What is a hiatal hernia?

A hiatal hernia occurs when a small area of the stomach enters the chest cavity through a hole in the diaphragm. Ordinarily, a hiatal hernia doesn't cause noticeable symptoms. A hiatal hernia is often first discovered during a routine test or procedure to find out the reason for heartburn or chest or upper abdominal pain.

Hiatal hernias are very common and estimated to impact up to 60 percent of people by the time they are 60 years old. Researchers aren't sure why they develop. Unless someone has an unusually intense and problematic hiatal hernia, the easiest way for them to reduce or prevent symptoms is to make lifestyle and dietary adjustments.


See: Functional medicine for GERD

Hiatal hernia symptoms

What are hiatal hernia symptoms?

 The main symptom of a hiatal hernia is indigestion. Some foods and lifestyle habits may increase an individual's likelihood of having uncomfortable symptoms associated with indigestion. The majority of the severe health issues related to the illness occur due to untreated chronic indigestion, such as internal bleeding and esophageal scarring.

Diet plays a significant role in the development, severity, and duration of hiatal hernia symptoms. But besides causing inflammation and aggravation, researchers aren't sure how and why certain foods trigger a hiatal hernia to grow.

The majority of the studies investigating the link between diet and indigestion have concentrated on gastroesophageal reflux disease (GERD), a condition that may result in a hiatal hernia.

It's interesting that there is still not a consensus amongst physicians concerning the proper purpose of the procedure in the management of GERD. Many doctors (especially surgeons) are very fond of the surgery. But many doctors (mostly non-surgeons) are very much opposed to it. Consequently, patients are often faced with advice from various sources that seems to be totally contradictory.

The fundamental problem in patients with GERD is that acid in the stomach refluxes up into the esophagus (food pipe). The barrier which prevents this from occurring is complex. But, there are only a couple of things that can go wrong here:

1. The lower esophageal sphincter muscle present at the base of the esophagus may become diminished.

2. An Individual may have a hiatal hernia. (In a healthy state, the esophagus should be in the chest, and the stomach should be in the abdomen. A thin muscle known as the diaphragm isolates the chest from the abdomen. In people who have a hiatal hernia, the stomach has moved up over the diaphragm and into the chest.)

When either of these problems occurs, the barrier between the stomach and the esophagus is less capable and more inclined to permit the reflux of stomach acid into the esophagus. A hiatal hernia will make the anti-reflux barrier weaker. Consequently, it allows acid reflux to occur more readily. The hiatal hernia itself generally does not cause symptoms unless it's reasonably large.

See: Ayurveda treatment for GERD and Acidity

Hiatal hernia diet

Natural remedies for a hiatal hernia

Since a hiatal hernia is a possible underlying cause of GERD symptoms, many are interested in remedies that work. Is there a particular hiatal hernia diet? Many health experts always encourage those suffering from acid reflux to start with diet and lifestyle modifications to control their symptoms.

Before any surgical procedure, experts first urge a comprehensive, natural approach to symptom management. Most physicians will recommend proton pump inhibitor drugs (PPI). However, there are numerous problems noted by the FDA, and medical research has also highlighted many possible medical dangers with these medications when taken daily for several years. A broader approach includes a GERD-friendly diet, exercise, and lifestyle changes. 

These foods aggravate acid reflux, and should be avoided:

- fatty or fried foods

- peppermint and spearmint

- whole milk

- fast foods

- chocolate

- creamed foods or soups

- oils


These foods irritate an inflamed lower esophagus and may have to be restricted or avoided:

- Citrus fruits and juices (grapefruit, pineapple, orange, tomato)

- Coffee, tea, caffeinated soft drinks

- Spicy or acidic foods might not be tolerated by some individuals.


The US News and World Report evaluates diets with a group of health experts. For the last five decades, including the 2020 report, the top-rated diet has become the DASH diet. DASH was designed to combat high blood pressure, much less an all-purpose diet. Nonetheless, it gets high marks for its nutritional completeness, security, ability to prevent or control diabetes, and function in supporting heart health.

See: GERD diet plan to prevent heartburn

Natural remedies for hiatal hernia

1. Foods to eat

A hiatal hernia diet should include leafy green vegetables. Foods with little or no acid will reduce the likelihood, seriousness, and duration of hiatal hernia symptoms. Foods that contain fiber may be among the best food choices. For those with food intolerances, elimination diets may be more appropriate for optimum improvement in symptoms.

