Whenever an internal body part or organ pushes into an area of the body where it simply does not belong, it leads to a hernia. A hiatal hernia happens when the upper part of your stomach pushes up against your diaphragm. This further pushes into your chest region. A diaphragm is a large muscle set that is located between your chest and abdomen. The diaphragm is used in breathing. As the stomach is located just below the diaphragm, people suffering from a hiatal hernia have an area of the stomach pushing up through the diaphragm muscle. The stomach is located in the abdominal cavity in normal circumstances. The opening that the stomach pushes up through is known as a hiatus. In a hiatal hernia, the stomach can also protrude through the esophageal hiatus and come to rest inside the chest cavity. A hiatal hernia mostly occurs in people who are over the age of 50 years. It is a pretty common phenomenon and affects almost 60% of people by the time they hit 60 years of age. A hiatal hernia is often seen in patients who are already suffering from gastroesophageal reflux disease (GERD).

Some factors that can actually your risk of having a hiatal hernia include smoking, ageing and obesity. In elderly patients who have been diagnosed with a hiatal hernia, it has commonly been found that over time, the phrenoesophageal membrane has weakened and a part of the stomach was able to protrude through this membrane to remain above the diaphragm permanently if not treated. While the causes of hiatal hernia can be many, there are certain dietary and lifestyle changes that you can make that will allow you to live a life free from heartburn even if you suffer from a hiatal hernia.

Managing Hiatal Hernia with Diet

A key way to manage hiatal hernia is to change your diet in order to relieve heartburn. These changes would include avoiding food that are known triggers for heartburn and also having smaller meals during the day rather than three big meals. Also, try to finish your meal two to three hours before going to bed. A way to enjoy more foods is to cook in a healthier manner. Some tips for making heartburn-friendly food include:

  • Bake or grill the food instead of frying them.
  • Opt for lean meats such as chicken, fish, minced turkey rather than minced beef, etc.
  • Trim the fat off from the meat before you start cooking.
  • Use seasoning in moderation.
  • Use only water to steam your vegetables.
  • Lay off the cream sauces, butter, and oils. A better option is to use cooking spray instead of cooking oil.
  • Use low-fat or no-fat ingredients rather than full-fat products.
  • Modify recipes to suit your lifestyle. Don't be afraid of trying out new things.

Foods to Avoid For Hiatal Hernia

There will be certain foods that are more likely to trigger symptoms in a person having a hiatal hernia. These foods are high in acid content and can also weaken the lower esophageal sphincter. This makes it easier for stomach acids to reflux up into your esophagus. You can observe if any of these listed foods trigger your symptoms and it is advisable to either avoid them or cut back on them.

  • Chocolate
  • Garlic and onions
  • Spicy food
  • Peppermint and spearmint
  • Fatty and fried foods
  • Citrus foods
  • Tomato-based foods such as pizza sauce, spaghetti sauce, salsa, tomato juice, etc.
  • Coffee or tea
  • Carbonated drinks
  • Alcohol
  • Oil and butter
  • Dairy products such as ice cream, whole milk, creamy food, etc.

Foods To Have For Hiatal Hernia

Foods that you can have and that is less likely to cause symptoms as they are low-acid-producing foods include:

  • Green beans, peas
  • Carrots and broccoli
  • Bananas and apples
  • Cereal grains such as bran and oatmeal
  • Bread
  • Rice
  • Pasta
  • Crackers
  • Low-fat or skimmed mil
  • Low-fat yogurt
  • Lean meats like fish and chicken
  • Water
  • Low-fat sweets, but no chocolate or mint
  • Pretzels, rice cakes, baked potato chips

You will have to determine for yourself which foods work best for you and do not aggravate your hiatal hernia symptoms. As everyone tolerates food differently, the best way to determine the ideal diet for you if you have hiatal hernia is to maintain a food diary for a couple of weeks and then go from there.

