Ultimate Guide to Paraesophageal Hernia Repair: Essential Diet Tips and Recovery Secrets

Hiatal hernia surgery aims to correct a hernia in the diaphragm. Following the procedure, adhering to specific dietary guidelines is crucial for effective healing and preventing complications. This article offers a comprehensive guide to navigating your diet and lifestyle after paraesophageal hernia repair, ensuring a smooth and successful recovery.

Immediate Post-Operative Care and Diet

Expect to stay in the hospital for one to two days after the surgery. The morning after, a swallowing study will be performed to ensure everything is in the proper place. Post-surgery, dietary restrictions are necessary.

Initial Liquid Diet

For approximately three weeks after surgery, you will need to stay on a liquid/soft diet. The reason for this is that there will be some swelling in your esophagus where your hernia was repaired. You may also notice that swallowing feels a little "tight" - this will improve as the swelling goes down.

Clear Liquid Diet: Initially, you'll be on a clear liquid diet, which includes only liquids you can see through. Clear liquids are easiest for your body to digest. Examples include:

Water
Broth
Clear juices (apple, grape)

Full Liquid Diet: After a few days, you can move to full liquids, which include all the liquids in a clear liquid diet, plus liquids that are thicker or not clear. Examples include:

Read also: Hiatal Hernia and Diet

Soups
Milk
Smoothies

Transition to Soft Foods

During the liquid diet phase, you can experiment with soft, mushy foods. These foods are easy to digest and less likely to irritate the healing tissues of your upper digestive system. Options include:

Tuna
Mashed potatoes
Eggs
Cottage cheese
Thick soups

Dietary Progression and Long-Term Recommendations

With time, you will be able to digest foods normally. The general progression of your diet after hiatal hernia surgery includes a gradual move from liquid to solid food.

Weeks 4-6: Incorporating Solid Foods

When 4 to 6 weeks have passed, you can start incorporating solid foods into your diet. It’s critical to choose low-fat, non-spicy, and non-acidic foods. Opt for lean proteins, whole grains, and cooked vegetables.

Long-Term Diet

Even after recovery, maintaining a diet low in fat and high in fiber is beneficial. This helps prevent complications such as acid reflux and indigestion. It’s also wise to avoid foods known to trigger heartburn or gastrointestinal discomfort, such as caffeine, citrus fruits, and spicy foods.

What to Eat After Hernia Surgery: Key Nutrients

After surgery, your body shifts into healing mode. That means it needs high-quality fuel. Nutrient-dense foods reduce inflammation, strengthen your immune system, and help repair tissue.

Foods That Promote Healing

The best foods to eat after hernia surgery are simple, wholesome, and easy to digest. Start with lean proteins such as chicken, turkey, fish, tofu, or lentils. These options provide amino acids essential for rebuilding muscle and tissue around the surgical site. Whole grains-including brown rice, oats, and quinoa-offer sustained energy and fiber, which helps prevent constipation. Add fruits and vegetables in every meal to get vitamins, antioxidants, and hydration. Berries, greens, bananas, and squash are all excellent choices.

Understanding Post-Hernia Surgery Nutrition

What to eat after hernia surgery should focus on repair, hydration, and gut-friendly nutrients. Proteins, vitamins, and minerals all help rebuild tissue and reduce inflammation. Lean meats, eggs, beans, and fish are ideal protein sources that give your body the tools it needs to mend. Micronutrients like vitamin C and zinc also support wound healing and immune function. Add fruits such as oranges, berries, and kiwi, and vegetables like spinach, sweet potatoes, and bell peppers to your plate. These ingredients not only provide essential nutrients but also help fight inflammation naturally.

Low-Acid-Producing Foods

The following foods are low-acid-producing foods and are less likely to aggravate your hiatal hernia symptoms:

Bananas and apples
Green beans, peas, carrots, and broccoli
Grains, like cereals (bran and oatmeal), bread, rice, pasta, and crackers
Low-fat or skim milk and low-fat yogurt
Fat-free cheeses, cream cheese, and fat-free sour cream
Lean meat, chicken, and fish
Water
Pretzels, graham crackers, rice cakes, and baked potato chips
Low-fat sweets (no chocolate or mint)

Foods to Avoid

Equally important as knowing what to eat after hernia surgery is understanding what not to eat. Certain foods can increase bloating, discomfort, or slow healing. By avoiding these foods, patients can reduce complications and support a smoother recovery.

Highly Acidic Foods

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.

