A hiatal hernia is a condition in which the upper part of the stomach bulges through a muscle called the diaphragm into the chest cavity.
The condition can cause acid reflux and heartburn and may require hernia repair surgery if these symptoms are severe.
Diet plays an important role in managing these symptoms and in the recovery process following the procedure.
This article explains what to eat and avoid with a hiatal hernia — including after hernia repair surgery — and provides a sample hiatal hernia diet menu.
What is a hiatal hernia?
A hiatal hernia is a condition in which the upper part of the stomach bulges through an opening called a hiatus in the diaphragm, a muscle that separates the abdomen from the chest (1).
A hiatal hernia may be present at birth or be developed later on.
The condition tends to be more common in older adults but it may also develop from conditions or factors that increase pressure within the abdominal cavity, such as obesity, pregnancy, chronic constipation, and chronic obstructive pulmonary disease (COPD) (1).
There are four types of hiatal hernias, with type 1 or sliding hernias being the most common (2).
Heartburn and sometimes regurgitation — the sensation of acid backing up into your throat or mouth — tend to be the most common symptoms of a hiatal hernia (1).
This is because the hiatus in the diaphragm — the opening through which the stomach travels in a hiatal hernia — is also the opening through which the esophagus — or food pipe — travels.
Consequently, the pushing through this opening weakens the lower esophageal sphincter (LES) muscle, which acts as a gate between the esophagus and stomach.
When this muscle is weakened, stomach acid can travel back up through the esophagus, causing heartburn and other symptoms of gastroesophageal reflux disease (GERD).
Small hiatal hernias can typically be managed with medications but larger ones may require surgery, especially if they cause dysphagia — or difficulty swallowing – or Barrett’s esophagus.
In either case, diet — regardless of whether surgery is necessary — plays an important role in the management of a hiatal hernia.
Hiatal hernia diet
A hiatal hernia diet focuses on reducing the symptoms of acid reflux and regurgitation by avoiding or limiting foods that relax the LES muscle or irritate the esophagus lining (2).
- Citrus fruits: citrons, clementines, grapefruit, lemons, limes, mandarin oranges, oranges, pomelos, tangerines
- Fried foods: cheese curds, chicken strips, donuts, french fries, potato chips, etc.
- Spicy foods: dishes, sauces, or spices that contain hot peppers, such as cayenne, chili, habanero, jalapeños peppers
- Caffeine: coffee, cocoa beans and chocolate, energy drinks, tea, soda, and some supplements
- Other items: alcohol, processed meats, and carbonated beverages
However, depending on the severity of your hiatal hernia, these foods may or may not cause symptoms.
As such, you should keep a food journal so you can document which foods trigger your symptoms and avoid or limit them going forward.
It’s also possible that you may still be able to tolerate these foods in small amounts so keeping a food diary can also help you identify the amounts of a food you can eat before it triggers symptoms.
Beyond avoiding or limiting the foods that may trigger symptoms, you should follow a varied, nutrient-dense diet consisting primarily of fruits, vegetables, whole grains, lean proteins, and healthy fats.
Hernia surgery repair diet
If you require hernia surgery there isn’t necessarily a specific diet you have to follow post-hernia repair.
However, your surgeon may recommend that you temporarily follow a dysphagia diet since many people experience difficulty swallowing after surgery (5).
With a dysphagia diet, the consistency of your drinks, food, or both are modified to promote safe and efficient swallowing.
Diet likely has no significant role in preventing the recurrence of a hiatal hernia but you should still follow a varied, nutrient-dense diet to support overall health and reduce further harm to your esophagus that may have been caused by the hiatal hernia.
3-day sample hiatal hernia diet
Here’s a 3-day sample hiatal hernia diet that excludes common foods that may trigger heartburn and regurgitation:
- Breakfast: cottage cheese toast with avocado
- Lunch: grilled chicken wrap
- Snack: Greek yogurt and walnuts
- Dinner: roasted pork loin, carrots, and brussels sprouts
Day 2 (vegan option)
- Breakfast: high-fiber cereal topped with soymilk and berries
- Lunch: chickpea salad
- Snack: apple slices and almonds
- Dinner: Mediterranean quinoa pasta salad
- Breakfast: spinach and eggs scramble and oatmeal topped with fruit
- Lunch: grilled lemon chicken salad
- Snack: string cheese stick, strawberries, and almonds
- Dinner: roasted salmon and green beans with brown rice
The bottom line
A hiatal hernia occurs when the stomach pushes through the diaphragm into the chest cavity.
This can weaken the LES of the esophagus and cause symptoms such as heartburn and regurgitation.
Limiting or avoiding foods that relax the LES like spicy, acidic, and fried foods can decrease these symptoms.
While there’s no specific diet to follow after hernia repair surgery, you may have to temporarily follow a dysphagia diet since difficulty swallowing is common after surgery.