A hiatal hernia occurs when a portion of the stomach protrudes through the diaphragm, the muscle that separates the chest and abdomen, into the chest cavity. This condition can lead to acid reflux, heartburn, and other uncomfortable symptoms. While hiatal hernias are common, understanding how diet and lifestyle choices impact these symptoms is crucial for effective management. Dietary adjustments and lifestyle changes are often the first line of defense. This article provides a comprehensive guide to dietary recommendations for managing hiatal hernia symptoms, including foods to enjoy, foods to limit, and lifestyle adjustments that can help.
Understanding Hiatal Hernia
A hiatal hernia involves a part of the stomach extending or pushing through a small opening (hiatus) in your diaphragm. The diaphragm is a parachute-shaped muscle that extends along the rib cage, under the lungs, and helps you breathe in and out. Your food pipe passes through the muscle to connect to the stomach. While researchers are not entirely sure why hiatal hernias develop, they are prevalent, affecting a significant portion of the population, with estimates suggesting that up to 60% of people may have one by age 60.
Symptoms of Hiatal Hernia
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, in fact, one of the leading causes of gastroesophageal reflux disease (GERD). Many people with a hiatal hernia have no symptoms. For those who do, what they eat may make a difference between a good day (or night) and a bad one. Diet can play an important role in controlling the symptoms of hiatal hernia, namely heartburn and acid indigestion.
The Role of Diet in Managing Hiatal Hernia
Your diet may significantly impact acid reflux and other symptoms associated with a hiatal hernia. What you eat may soothe or worsen these symptoms. The primary symptom of a hiatal hernia is heartburn. Certain foods and lifestyle habits can increase a person’s chances of experiencing uncomfortable symptoms. By making dietary changes, you can help ease symptoms of heartburn and acid reflux. Diet modification is one of the cornerstones of hiatal hernia treatment. While there is no "hiatal hernia diet" per se, there are guidelines that help direct not only what you eat but how you eat.
Read also: The Hoxsey Diet
Foods to Include in Your Diet
In general, you want to add foods that reduce inflammation, neutralize stomach acid, and prevent tissue irritation. Alkaline foods are those with a pH of over 7.0. Watery foods help manage GERD by diluting stomach acids. High-fiber foods increase satiety (a feeling of fullness). Lean proteins are needed to build lean muscle. Some studies suggest that probiotic foods may be beneficial to people with GERD.
Non- or low-acidic foods may reduce the likelihood and severity of hiatal hernia and GERD symptoms. The best food choices for people with hiatal hernias are non-acidic, minimally processed, and high in fiber. Eating high-protein, high-fiber foods that are not acidic can help control hiatal hernia symptoms. You should also look for foods that are low in fat and mild (no spicy salsa!).
Safe foods to eat may include:
- Non-Citrus Fruits: Apples, pears, melons, berries, and papayas are gentle on the stomach and less likely to trigger acid reflux. Bananas and apples are low-acid-producing foods and are less likely to aggravate your hiatal hernia symptoms.
- Fresh Vegetables: Artichokes, carrots, sweet potatoes, asparagus, squash, green beans, leafy greens, and peas are all good choices. Leafy greens, artichoke and asparagus are examples of such choices.
- Whole Grains: Opt for whole grains like brown rice, oatmeal, and whole-wheat bread. Grains, like cereals (bran and oatmeal), bread, rice, pasta, and crackers are beneficial. The fiber content of fresh foods should help with your acid reflux.
- Lean Proteins: Choose lean meats like turkey and chicken, other lean proteins, rice, pasta, and breads. Include lean beef cuts (round, chuck, sirloin, or loin) and lean pork cuts (tenderloin or loin chop). Lean meat, chicken, and fish are good options.
- Nuts and Seeds: Almonds, chia seeds, and sunflower seeds can be healthy additions to your diet. Whole nuts and seeds are recommended.
- Low-Fat Yogurt: Choose low-fat yogurt, preferably unsweetened. Low-fat or skim milk and low-fat yogurt are good choices.
- Probiotic Foods: Sauerkraut, kombucha, kimchi, kefir, cheese, miso, tofu and buttermilk are fermented foods that are rich in probiotics. Fermented or cultured foods that are rich in probiotics (acid-neutralizing stomach bacteria) may also help reduce hiatal hernia symptoms.
