the first line of management for acid reflux, GERD, and hiatal hernias.
Read also: Hiatal Hernia and Diet
Your diet may significantly impact acid reflux and other symptoms associated with a hiatal hernia. Dietary changes can help manage and prevent symptoms. There are certain foods that a person can add to their eating plan to help with symptoms, these include lean meats, non-citrus fruits, and certain fermented foods. Foods to limit or avoid include, spicy foods, fried foods, and vegetables, like garlic and onions.
Hiatal hernia diets are similar to those recommended for GERD. The first step is usually identifying triggers (foods that cause symptoms to worsen) and then avoiding these foods. Not everyone has the same trigger foods, so it may be worth paying close attention to the relationship between what you eat and your symptoms.
Foods to Incorporate into Your Hiatal Hernia Diet
The best food choices for people with hiatal hernias are non-acidic, minimally processed, and high in fiber. In general, you want to add foods that reduce inflammation, neutralize stomach acid, and prevent tissue irritation. Non- or low-acidic foods may reduce the likelihood and severity of hiatal hernia and GERD symptoms.
Examples of foods to eat may include:
- Lean Meats: Opt for lean sources of protein like turkey and chicken. Choose lean meats, such as skinless chicken, meat with little visible fat, ground turkey instead of ground beef, and fish. Lean beef cuts include round, chuck, sirloin, or loin. Lean pork cuts include tenderloin or loin chop.
- Other Lean Proteins
- Rice, Pasta, and Breads
- Non-Citrus Fruits: Include fruits like apples, bananas, pears, melons, berries, and papaya. Bananas and apples are good choices.
- Fresh Vegetables: such as artichokes, carrots, sweet potatoes, asparagus, squash, green beans, leafy greens, and peas. Green beans, peas, carrots, and broccoli are also recommended.
- Crackers or Pretzels
- Whole Grains: The fiber content of fresh foods should help with your acid reflux.
- Nuts and Seeds: like almonds chia seeds, and sunflower seeds.
- Low Fat Yogurt
- Probiotic Foods: Fermented or cultured foods that are rich in probiotics may also help reduce hiatal hernia and GERD symptoms. Popular fermented foods include unsweetened yogurt, kimchi, kefir, sauerkraut, kombucha, cheese, miso, tofu, and buttermilk. Cultured vegetables, like pickles, are a tasty option. Yogurt, kefir, and kombucha are other good choices. Taking a probiotic supplement is also an option.
- Plant-Based Milks: (preferably low in sugar), like soy milk, oat milk, and almond milk. Try soy milk; it may be a good milk substitute.
- Certain Natural Juices: such as aloe vera, carrot, and cabbage juice.
- Water: Drinking 8 glasses of water per day may help. Try adding lemon to your water for additional acid-lowering power. Lemon is a fruit that, although acidic outside the body, is metabolized to have alkaline byproducts.
Try to choose fresh and whole foods over processed ones whenever possible.
Read also: Understanding Hiatal Hernia Before Weight Loss
Foods to Limit or Avoid
Limiting or avoiding certain foods might help reduce and prevent symptoms of indigestion or GERD, including heartburn, bloating, gas, and regurgitation. The following foods are highly acidic or may weaken the lower esophageal sphincter, making it easier for stomach acids to back up into your esophagus. They may cause heartburn symptoms.
It is a good idea for people with a hiatal hernia to limit or avoid foods that are acidic, rich, oily, or contain preservatives. Foods to limit or avoid may include:
- Fried Foods Fried and fatty foods, such as fried chicken and fatty cuts of meat
- Spicy or Highly Seasoned Foods Spicy food
- Certain Vegetables: such as garlic, onion, and peppers. Garlic and onions
- Smoked or Salted Fish
- Pickles, Vinegar, or Mustard
- Strongly Flavored Meats and Sausages
- Strong Cheeses
- Dried Nuts and Fruit
- Strong Tea or Coffee Coffee, tea (including decaffeinated versions)
- Alcohol: such as wine, beer, and spirits
- Chocolate
- Mint: Peppermint and spearmint has also been reported as a trigger for GERD symptoms in some people.
- Citrus Foods: such as oranges, grapefruits, and lemons, and orange juice, grapefruit juice, cranberry juice, and lemonade
- Tomato-Based Foods: such as spaghetti sauce, pizza, chili, salsa, and tomato juice
- Carbonated Beverages Carbonated drinks, such as seltzer water and soda
- Dairy Products: such as whole milk, ice cream, and creamed food. Also, mild cheeses, like feta or goat, may be enjoyed in moderation.