Safe foods to consume may include the following:

- Leafy greens, beans, and legumes

- whole grains, whole nuts, and seeds

- lean proteins, such as fish

- artichoke and asparagus

- cinnamon, ginger, coriander

- apple cider vinegar

- non-citrus fruits and juices, non-caffeinated teas, especially green teas

Fermented foods rich in probiotics (acid-neutralizing gut bacteria) can be useful in reducing GERD symptoms. Popular fermented foods include kimchi, kefir, pickles, quark, miso, tofu, buttermilk, sauerkraut & kombucha.



2. Foods to exclude

Avoiding certain foods may help reduce and prevent symptoms of indigestion, such as heartburn, gas, bloating, and regurgitation. Tomatoes and onions should be avoided since they will aggravate a hiatal hernia.

It's best for people with a hiatal hernia to keep away from foods that are acidic, rich, oily or contain additives.

Foods to avoid include:

- Fried or fatty foods

- alcohol

- cocoa and chocolate

- red meat

- caffeine

- tomatoes and tomato sauces

- soft drinks and carbonated beverages

- peppermint and spearmint


3. Lifestyle changes

Apart from diet, someone could try making some lifestyle adjustments to help manage their hiatal hernia symptoms.

Lifestyle Strategies for treating hiatal hernia symptoms include:

- staying hydrated

- eating regular, smaller snacks and meals spread throughout the day

- eating slowly and drinking a lot of fluids with meals

- no eating before exercise

- preventing bending or laying down within 3 hours of ingestion

- keeping a healthy body weight

- no alcohol or smoking


Having a small amount of diluted apple cider vinegar at the start of foods may also help reduce symptoms. Handling stress and practicing stress-reducing strategies, like walking, being in nature, mindfulness, meditation, or yoga, may help someone feel better.

See: Apple Cider Vinegar for Acid Reflux

Summary

A hiatal hernia diet alone is a vital element to symptom relief, but by itself, it might not be adequate. Before making any changes, consult with a GERD health expert.

See: Sample Meal Plan for GERD- Gastrointestinal reflux disease

References

  1. 1. Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/hiatal-hernia/diagnosis-treatment/drc-20373385
  2. 2. Hiatus hernia. (2015, March 12) nhs.uk/conditions/hiatus-hernia/
  3. 3. Hyun, J. J., & Bak, Y.-T. (2011, September). Clinical significance of hiatal hernia. Gut and Liver, 5(3), 267–227 ncbi.nlm.nih.gov/pmc/articles/PMC3166665/
  4. 4. Jackson, F. (n.d.). Very common, yet high predisposition ecaware.org/what-is-esophageal-cancer/risk-factors/hiatus-hernia/
  5. 5. Ebrahimi-Mameghani, M., Sabour, S., Khoshbaten, M., Arefhosseini, S. R., & Saghafi-Asl, M. (2017, June 14). Total diet, individual meals, and their association with gastroesophageal reflux disease. Health Promotion Perspectives, 7(3), 155–162 ncbi.nlm.nih.gov/pmc/articles/PMC5497367/
  6. 6. Eslami, O., Shahraki, M., Bahari, A., & Shahraki, T. (2017, November 28). Dietary habits and obesity indices in patients with gastro-esophageal reflux disease: A comparative cross-sectional study. BMC Gastroenterology, 17, 132  ncbi.nlm.nih.gov/pmc/articles/PMC5704630/
  7. 7. International Foundation for Gastrointestinal Disorders, Inc. (IFFGD)  https://www.aboutgerd.org/surgery/gerd-and-hiatal-hernia-surgery.html
  8. 8. Hyun, J. J., & Bak, Y.-T. (2011, September). Clinical significance of hiatal hernia. Gut and Liver, 5(3), 267–227 ncbi.nlm.nih.gov/pmc/articles/PMC3166665/
  9. 9. Jarosz, M., & Taraszewska, A. (2014, October 19). Risk factors for gastroesophageal reflux disease: The role of diet. Przegla̜d Gastroenterologiczny, 9(5), 297–301 ncbi.nlm.nih.gov
  10. 10. U.S. News & World Report, https://www.usnews.com/info/blogs/press-room/articles/2020-01-02/us-news-reveals-best-diets-rankings-for-2020

Get a Consultation
(650) 539-4545
Get more information via email