Hiatal Hernia Self-Care: Diet and Lifestyle Adjustments

Many people diagnosed with a hiatal hernia will not have any symptoms. Those who do usually experience heartburn and indigestion. While medications may provide some relief, effective hiatal hernia self-care strategies can also help with pain and discomfort.

Several diet and lifestyle interventions are often helpful in reducing and preventing symptoms associated with hiatal hernias.

Diet

If you have a hiatal hernia, part of your upper stomach bulges into your diaphragm. Your diaphragm helps prevent stomach acid from entering your esophagus. In individuals with hiatal hernias, it's easier for stomach acid to enter the esophagus, causing gastroesophageal reflux disease (GERD).

GERD can cause several uncomfortable symptoms, such as heartburn, nausea, vomiting, bad breath, and issues swallowing. What and how you eat can help manage GERD associated with hiatal hernias.

What You Eat

A bland diet can help reduce GERD and its uncomfortable symptoms, such as heartburn and nausea. Examples of foods to try with a bland diet include:

• Potatoes
• Canned fruit (e.g., peaches or pears)
• White breads, graham crackers, and other crackers
• Popsicles
• Eggs
• Tofu
• Cooked veggies (frozen or canned work, too)
• Lean meats and proteins

To reduce symptoms, it is recommended to avoid the following foods:

• Fatty foods
• Sugary foods
• Spicy foods
• Fried foods
• Alcohol
• Coffee
• Mint
• Acidic foods (e.g., tomato juice and sauce)
• Chocolate
• Carbonated drinks

How You Eat 

How you eat is also essential when it comes to acid reflux and other hiatal hernia symptoms.

One way that hiatal hernias cause GERD is through the protrusion of the stomach into the chest cavity, which can alter the alignment of the lower esophageal sphincter (LES). This valve protects your esophagus from the contents of your stomach. As a result, food and acid can leak through this otherwise protective gateway—often profusely.

Another way hiatal hernias can cause GERD is pressure from gastric contents becoming trapped in the hernial sac.

To reduce GERD, be mindful of the position of your stomach as you eat. Also, take steps to avoid overtaxing the stomach so food can move through the digestive tract without complication.

To achieve this:

• Sit up straight in a chair while eating. Sitting straight ensures your stomach is in the best alignment to receive food. By contrast, slouching (for instance, on the sofa) not only places your stomach in a more horizontal position, but it also compresses the junction between the stomach and esophagus, promoting backflow. 
• Eat smaller, more frequent meals. Also, do not skip meals. Doing so can lead to overeating by becoming too hungry.
• Eat at a table. When you eat in front of the TV, you may mindlessly put food into your mouth without even realizing it. Sitting at a table with prepared portions helps avoid this.
• Take smaller bites and chew longer. The rationale is simple: The more your food is pulverized before swallowing, the less the stomach has to do to digest it. This translates to less stomach acid and less acid reflux.
• Avoid eating right before bedtime. Avoiding late-night snacks and sleeping with an emptied stomach means a lesser chance of middle-of-the-night reflux.
• Wait to lie down for two to three hours after eating. Staying upright for a period after eating can help give your food a chance to digest.

Weight Loss

Obesity increases the risk of heartburn in people who have a hiatal hernia by exerting excessive pressure on the abdominal wall. This compresses the stomach against the diaphragm by altering its position and causing it to bulge further into the chest cavity.

Including weight loss in a treatment plan is helpful for some. Individuals who experience obesity have an increased risk of developing metabolic syndrome and hiatal hernias.

A dietician or medical provider specializing in weight loss or metabolic syndrome can provide guidance. Dietary recommendations often include the following:

• Eating a low-fat, high-fiber diet is key to weight loss and normalizing your digestive function. A low-fat diet should include complex carbohydrates that don't cause a rapid rise in blood sugar. A diet high in soluble fiber can help treat constipation and alleviate straining, reducing herniation.
• Drinking enough water daily can relieve constipation and reduce the acid concentration in your stomach.
• Taking a reasoned approach to exercise. An informed fitness program should start gradually and gradually increase in intensity and duration. Consider working with a trainer to get started and adjust your program as you build endurance and strength.

Lifestyle

Regarding hiatal hernia symptoms, self-care may help reduce and prevent hernias from returning.

Consider adding the following self-care measures:

• Try relaxation techniques: Stress and anxiety can worsen the symptoms of GERD. Try sitting calmly and engaging in deep breathing exercises or meditation. Ensure you are someplace quiet where you can sit comfortably until the symptoms pass.
• Loosen your belt and remove tight clothing: Anything that constricts the abdomen can trigger symptoms. Avoid cinched waistlines or anything that places direct stress on the stomach.
• Take a fiber supplement: If you experience constipation, a daily fiber supplement can help improve your regularity.
• Elevate the head of your bed by 4 to 8 inches: This is especially useful for people who are overweight or have symptoms of GERD. Aligning the stomach in an ascending (rather than flat) position lowers the risk of gastric backflow related to hiatal hernias.
• Consider trying yoga: Yoga is one of the best exercises you can try for hiatal hernias. It may help relieve symptoms, reduce stress, and promote a sense of calm.

Try avoiding the following activities which can worsen hiatal hernias:

• Avoid heavy lifting: Lifting heavy objects will worsen the condition if you have been diagnosed with a large hernia. Use a cart or trolley or ask someone for help if you must move something heavy. You may also need to alter your workout routine if you use heavy weights.
• Avoid smoking: While smoking doesn't cause acid reflux, it can affect gastric motility and how food moves through the esophagus. Smoking can also dull the responsiveness of your LES and promote dysphagia (swallowing difficulty). These effects are long-lasting and may become permanent in heavy smokers, which can worsen a hernia.

When to See a Healthcare Provider

Rarely do hiatal hernias cause severe complications. Only about 1% of them will require surgical intervention. When a hiatal hernia causes complications that require medical care, symptoms may include:

• Severe pain
• Nausea
• Fullness
• Vomiting

Additionally, Cameron ulcers (a type of gastrointestinal ulcer) are sometimes seen in individuals with hiatal hernias. These ulcers may cause upper gastrointestinal bleeding. If you notice blood in your vomit or black stools, contact a healthcare provider.

Summary

Hiatal hernias often do not cause symptoms. However, when they cause symptoms, GERD is one of the most common.

You can take several hiatal hernia self-care measures at home to reduce symptoms, such as avoiding certain foods and being mindful of how you are eating. Stress reduction and relaxation techniques may also be helpful.

Discuss options with your healthcare provider if you do not find relief from self-care measures at home. There are medications (both over-the-counter and prescription) and procedures if conservative treatment options aren't effective.

Hiatal Hernia Doctor Discussion Guide

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