Dietary management in Hiatus Hernia

Dr. Mian Kamran Sharif

Associate Professor
National Institute of Food Science & Technology
University of Agriculture, Faisalabad

1 Updated on 2020-03-05
 Hiatus Hernia
 An abnormal condition in which part of the stomach protrudes upward
through the esophageal cleft in the diaphragm, sometimes causing a
backflow of acid stomach contents into the esophagus

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 Diet Therapy in Hiatus Hernia
Objectives
 The diet is designed to restrict foods which may cause reflex into the
esophagus or increase gastric acidity

Use
 This diet is used in the treatment of hiatus hernia
 The modification of diet may vary, based on individual’s nutritional need

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 Diet Therapy in Hiatus Hernia
Physiology
 Hiatal hernias are a common condition seen most often in adults over
the age of 50
 Although the cause is unknown, a hiatal hernia may be the result of a
weakening of the tissues supporting the digestive tract
 Food enters the body through the mouth and travels down the
esophagus
 The esophagus passes through the diaphragm and into the abdominal
cavity via an opening in the diaphragm called the esophageal hiatus
 The esophagus then connects with the stomach just below the
diaphragm
 Hiatus hernia is caused by protrusions of part of the stomach above the
diaphragm muscle, which separate the chest from the abdomen
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 Diet Therapy in Hiatus Hernia
 A hiatal hernia occurs when a portion of the upper stomach slips up
through the hiatus and into the chest
 Hiatus hernia may show no symptoms or may cause symptoms which
may vary according to the size and position of the hernia, but they can
include heartburn, chest pain, and difficulty swallowing
 Symptoms of a hiatal hernia can be relieved with weight reduction and
with smoking cessation
 It is also important to avoid eating large meals and to also avoid lying
down after eating
 Medications can be prescribed, and occasionally surgical repair of the
hernia is required
 Increasing age, obesity, and smoking are risk factors for development of
hiatal hernias in adults.
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 Diet Therapy in Hiatus Hernia
Modifications
 Objectives are to minimize reflux into the esophagus and or
decrease the gastric acidity and to avoid irritation of an
inflamed esophagus
 Dietary restriction are based on the individual’s nutritional requirement
and food tolerance; however, some general recommendations are to:
 Avoid large meals
 Remain upright for 2 hours after meal
 Avoid lying down, bending over immediately after meals & avoid
constricting clothes
 Eat food which is low in fat and contain less spices
 Loose weight if overweight, it will result in decreased abdominal pressure
 Stop smoking
 Avoid alcohol, chocolate, coffee especially in the evening
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 Drink most fluids between meals rather than with meals
 Diet Therapy in Hiatus Hernia
Modifications
 The diet plan should be based on gentle, smooth and soft cooked meat,
daals, cereals and vegetables with moderate fat, spices and condiments
 The diet should be served in small portions after short intervals may be
six meals per day
 In this way the ingested foods passes quickly to duodenum without any
complication

Adequacy
 The composition of hiatus hernia diet should meet all the nutritional
requirements and is adequate in most of the nutrients providing
proteins, fats, carbohydrates, vitamins and mineral contents and
furnishes appropriate amount of food energy as required by individuals
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 Diet Therapy in Hiatus Hernia
Foods That May Cause Symptoms
 Citrus foods, such as oranges, grapefruits, lemons, grapefruit etc.
 Chocolate
 Fatty and fried foods, such as fried chicken and fatty cuts of meat
 Garlic and onions
 Spicy food
 Tomato-based foods such as spaghetti sauce, pizza, chili, salsa, and
tomato juice
 Coffee, tea (including decaffeinated versions)
 Carbonated beverages
 Dairy products, such as whole milk, ice cream, and creamed food
 Oil and butter
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 Diet Therapy in Hiatus Hernia
Foods That Are Less Likely to Cause Symptoms

• Bananas and apples

• Green beans, peas, carrots, and broccoli
• Grains, like cereals (bran and oatmeal), bread, rice, pasta, and
crackers
• Low-fat or skim milk and low-fat yogurt
• Fat-free cheeses, cream cheese, and fat-free sour cream
• Lean meat, chicken, and fish
• Water
• Pretzels, graham crackers, rice cakes, and baked potato chips
• Low-fat sweets

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 Food Choices
Food Groups Food Allowed Foods Restricted
Bread, cereals and All types of bread, rusk Paratha, roghni naan,
grains (paapay) khitchri, roti, taftaan, kulcha, baqar
naan, rice, pasta, khani, puri etc.
noodles, cake-rusk
Milk and milk All (low-fat version) None
products
Meat (red/white Cooked in moderate fat, Spicy and oily, fried meat
meat and egg) mild spices and eggs dishes, highly seasoned,
qorma biryani, kabab,
broast
Daals with/without All Fried and Spicy
husk)

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 Food Choices
Food Groups Food Allowed Foods Restricted
Vegetables (Green All Cooked in a lot of
leafy/ starchy) fat and Spicy
Fresh Fruits All fresh Fruit chaat, citrus
fruits and fruit
juice
Dry fruits, nuts and All in moderate quantity None
seeds
Fats and oils All in moderate quantity Deep fried food
and highly
seasoned

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 Food Choices
Food Groups Food Allowed Foods Restricted
Desserts and sweets All custard, pudding, jelly, Rich creamy
firni, kheer
Fluids and drinks All Carbonated drinks,
coffee, strong tea

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