Lifestyle Changes to Manage Hiatal Hernia

No matter what type of a hernia you suffer from, there are certain tips that can help limit the amount of pain and discomfort one feels in a hernia. Some tips for dealing with a hiatal hernia are given below.

  1. Reduce gastric pressure by eating slowly by eating six small meals in the day as compared to three big meals. This keeps your stomach from getting too full and thus prevents the occurrence of a hiatal hernia as well.
  2. To manage hiatal hernia better, try to avoid eating or drinking anything at least two to three hours before you go to sleep. The concept behind this advice is that lying down with a full stomach causes the stomach contents to push harder against a hernia, and increases the chances of acid reflux. If you want to take a nap right after you ate something, you could try sleeping in a chair in order to avoid putting pressure on the hernia.
  3. Acid reflux or heartburn is something you should work hard to avoid. You should try to avoid the foods that are known to cause heartburn. These foods work by either increasing gastric pressure or increasing acid production in the stomach. They can also loosen the lower sphincter muscle. Some foods and beverages that worsen the classic symptoms of GERD include coffee, chocolate, spicy foods, high-fat foods, citrus fruits, carbonated beverages, etc. If you are unsure about what causes heartburn, then you may try to maintain a heartburn record for a week to determine which foods suit you and vice versa. You should also read up on foods that have little risk of causing heartburn. New research suggests that having a high-fiber diet may lower your GERD symptoms, thus providing you relief in your hernia as well.
  4. Obesity or being overweight is important for easing GERD symptoms as it can aggravate your hiatal hernia. Therefore lose weight and maintain a healthy lifestyle in order to keep your hernia symptoms under control.
  5. People suffering from hiatal hernia should avoid consuming alcohol as it leads to an increase in the production of stomach acid and also relaxes the lower esophageal sphincter. This allows the stomach contents to reflux back into the esophagus, aggravating your hiatal hernia. Therefore if you still want to consume alcohol, you should find out which type of alcohol to have that does not give you heartburn.
  6. Sleeping with your head placed higher than your stomach helps in relieving pressure on the stomach and also keeps the stomach contents inside the stomach itself. You can elevate your head by placing either a block or a pillow.
  7. Wearing clothes that do not fit tightly around your abdomen. Tight fitting clothes tend to squeeze the stomach, pushing the food up against a hiatal hernia. This can cause food to reflux into the esophagus. Slenderizing undergarments and tight-fitting belts can cause the maximum discomfort.
  8. Avoid lifting heavy items or straining during bowel movements as this can cause strain on your abdomen. While lifting something heavy, bend your knees and lift with your legs, but do not bend at the waist level to lift the heavy object. A stool softener can prevent straining during bowel movements.

Treatments for Hiatal Hernia

Most people having a hiatal hernia do not need any treatment. Treatment is generally provided to ease the accompanying symptoms such as acid reflux and heartburn. Some of the key medications that your doctor may prescribe to help with your hiatal hernia symptoms include:

  • Common over-the-counter antacids that will help in neutralizing the stomach acid.
  • Over-the-counter or even prescription H2-receptor blockers that help in controlling the production of stomach acid.
  • Prescription or over-the-counter proton pump inhibitors that block or prevent the production of stomach acid.
  • Most of these medicines will give time for your esophagus to heal and recover from the stomach acid.

If medications do not work, then you may have to undergo a surgery for treating your hiatal hernia. Generally, though, doctors do not recommend surgery. If surgery needs to be done, then they help in rebuilding the esophageal muscles that have gotten weak over time, and also puts your stomach back in the abdominal cavity, making the hiatus smaller.

While the symptoms of a hiatus hernia can be troubling, but usually most patients feel better after they make some dietary changes and adjust their lifestyle to live a healthier life. By following a healthy diet and lifestyle, you will be able to avoid a hiatal hernia completely. By maintaining a healthy weight, avoiding certain abdominal exercises, lifting heavy objects with the proper help, and treating the symptoms of constipation, you will be able to lower your risk of getting a hiatal hernia.

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Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: November 24, 2017

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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