7 Foods to avoid if you have a hiatal hernia

A hiatal hernia is when a part of the stomach pushes up or protrudes through the breathing muscle (diaphragm) into the chest area.

The protrusion is the result of increased pressure inside the abdominal area, which squeezes part of the stomach. This leads to symptoms like acid reflux.

According to the National Institutes of Health (NIH), hiatal hernias are often associated with gastroesophageal reflux disease (GERD) and with symptoms like:

• heartburn
• chest pain
• difficulty swallowing
• belching
• a chronic cough

Your dietary choices may lower the discomfort and risk of complications of a hiatal hernia.

Foods and drinks to avoid, and why

Every individual is unique, and the factors that trigger hiatal hernia symptoms can vary from person to person. What may cause symptoms in one individual might not necessarily result in symptoms for another. To identify which foods you need to avoid, consider keeping a log of your eating choices and symptoms.

According to a 2023 review and 2021 systematic review, avoiding these foods may help you manage a hiatal hernia:

1. Citrus fruits and juices

Oranges, grapefruits, lemons, and limes may lead to reflux-like symptoms because they stimulate certain receptors in the lining of the esophagus. If this happens frequently, it may damage the tissue and further worsen the symptoms.

2. Acidic foods

Like citrus, other acidic foods like tomatoes, vinegar, or pickled foods may worsen symptoms of hiatal hernias.

3. Spicy foods

Hot peppers, chilies, and curry contain capsaicin, a natural compound from chili plants. Capsaicin may increase the pressure of the lower esophageal sphincter (LES) and trigger hiatus hernia symptoms in some people. The spicier the food, the worse the symptoms may be.

4. Fried and fatty foods

Foods that are high in fat and deep-fried can slow down digestion. This leads to increased pressure on the stomach and a higher likelihood of acid reflux. These foods also tend to be more challenging to digest, which can add to the bloating and discomfort of a hiatal hernia.

5. Coffee and tea

Some people experience worsened hiatal hernia or GERD symptoms after drinking tea or coffee. In particular, peppermint tea appears to be a common trigger. This may be linked to the caffeine content, pH level, or certain compounds found in these drinks.

6. Alcohol

Alcohol is a common cause of worsened hiatus hernia and GERD symptoms. This may be because it can relax the LES and allow stomach acid to travel back up the food pipe. It may also slow digestion and alter the stomach’s pH to worsen the symptoms further.

7. Carbonated beverages

The bubbles in sodas, sparkling water, and other carbonated beverages may lead to bloating. Drinking these beverages may also lead to increased pressure on the stomach and potentially trigger acid reflux and burping.

You may not always experience symptoms immediately after consuming these foods or beverages, but symptoms may appear hours later. Keeping a food log can help you recognize any patterns and identify triggers related to your hiatal hernia.

Even if you don’t experience symptoms, untreated hiatal hernias may sometimes lead to esophagitis, stomach ulcers, or stomach bleeding in some people.

To lower the risk of complications, avoid your individual trigger foods and follow lifestyle recommendations from a healthcare professional.

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Dietary and lifestyle recommendations

Some people with hiatal hernias may experience severe symptoms, while others might be symptom-free for months at a time.

If you experience discomfort, try some of these recommendations, as per the NIH:

• eat smaller but more frequent meals instead of fewer larger ones
• chew your food thoroughly before swallowing to improve digestion
• avoid sitting or resting immediately after eating
• take a leisurely walk after eating to aid digestion
• avoid eating at least 3 hours before bedtime
• talk with your doctor about weight management if you’re not at the recommended weight for your age
• sleep with your head elevated and on your left side
• engage in regular physical activity
• try to stop or reduce tobacco consumption (if applicable)

Hiatal hernia treatment

While dietary changes may help manage a hiatal hernia, medications may help with severe symptoms.

Medication options may include:

• Proton pump inhibitors (PPIs): Examples include omeprazole (Prilosec OTC) and esomeprazole (Nexium). PPIs reduce stomach acid production, providing relief from heartburn and acid reflux.
• H2 receptor blockers: Famotidine (Pepcid) is an example of an H2 blocker. These medications help reduce stomach acid production.
• Antacids: Over-the-counter antacids like Tums and Rolaids can provide temporary relief from heartburn by neutralizing stomach acid.

If you have hiatal hernia symptoms, ask your healthcare professional about treatment options that are right for you.

If lifestyle changes and medications are not enough to manage your symptoms, or if your symptoms continue to be severe, your doctor may recommend hiatal hernia surgery.

Doctors generally perform a hiatal hernia surgery through the abdomen or the left side of your chest. A common procedure is laparoscopic fundoplication, where the upper stomach is wrapped around the lower esophagus to prevent acid reflux.

Summary

You can manage hiatal hernia symptoms by avoiding acidic, fatty, and spicy foods, as well as carbonated drinks.

Opting for smaller, more frequent meals and avoiding rest after eating may also help.

Medications that may help with more severe symptoms include PPIs, H2 blockers, and antacids. In some cases, a healthcare team may recommend surgery.

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