Citrus foods, such as oranges, grapefruits, and lemons, and orange juice, grapefruit juice, cranberry juice, and lemonade
Chocolate
Fatty and fried foods, such as fried chicken and fatty cuts of meat
Garlic and onions
Spicy food
Peppermint and spearmint
Tomato-based foods such as spaghetti sauce, pizza, chili, salsa, and tomato juice
Coffee, tea (including decaffeinated versions), and alcohol
Carbonated beverages
Dairy products, such as whole milk, ice cream, and creamed food. Try soy milk; it may be a good milk substitute. Also, mild cheeses, like feta or goat, may be enjoyed in moderation.
Oil and butter

What Not to Eat: Foods to Avoid After Hernia Surgery

Foods high in sugar and high in fat can slow healing and increase discomfort. Processed items high in sodium may cause water retention, while fried foods and fatty meats are harder to digest. Carbonated drinks can also add excess gas and discomfort.

Eating Habits and Lifestyle Adjustments

In addition to making adjustments to what you eat and how you cook, changing certain habits may lessen heartburn symptoms too.

Do not overeat. Instead, eat small, frequent meals. And take your time. Eating fast can make heartburn symptoms worse.
Avoid lying down or going to sleep for at least three hours after a meal.
Do not bend over right after eating.
Do not smoke.
Lose weight, if necessary.
Wear loose-fitting clothes so as to not add extra pressure on your stomach.
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 small, frequent meals (six to eight per day).
Eat very slowly.
Sit upright while eating and stay upright for 30 minutes after each meal. Gravity can help food move through your digestive tract. Do not lie down after eating.
Avoid sticky, gummy foods such as bananas.
Eat desserts and sweets at the end of your meal to avoid “dumping syndrome.” This describes the rapid emptying of foods from the stomach to the small intestine. Sweets move more rapidly and dump quickly into the intestines.
Drinking large amounts of fluids with meals can stretch your stomach.
Avoid drinking through a straw and chewing gum or tobacco. These actions cause you to swallow air, which produces excess gas in your stomach.
Avoid any foods that cause stomach gas and distention.

Cooking Tips

A good way to enjoy the foods listed above is to cook them in a healthy way. Here are some heartburn-friendly cooking tips:

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 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.
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.

Other Post-Operative Instructions

Activity

There are no significant restrictions on activity after surgery. That means it is OK to walk, climb stairs, have sexual intercourse, mow the lawn, or exercise as long as it doesn't hurt. In fact, returning to normal activity as soon as possible will most likely enhance your recovery. However, if it doesn't feel good, don't do it. Take it easy and let the pain be your guide.

Returning to Work

Everyone has different motivations toward their job, and thus everyone returns to work at different times. As a rough guide, most people take at least 1 - 2 weeks off prior to returning to work.

Bowel Movements

The first bowel movement may occur anywhere from 1 - 5 days after surgery - as long as you are not nauseated or having abdominal pain this variation is acceptable. Remember that it is very common to pass a lot more gas from your rectum than you used to - this is because you will not be able to really belch. Some patients also find that they have diarrhea or "loose bowels" for the first days after their hernia repair - in the vast majority of cases, the bowel function normalizes with time. Constipation may also be common due to the pain medication.

Incision Care

It is OK to shower starting around 36 hours after surgery. You might see little pieces of tape (called steri-strips) directly attached to your skin. It is OK to get these little tapes wet in the shower. The tapes will begin to peel up on the ends 7 - 10 days after surgery - at this point they have done their job and it is OK for you to peel them the rest of the way off if you wish. We try to close your incisions to leave the smallest possible scar. You’ll have 6 small incisions in your abdomen after your surgery. It’s normal to have some bruising and tenderness around your incisions. This will go away with time. If the bruising or tenderness gets worse, call your healthcare provider. You’ll have sutures (stitches) inside your incisions to help them heal. They will dissolve on their own. If you do, they will loosen and fall or peel off on their own. Taking a warm shower is relaxing and can help with aches and pains. Use soap and gently wash your incisions when you shower. After your shower, pat your incisions dry with a clean towel.

Lifting Restrictions

Do not lift anything heavier than 10 pounds (4.5 kilograms).

Managing Pain

You may have some pain after your surgery. Your healthcare providers will ask you about your pain often and give you medication as needed. If your pain is not relieved, tell one of your healthcare providers. It’s important to control your pain so you can use your incentive spirometer and move around. You’ll get a prescription for pain medication before you leave the hospital. Talk with your healthcare provider about possible side effects. Moving around and walking will help lower your risk for blood clots and pneumonia (lung infection). It will also help you start passing gas and having bowel movements (pooping) again. Getting up and walking every 2 hours is a good goal. Try to walk for as long as you comfortably can.

