A hiatal hernia occurs when part of the stomach moves up into the chest cavity and presses through an opening in the diaphragm. The most common type is a sliding hiatal hernia, which is when part of the stomach slides in and out of the chest cavity. A fixed hiatal hernia, on the other hand, is when the upper part of the stomach remains in the chest cavity. The cause of hiatal hernias is unclear, but they are most common in adults over age 50; obesity and abdominal injury increase your risk. Unless you're experiencing acid reflux, it's usually unnecessary for you to avoid certain foods, according to the Cleveland Clinic.
Diet and Hiatal Hernias
Many people with a hiatal hernia have no symptoms, in which case changes in diet are not necessary, according to the Cleveland Clinic. However, because the stomach has moved from its normal position, symptoms of hiatal hernia are commonly related to gastroesophageal reflux, or GERD, according to the Cleveland Clinic. GERD occurs when contents of the stomach move back up the esophagus. Symptoms include heartburn, pain in the back of the throat and abdominal discomfort. If you experience these symptoms, your treatment may include dietary changes aimed at avoiding foods that may trigger GERD.
Potential Food Irritants
If GERD is present, you should avoid foods that irritate the lining of the esophagus. These include spicy foods, such as jalapeno peppers; foods prepared with black pepper; and any food that exerts a "heat" sensation. The acid in citrus fruit and citrus juices can cause irritation as well. It's a good idea to avoid carbonated beverages, caffeine and tomato products for the same reason.
Other Problem Foods
Foods that might contribute to relaxing the lower esophageal sphincter -- a band of muscle that controls the opening between the stomach and the esophagus -- may cause problems. If the esophageal sphincter relaxes when it's not supposed to, stomach contents can back up into the esophagus. For this reason, you may need to avoid chocolate, peppermint, coffee, alcoholic beverages and foods high in fat. Tolerance can vary, so it may not be necessary to eliminate these foods completely, but you may need to limit them to reduce symptoms of GERD.
If you're carrying some extra pounds, losing weight may help reduce symptoms. In addition, consuming smaller meals throughout the day may help minimize acid reflux. For example, you can have four to six small meals instead of three large meals. Not eating two to three hours before going to bed may help reduce acid reflux as well. Surgery may be necessary if you have severe GERD that doesn't get better with treatment, or if your hiatal hernia is at risk of twisting and interfering with the blood supply to your stomach.