- Plant-Based Milks: Soy milk, oat milk, and almond milk are good alternatives to whole milk. Try soy milk; it may be a good milk substitute.
- Certain Natural Juices: Aloe vera, carrot, and cabbage juice may be soothing. Non-citrus fruits and juices are recommended.
- Other: Beans and peas, ginger, cardamom, coriander, apple cider vinegar, non-caffeinated teas (especially green tea), and cinnamon are also beneficial.
Foods to Limit or Avoid
Knowing which foods to avoid if you have a hiatal hernia is as important as knowing which foods to eat. Limiting or avoiding certain foods might help reduce and prevent symptoms of indigestion or GERD, including heartburn, bloating, gas, and regurgitation.
A good idea for people with a hiatal hernia to limit or avoid foods that are acidic, rich, oily, or contain preservatives. Limit butter, oils, and cream sauces.
Read also: Walnut Keto Guide
Foods to limit or avoid may include:
- Citrus Fruits: Limes, oranges, and other citrus fruits can worsen symptoms. Acidic foods like citrus fruits, like oranges and grapefruit, increase the acidity in the stomach and typically make heartburn symptoms worse. Citrus foods, such as oranges, grapefruits, and lemons, and orange juice, grapefruit juice, cranberry juice, and lemonade should be avoided.
- Tomatoes and Tomato-Based Foods: Salsa, bruschetta, spaghetti and pizza sauces, and other tomato-based foods can trigger acid reflux. Tomato-based foods such as spaghetti sauce, pizza, chili, salsa, and tomato juice should be avoided.
- Spicy Foods: Spicy foods can irritate the esophagus and worsen heartburn.
- Fried and Fatty Foods: These foods can slow down digestion and increase the risk of acid reflux. The Canadian Society of Intestinal Research (CSIR) recommends avoiding high-fat foods if you have GERD. Fatty and fried foods, such as fried chicken and fatty cuts of meat should be avoided.
- Sugary Foods: Foods high in sugar can contribute to inflammation and worsen symptoms. It is also important to keep in mind that reducing sugar intake may help improve GERD symptoms. This means that probiotic ice creams, juices, yogurts, sweetened protein powders, and gummies are typically not a good source of probiotics.
- Foods High in Sodium: High-sodium foods can increase stomach acid production.
- Chocolate: Chocolate can relax the lower esophageal sphincter and increase acid reflux.
- Peppermint and Mint: Peppermint and mint can relax the lower esophageal sphincter. Mint has also been reported as a trigger for GERD symptoms in some people.
- Alcohol: Wine, beer, and spirits can irritate the esophagus and worsen symptoms. Alcohol, such as wine, beer, and spirits should be avoided.
- Coffee and Caffeinated Teas: Caffeine can increase stomach acid production. Coffee, tea (including decaffeinated versions) should be avoided.
- Carbonated Drinks: Seltzer water and soda can increase pressure in the stomach. Carbonated beverages, such as seltzer water and soda should be avoided.
- Whole Milk: Dairy products, such as whole milk, ice cream, and creamed food should be avoided. Try soy milk; it may be a good milk substitute. Also, mild cheeses, like feta or goat, may be enjoyed in moderation.
- Other: Onions and garlic, certain vegetables, such as garlic, onion, and peppers, smoked or salted fish, pickles, vinegar, or mustard, strongly flavored meats and sausages, strong cheeses, dried nuts and fruit, strong tea or coffee should be avoided.
Cooking and Eating Habits
The way you cook and eat your food can make a difference. How you eat is as important as what you eat when you have a hiatal hernia. Good eating habits are key to controlling symptoms of GERD.
To reduce the chance of acid reflux, consider these tips:
- Cook with Healthy Fats: Use avocado, coconut, and olive oils. Use healthy oils like olive, grapeseed, or avocado oil. Avoid butter, lard, ghee, and coconut oil.
- Eat Whole Foods: Choose whole foods instead of processed foods whenever possible. The fiber content of fresh foods should help with your acid reflux.
