Diet for Hiatal Hernia

Have you been diagnosed with a hiatal hernia? In that case, you'll be interested in knowing how to reduce the symptoms of the disease through a dietary intervention.

Written and verified by el nutricionista Saúl Sánchez.

Last update: 11 July, 2023

Hiatal hernia is a health problem that occurs in the upper part of the stomach, where a portion of the tissue protrudes through the hiatus. This condition usually generates the appearance of esophageal reflux, as the sphincters fail to perform their function correctly and stomach content rises through the tube.

There are many cases of hiatal hernias that don’t produce symptoms. However, on other occasions, they generate a series of problems that negatively affect the well-being of the person. In these cases, a change in diet and lifestyle must be proposed to better manage the disease.

Diet for hiatal hernia

The goal of the diet for hiatal hernia is to achieve easy digestion of meals, in addition to improving the state of body composition. If excess weight is corrected, the stomach tissues are subjected to less pressure, so the part that protrudes through the hiatus could be progressively reduced. This would correct the problem.

However, this “resolution” of the hernia doesn’t always occur, although on many occasions it can become asymptomatic with a change in lifestyle. It’s important to eliminate certain irritant foods from the diet, which we’ll see below, as they can cause digestive problems.

It should be noted that the diet for hiatal hernia has a very individual nature. There’s no consensus on which foods cause discomfort at a general level, so tolerance must be tested in each person. Yes, it’s necessary to avoid some of them, but other foods considered healthy may feel different for each patient.

The truth is that one of the key points has to do with reducing the time that food spends in the stomach. This causes less internal acid secretion, which will relieve symptoms and reduce possible reflux. To do this, it’s important to choose foods that are easy to digest.

Those foods that manage to prolong gastric emptying time are those with the highest fat content. Examples would be fried foods, cheeses, ice cream, ultra-processed foods, cold cuts…

Proteins in hiatal hernia

A key nutrient in the diet for treating hiatal hernia is protein. These elements are capable of helping tissue restructuring and recovery, which in some cases could cause a sphincter closure. Likewise, it may be key to increase the contribution of vitamin C.

This nutrient is key when it comes to increasing endogenous collagen synthesis, according to a study published in the International Journal of Sport Nutrition and Exercise Metabolism. This protein is the most abundant in muscle. When its production is increased, a more efficient repair of the tissue occurs, which can benefit the sphincters of the esophagus.

Daily supplementation with one gram of the vitamin is usually considered to achieve a beneficial effect on protein synthesis. However, it’s not a miracle remedy, so it’s important to combine it with other key points at the dietary level to achieve a significant symptomatic improvement.

The fat intake in the diet for hiatal hernia

Despite the fact that fats cause a delay in gastric emptying time, it’s not advisable to completely suppress their contribution. It’s essential to ensure that high-quality, cis-type lipids are consumed. Among them, unsaturated fats have an anti-inflammatory nature, according to research published in the journal International Immunology.

There are reviews that support the approach of a diet with a low amount of carbohydrates, a high dose of protein, and a moderate dose of fat for the treatment of hiatal hernia and reflux. The results in the analyzed samples are positive, especially when the contribution of simple and derived sugars is low.

Irritating foods

Some products commonly consumed in the diet have an irritating nature. These aren’t recommended in the case of experiencing a hiatal hernia, as they could increase the production of acid in the stomach or irritation in the epithelium, thus aggravating the symptoms.

The most classic examples are coffee and chocolate. However, some people tolerate them well and don’t have too many problems after consumption. For this reason, it’s important to individualize nutrition and assess the digestion of these foods individually.

Most of the studies published in scientific literature show that the inclusion in the diet of beverages such as coffee, tea, or soda causes an increase in symptoms. Therefore, in most cases, it’s usually best to avoid them.

Keep in mind that it’s essential to avoid alcohol. In this case, there’s a clear consensus. According to research published in the journal Integrated Pharmacy Research & Practice , the consumption of alcoholic beverages and smoking tobacco cause an increase in the symptoms of reflux and hiatal hernia, so they should be restricted.

