The best diet for hiatal hernias

In this article:

• What is the best hiatal hernia diet?
• 14 foods to relieve hiatal hernia symptoms
• 8 foods that may worsen hiatal hernia symptoms
• Other ways to manage hiatal hernia symptoms

In this article

• What is the best hiatal hernia diet?
• 14 foods to relieve hiatal hernia symptoms
• 8 foods that may worsen hiatal hernia symptoms
• Other ways to manage hiatal hernia symptoms

Hiatal hernias occur when part of your stomach pushes up through the hiatus—the spot in your body where the esophagus passes from the chest cavity through the diaphragm into your abdomen. This condition makes it easier for stomach acid to flow up into the esophagus, causing heartburn and acid reflux—which can lead to gastroesophageal reflux disease (GERD). Dietary changes are the first-line treatment to reduce hiatal hernia symptoms.

Although there isn’t one specific diet that is universally recommended, a high-fiber, high-protein diet can help minimize indigestion, says Mir Ali, MD, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California. Eating smaller, more frequent meals can also help, says Raj Dasgupta, MD, internist and professor at the University of Southern California.

What is the best hiatal hernia diet?

There is no specific eating plan that is perfect for hiatal hernia, such as the keto or Mediterranean diet. Rather, it’s all about eating foods that can improve symptoms and minimizing trigger foods that worsen symptoms.

There are a few types of food that can reduce acid reflux:

• High-fiber, high-protein foods: Overeating can cause indigestion. These foods help you feel fuller longer.
• High-water-content foods: Fruits and vegetables with a high water content can dilute stomach acid and reduce reflux. So can drinking lots of water. One caveat is that fruits and vegetables tend to sit in the stomach longer, and so may cause bloating in some people.
• Alkaline foods: Eating basic, or alkaline, foods can help counteract excess stomach acid.

On the flip side, certain types of food and drinks can exacerbate symptoms and lead to progression of the hernia, such as:

• Acidic foods: Tomato-based foods and citrus fruits are the biggest culprits that add acid to an already acidic environment.
• High-fat foods: Fatty, fried, and greasy foods stay in your stomach longer, requiring more acid to digest them.
• Spicy foods: For some people, spiced foods can further irritate an already inflamed esophagus.

Additionally, caffeine, chocolate, mint, and alcohol are known to make heartburn worse.

Dietary changes cannot cure or shrink a hiatal hernia. “The whole goal is trying to manage the symptoms and prevent the enlargement or progression of the hernia,” says Dr. Ali. The good news is that “paying attention to what you eat can definitely help,” says Dr. Dasgupta. “These simple changes can make a big difference in how you feel.”

14 foods to relieve hiatal hernia symptoms

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!). Drs. Dasgupta and Ali recommend adding these foods to your diet:

1. Bananas
2. Apples
3. Avocados
4. Whole grains
5. Vegetables such as carrots, green beans, spinach, and kale
6. Lean proteins, such as eggs, chicken, fish, turkey, and tofu
7. Nuts
8. Rice
9. Pasta
10. Bread
11. Crackers
12. Herbal teas
13. Low-fat dairy, such as yogurt
14. Fermented foods, such as sauerkraut or kefir

8 foods that may worsen hiatal hernia symptoms

“Acidic foods like citrus fruits, like oranges and grapefruit, increase the acidity in the stomach and typically make heartburn symptoms worse,” Dr. Ali says. “And foods that sit heavy in the stomach, like fatty and greasy foods, can make the reflux worse.” To minimize hiatal hernia symptoms, try to steer clear of these foods:

1. Spicy foods
2. Citrus fruits like oranges, grapefruit, and limes
3. Fatty, fried, or greasy foods
4. Caffeine, such as in coffee, tea, and soda
5. Alcohol
6. Chocolate
7. Peppermint
8. Tomatoes or tomato products, like sauce or ketchup

Other ways to manage hiatal hernia symptoms

Lifestyle changes are the primary treatment for hiatal hernia. Still, prescription and surgical treatment options are available if you are in a lot of pain and over-the-counter medications aren’t helping. The following strategies can help manage heartburn and acid reflux from hiatal hernia.

Lifestyle changes

In addition to dietary changes, Drs. Ali and Dasgupta recommend the following to help treat hiatal hernias:

• Eat smaller, more frequent meals. Too much food in your stomach can put pressure on the valve that keeps acid in your stomach and out of your esophagus.
• Avoid lying down immediately after eating. Staying upright makes it harder for acid to flow into your esophagus.
• Prop up the head of your bed at night.
• Get to a healthy weight. Excess weight can add pressure on your stomach.
• Quit smoking and drinking alcohol. Both habits can exacerbate reflux.
• Don’t slouch, as it can put extra stress on your stomach. Try sitting up with a straight back.
• Incorporate exercises like walking, running, swimming, and biking into your fitness routine. Avoid movements that increase pressure on the belly, like abdominal exercises and heavy lifting.
• Experiment with different cooking methods. If you’re used to frying foods, try grilling, baking, and steaming. Use spices in lieu of butter and oils to add flavor.

Medication

Over-the-counter (OTC) antacids and heartburn treatments can help prevent symptoms of hiatal hernia. If OTC remedies don’t work, visit a gastrointestinal specialist for an exam and prescription-strength antacids or proton pump inhibitors.

Surgery

In severe cases, hiatal hernia surgery may be necessary to correct the issue. The procedure involves pulling the stomach back down into the abdomen and decreasing the size of the opening in your diaphragm.