- Eat Small, Frequent Meals: Eat small meals every few hours instead of three large meals during the day. Do not overeat. Instead, eat small, frequent meals. And take your time. Eating fast can make heartburn symptoms worse. Eat smaller, more frequent meals.
- Add Probiotic Foods: Cultured vegetables, like pickles, are a tasty option. Yogurt, kefir, and kombucha are other good choices. Taking a probiotic supplement is also an option. Add probiotic foods to your diet.
- 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. Fruits and vegetables with a high water content can dilute stomach acid and reduce reflux. So can drinking lots of water.
- Choose Lean Meats: Opt for 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. 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.
- Bake or Broil: Prepare foods by baking or broiling instead of frying. Avoid deep-frying. Instead, try broiling, steaming, or baking meats, fish, and vegetables.
- Skim Fat: Remove fat from meat during cooking. Skim off fat from meat during cooking.
- Go Easy on Seasoning: Use seasonings in moderation, avoiding spicy options. Most seasonings are OK as long as they are not spicy but should be used in moderation.
- Substitute Low-Fat Dairy: Replace ice cream with low-fat yogurt. Substitute low-fat dairy foods, such as low-fat yogurt, for ice cream.
- Steam Vegetables: Steam vegetables with water only. Steam your vegetables with water only.
- Limit Fats: Reduce the use of butter, oils, and cream sauces. Use cooking spray instead of cooking oil when sautéing. Limit butter, oils, and cream sauces. Use cooking spray instead of cooking oil when sautéing.
- Choose Low-Fat Ingredients: Opt for low-fat or nonfat ingredients over full-fat products. Choose low-fat or nonfat ingredients over full-fat products.
- Get Creative: Modify recipes to make them healthier and more suitable for your condition. Get creative. There are all kinds of ways to modify recipes. Don't be afraid to try new things.
- Focus on Whole Foods: Focus on whole foods.
- Eat Sitting: Eat sitting in a straight-backed chair.
- Eat Slowly: Eat slowly to avoid gulping air.
- Do Not Lie Down: Do not lay down or bend over right after meals. Avoid lying down immediately after eating. Do not bend over right after eating.
- Avoid Very Hot or Cold Foods: avoid eating foods that are very hot or very cold
- Drink Fluids After Meals: drink fluids after a meal instead of during it
Lifestyle Adjustments
Aside from diet, a person could try making some lifestyle adjustments to help manage hiatal hernia and GERD symptoms. Lifestyle changes are the primary treatment 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 is important. Get to a healthy weight.
- Quit or Avoid Smoking: Stopping tobacco use if you smoke is crucial. Quit cigarettes. Quit smoking and drinking alcohol.
- Elevate the Head While Sleeping: Elevating the head of your bed so your chest is slightly higher than the legs is recommended. 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 smaller and more frequent meals.
- Do Not Skip Meals: Do not skip meals.
- Drink Fluids After Meals: drink fluids after a meal instead of during it
- Avoid Eating Late at Night: avoiding eating or drinking late at night
- Eat Slowly and Chew Food Well: eat slowly and chew food well
- Avoid Very Hot or Very Cold Foods: avoid eating foods that are very hot or very cold
- Avoid Lying Down After Eating: Avoid lying down immediately 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.
- Walking After Eating: walking after eating and avoiding going to bed shortly after a meal
- Sleeping on Your Left Side: sleeping on your left side
- Skipping Tight-Fitting Clothes: skipping tight-fitting clothes, which can make your heartburn worse
- Don’t slouch: Don’t slouch, as it can put extra stress on your stomach.
- Incorporate exercises: Incorporate exercises like walking, running, swimming, and biking into your fitness routine.
Over-the-Counter Medications
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. Over-the-counter (OTC) antacids and heartburn treatments can help prevent symptoms of hiatal hernia.
Read also: Weight Loss with Low-FODMAP
When to Seek Medical Attention
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.
Surgical Options
Sometimes surgery may be necessary. In severe cases, a hiatal hernia can become "pinched" in the diaphragm, cutting off blood flow to the stomach (strangulation). In severe cases, hiatal hernia surgery may be necessary to correct the issue.
tags: #hiatal #hernia #diet #recommendations