Preventing Constipation

It’s important to avoid constipation after your surgery. Constipation can lead to your hiatal hernia coming back. Talk with your nurse about how to prevent and manage constipation. Both over-the-counter and prescription medications are available to prevent and treat constipation. Ask your healthcare provider before taking any medications for constipation. This is very important if you have an ostomy or have had bowel surgery. Follow the instructions on the label or from your healthcare provider.

Docusate sodium (Colace®). This is a stool softener (medication that makes your bowel movements softer) that causes few side effects. You can use it to help prevent constipation.
Polyethylene glycol (MiraLAX®). This is a laxative (medication that causes bowel movements) that causes few side effects. Take it with 8 ounces (1 cup) of a liquid.
Senna (Senokot®). This is a stimulant laxative, which can cause cramping. It’s best to take it at bedtime.
Go to the bathroom at the same time every day. Your body will get used to going at that time. Try to use the bathroom 5 to 15 minutes after meals. After breakfast is a good time to go.
Exercise, if you can.
Drink 8 to 10 (8-ounce) cups (2 liters) of liquids daily, if you can. Choose liquids such as water, juices (such as prune juice), soups, and ice cream shakes. Avoid liquids with caffeine (such as coffee and soda).

Lung Exercises

It’s important to exercise your lungs so they expand fully. Your nurse will give you an incentive spirometer. Use it 10 times every hour you’re awake. Keep using it for 1 to 2 weeks after you’re discharged from the hospital. Do coughing and deep breathing exercises.

Additional Tips for a Smooth Dietary Transition

Chew Food Thoroughly: Properly chewing your food can help ease the digestive process and prevent discomfort.
Stay Hydrated: Drink plenty of water throughout the day, but avoid consuming large amounts with meals to prevent bloating.
Keep an Eye on Food Triggers: Keep track of any foods that cause discomfort or reflux and avoid them. Common triggers include spicy foods, caffeine, and fatty foods.
Follow Your Doctor’s Advice: Adhere strictly to your surgeon’s dietary recommendations and follow-up appointments. Your care team can provide personalized guidance based on your specific needs and progress.
Gradual Introduction: Reintroduce foods slowly and observe how your body reacts. This gradual approach helps identify any potential issues early on. In doing so, your doctor can address these issues before they lead to any complications.
Get Plenty of Rest: Even if you’re feeling relatively good in the weeks following your procedure, be sure to take it easy and get adequate sleep.

Long-Term Side Effects

Though many people experience significant relief following a hiatal hernia surgery, some long-term effects may occur.

Dysphagia (Difficulty Swallowing): Some individuals may experience difficulty swallowing. This condition, known as dysphagia, may improve over time but can be persistent for some.
Gas and Bloating: After surgery, you might experience increased gas and bloating. This is due to changes in the digestive process. It can generally be managed with dietary adjustments and medications if necessary.
Reflux Symptoms: While the surgery is intended to reduce acid reflux, some people may still experience reflux symptoms. This can occur if the surgery does not fully correct the hernia or if the individual does not adhere to their doctor’s dietary recommendations.
Infection or Wound Complications: As with any surgical procedure, there is a risk of infection at the surgical site. Following post-operative care instructions and maintaining good hygiene can help reduce these risks.
Changes in Eating Habits: Long-term changes in eating habits may be necessary to manage symptoms. Some people may need to make permanent adjustments to their diet to avoid foods that trigger discomfort.
Scarring and Adhesions: Internal scarring or adhesions can sometimes develop after surgery. Regular follow-up with your healthcare provider can help monitor and address these potential issues before they become troublesome.

How Long Does it Take for the Stomach to Heal?

Healing after hiatal hernia surgery is often a complex process that can vary somewhat in duration. Healing times depend on multiple factors, including the individual’s overall health. Those in good physical condition are likely going to experience quicker recoveries while individuals with pre-existing conditions may need longer to heal. Additionally, the type of surgery performed can greatly influence a patient’s healing time. Minimally invasive surgeries typically result in faster recoveries, while open surgeries may need more extended healing times. Another important factor is the patient’s adherence to their doctor’s post-operative instructions. These include following a specific diet, avoiding strenuous activities, and taking any prescribed medications to prevent complications. On average, the stomach and surgical site may take anywhere from a few weeks to several months to fully heal, depending on these variables. Each patient’s journey to recovery is unique, and close communication with healthcare providers is a must for ensuring as smooth a recovery as possible.

When to Contact Your Healthcare Provider

Call your healthcare provider if you have any of the following:

A fever of 100.4° F (38° C) or higher
Chills
Increased pain, redness, swelling, or bleeding from your incision
Nausea or vomiting
Trouble swallowing
Any other concerns or questions

tags: #paraesophageal #hernia #repair #diet