A hiatal hernia occurs when part of the stomach enters the chest cavity through a hole in the diaphragm. Usually, a hiatal hernia does not cause noticeable symptoms.
The primary symptom of a hiatal hernia is indigestion; certain foods and lifestyle habits can increase a person's chances of experiencing uncomfortable symptoms.
Unless a person has an unusually severe and problematic hiatal hernia, the best way for them to reduce or prevent symptoms is to make dietary and lifestyle adjustments.
Non- or low-acidic foods will reduce the likelihood and severity of hiatal hernia symptoms. The best food choices for people with hiatal hernias are non-acidic, minimally processed, and contain dietary fiber.
There are some exceptions for those who have food intolerances. Elimination diets may be helpful for optimal improvement in symptoms.
Safe foods to eat may include:
- leafy greens
- beans and peas
- whole grains
- lean proteins, including tofu and fish
- whole nuts and seeds
- non-citrus fruits and juices
- artichoke and asparagus
- low-fat, non-sweetened dairy products
- apple cider vinegar
- non-caffeinated teas, especially green teas
Fermented or cultured foods that are rich in probiotics (acid-neutralizing stomach bacteria) may also help reduce hiatal hernia symptoms.
Popular fermented foods include:
- unsweetened yogurt
It is important to note that consuming processed sugar alongside probiotics may be counterproductive. Sugar supports the growth of stomach microbes that destroy and consume probiotics.
This means that probiotic ice creams, juices, yogurts, sweetened protein powders, and gummies are typically not a good source of probiotics.
It is best for people with a hiatal hernia to stay away from foods that are acidic, rich, oily, or contain preservatives.
Foods to avoid may include:
- fried or oily foods
- fatty foods
- red meat
- cocoa and chocolate
- tomatoes and tomato sauces
- soft drinks and carbonated drinks
- most types of mint, such as peppermint and spearmint
- sweetened juices or teas
- high amounts of cooking oils
- garlic, onions, green onions, shallots, scallions, leeks, and chives
- high-fat dairy products
- salty foods
- deli meats
- pre-prepared or fast foods
- bread and cereals
Aside from diet, a person could try making some lifestyle adjustments to help manage their hiatal hernia symptoms.
Lifestyle tips for treating hiatal hernia symptoms include:
- staying hydrated
- keeping a log of trigger foods and avoiding them
- eating frequent, smaller snacks and meals spread throughout the day
- eating slowly and drinking plenty of fluids with meals
- getting enough dietary fiber
- avoiding non-clear liquids within 3 hours before bed
- avoiding eating before exercise
- avoiding bending over or laying down within 3 hours of eating
- wearing loose-fitting clothing
- maintaining a healthy body weight
- using a wedge pillow to elevate the head 8 to 10 inches while sleeping, making it harder for stomach acid to travel up the esophagus (food pipe)
- quitting smoking
- taking probiotics
- eating whole foods instead of processed or refined foods
- exercising moderately for at least 20 minutes daily
- avoiding fried foods
- using small amounts of healthful cooking oils, such as coconut, rice, and olive oil
- avoiding being too hungry or too full
Drinking a small amount of diluted apple cider vinegar at the beginning of meals may also help reduce symptoms.
A person can also take over-the-counter antacids, though long-term use does carry risks.
Indigestion is the primary and often the only symptom of a hiatal hernia. Most of the more serious health complications associated with the condition occur because of untreated chronic indigestion.
These complications include esophageal scarring and internal bleeding.
Diet plays a significant role in the development, severity, and length of hiatal hernia symptoms. But aside from causing inflammation and irritation, researchers are not sure how and why certain foods cause a hiatal hernia to develop.
Most of the studies exploring the connection between diet and indigestion have focused on gastroesophageal reflux disease (GERD), a condition that may lead to a hiatal hernia.
A person should seek medical attention for indigestion that lasts longer than 3 consecutive days.
A doctor should also assess heartburn, abdominal pain, bloating, gas or regurgitation that does not improve with the use of antacids, dietary changes, and lifestyle adjustments.
Hiatal hernias can cause serious health risks, including esophageal damage and associated internal bleeding, though this is rare.
A doctor can prescribe medications designed to treat indigestion that can reduce discomfort and improve the overall quality of life for people with hiatal hernias. However, making lifestyle and diet changes is often the best first step as there is unlikely to be any side effects.
Sometimes, if a hiatal hernia causes particularly bothersome symptoms, surgery may be necessary.