How to plan the diet for hiatal hernia

We’ve discussed the key points when making the diet for hiatal hernia, but now we’re going to focus on the details for its correct configuration.

Duration

The duration of the diet can vary depending on the person. In most cases, the symptoms will improve, so after a few months, more flexibility in diet can be allowed, although without neglecting some key aspects already mentioned, such as the restriction of alcohol and tobacco.

However, it’s possible that the patient doesn’t experience improvement despite varying diet and lifestyle. In this case, it may be necessary to resort to surgery. In any case, first, it will be important to discuss with the doctor if there’s any other less invasive pharmacological treatment that can be implemented conservatively.

What to eat

We’ve already mentioned that the diet for hiatal hernia has a very individual nature. There are many foods whose tolerance can be tested in each patient, to see if they cause symptoms or if they can be included in the diet occasionally.

However, there’s a set of edibles that don’t usually cause problems, which are the following:

• Nuts
• Fermented foods
• Foods with plenty of fiber
• Vegetables
• Protein products such as poultry and fish
• Non-citrus fruits
• Dairy products
• Tubers

On the other hand, it’s possible to identify some foods that can cause the appearance of symptoms. Among them, the following stand out:

• Alcohol
• Carbonated drinks
• Chocolate and cocoa
• Citrus
• Coffee
• Culinary spices
• Ultra-processed and precooked foods
• Fried foods
• Garlic and onion
• Foods with a lot of salt
• Tomato and derivatives

In general, it’s advisable to reduce the consumption of those products with a high content of simple sugars. These could promote the growth of pathogenic bacteria in the stomach, such as Helicobacter pylori. When this organism multiplies, symptoms consistent with hiatal hernia can be experienced.

It should be noted the importance of including vegetables and fish on a regular basis in the diet. These foods provide high-quality protein and antioxidants, which allows proper nutrition. In addition, they have rapid gastric emptying.

Other beneficial changes

In addition to intervening in diet, other changes can be made in lifestyle habits that improve the treatment of hiatal hernia. Among them, the following stand out:

• The consumption of frequent and small-volume meals.
• An increase in the intake of fresh water throughout the day.
• Correct chewing of food to facilitate subsequent digestion.
• Avoid eating just before exercising.
• The consumption of probiotics. There’s evidence that these bacteria are beneficial in helping to treat gastrointestinal problems and discomfort. This is stated in a review published in the journal Nutrients.

At the same time, it’s advisable to avoid having a late dinner and going to bed with a full stomach. During sleeping hours, digestion slows down, which can lead to problems related to reflux. An effective trick is to sleep lightly sitting up, to reduce the risk of stomach contents moving up the esophagus.

Culinary tips

When preparing menus, there are a number of culinary tips that can facilitate the management of hiatal hernia. The first of them has to do with the use of healthy oils, such as extra virgin olive.

It’s important to consume these raw or to at least avoid frying. At most, you can use a minimal amount so that the food doesn’t stick.

It’s convenient to avoid the consumption of precooked and prepackaged foods, as these foods have a higher proportion of trans fats and additives that can complicate the symptoms of hiatal hernia.

Animal-based fats may worsen the management of hiatal hernia, especially when consumed in large amounts. For this reason, the use of butter or lard must be restricted. When it comes to including meats in the diet, it’s always better to opt for lean cuts.

Diet improves hiatal hernia

Dietary changes are effective in optimizing the management of hiatal hernia, thus reducing symptoms. However, it’s also necessary to accompany the modifications in the diet with the promotion of other healthy lifestyle habits, such as the practice of physical exercise on a regular basis. Losing weight is usually a good solution, too.

Finally, keep in mind that if even with changes in your diet, you don’t experience an improvement in the problem, the most appropriate thing to do is go to a specialist. In some situations, there’s no choice but to resort to surgery to really achieve well-being. However, the conservative pathways must first be exhausted. Probiotic supplementation may be one of them.