- Oil and Butter
- Sugary foods
- Foods high in sodium
- Whole milk
Sample "Full Liquid" Diet Recipes
Most patients start out on a "full liquid" diet after having esophageal or stomach surgery. For many patients, that means 2 weeks on this diet, but may be longer depending on the patient and operation performed.
Here are some helpful hints to remember:
- Avoid carbonated beverages, straws, gum, or anything that makes you swallow air
- Avoid ice or chilled liquids for several weeks after surgery. Cold things can bother your esophagus and make you have a painful spasm. (If that happens to you - drink a glass of hot water!)
- Hot or room temperature liquids will be smoothing after surgery
- Spicy foods, tomatoes, and caffeine are fine after surgery
- No chunks - make sure everything is blended or strained.
- Eat slowly and mindfully.
Lifestyle Adjustments to Complement Your Diet
Aside from diet, a person could try making some lifestyle adjustments to help manage hiatal hernia and GERD symptoms.
Read also: Lifestyle Changes for Hiatal Hernia
Lifestyle tips for managing hiatal hernia symptoms include:
- Maintain a Moderate Weight: Managing your weight so it’s optimal for your age and height. Lose weight, if necessary.
- Quit or Avoid Smoking: Stopping tobacco use if you smoke. Do not smoke.
- Elevate the Head While Sleeping: Elevating the head of your bed so your chest is slightly higher than the legs. Raise the head of your bed 6 to 8 inches with wood blocks or some other sturdy objects. Propping your head up with pillows probably won't give you the relief you need.
- Eat Smaller and More Frequent Meals: Eat small meals every few hours instead of three large meals during the day. Do not overeat. Instead, eat small, frequent meals.
- Do Not Skip Meals
- Drink Fluids After a Meal Instead of During It
- Avoid Eating or Drinking Late at Night
- Eat Slowly and Chew Food Well: And take your time. Eating fast can make heartburn symptoms worse. Eating your meals in a calm and relaxing place eating slowly and chewing well.
- Avoid Eating Foods That Are Very Hot or Very Cold
- Avoid Triggering Foods
- Walking After Eating: walking after eating and avoiding going to bed shortly after a meal.
- Sleeping on Your Left Side
- Skipping Tight-Fitting Clothes: which can make your heartburn worse. Wear loose-fitting clothes so as to not add extra pressure on your stomach.
- Do not bend over right after eating.
- Managing Stress: Managing stress and practicing stress-reducing strategies, such as walking, being in nature, mindfulness, meditation, or yoga, may also help manage symptoms.
Additional Tips for Preventing and Managing Symptoms
- Cook with healthy fats: like avocado, coconut, and olive oils.
- Bake or broil foods instead of frying.
- Skim off fat from meat during cooking.
- Go easy on seasoning: Most seasonings are OK as long as they are not spicy but should be used in moderation.
- Substitute low-fat dairy foods: such as low-fat yogurt, for ice cream. Also, mild cheeses, like feta or goat, may be enjoyed in moderation.
- Steam your vegetables with water only.
- Limit butter, oils, and cream sauces: Use cooking spray instead of cooking oil when sautéing.
- Choose low-fat or nonfat ingredients over full-fat products.
- Get creative: There are all kinds of ways to modify recipes. Don't be afraid to try new things.
- Drink plain water: Drinking 8 glasses of water per day may help. Try adding lemon to your water for additional acid-lowering power. Lemon is a fruit that, although acidic outside the body, is metabolized to have alkaline byproducts.
Medical Interventions and When to Seek Help
A person can also take over-the-counter antacids, though long-term use does carry risks. Individuals should discuss the use of antacids with their healthcare professional. A person should seek medical attention if symptoms do not go away within 3 weeks or if their symptoms are severe or worsen over time.
A healthcare professional may assess heartburn, abdominal pain, bloating, gas, or regurgitation that does not improve with the use of antacids, dietary changes, and lifestyle adjustments.
A healthcare professional can prescribe medications designed to treat indigestion that can reduce discomfort and improve the overall quality of life for people with hiatal hernias. However, making lifestyle and diet changes is generally the first step.
Sometimes surgery may be necessary.
Bariatric surgery considerations
Bariatric surgery is a medical procedure performed on individuals who are severely obese, and it involves reducing the size of the stomach or rerouting the digestive system to promote weight loss.
It is commonly recommended for bariatric surgery patients to aim for at least 64 ounces (about 1.9 liters) of fluids per day. Bariatric surgery patients should be vigilant about signs of dehydration, including dark urine, dizziness, rapid heart rate, and dry mouth. Pay attention to your body's signals. If you're thirsty, drink water.
Early Post-Op Stage often involves sipping water throughout the day, starting with small amounts and gradually increasing as tolerated.