What to Eat When You Have a Hiatal Hernia

Dietary Recommendations for Better Management

Hiatal Hernia diet sweet potato, grilled chicken, kale, quinoa, and shredded apple

Verywell / Zorica Lakonic

A hiatal hernia is a condition that involves the upper part of the stomach abnormally protruding though the hiatus (an opening in the diaphragm between the stomach and the chest).

The esophagus (the tube that carries the food from the mouth to the stomach) normally goes through the hiatus. But, in a hiatal hernia, part of the stomach slips through the hiatus into the chest. 

Commonly, symptoms of a hiatal hernia include acid reflux, a condition in which gastric fluid flows upward into the esophagus. This may result in a condition called gastroesophageal reflux (GERD), which has symptoms of pain and discomfort (heartburn) in the chest area.

GERD may worsen after ingesting certain foods or beverages. According to Columbia University, “Most small hiatal hernias do not cause symptoms. The most common symptom of hiatal hernia is gastroesophageal reflux (GERD).”

hiatal hernia symptoms
© Verywell, 2018

The overall goal of the hiatal hernia diet is to eliminate foods that increase stomach acid, thus, lessening the symptoms of acid reflux. In addition, there are other several other lifestyle goals thought to improve symptoms of hiatal hernia.


Diet is thought to play a significant role in the severity of symptoms, as well as a possible underlying cause of hiatal hernia. 

Researchers know that some foods can cause irritation to the lining of the stomach and digestive tract and may cause inflammation. But scientists are not certain if certain foods can cause a hiatal hernia, and if so, it’s not well understood exactly how this may occur.

Most of the clinical research on hiatal hernia and diet involves the link between eating certain foods and gastroesophageal reflux disease (GERD).

In an online report by the Canadian Society of Intestinal Research, dietary recommendations include avoiding foods that delay the time it takes for the stomach to empty. 

The report explains that the more time it takes for foods to be digested and moved through the stomach, the more prolonged the exposure of stomach acid in the esophagus, increasing the likelihood of gastric reflux in those with GERD. 

Foods said to prolong gastric (stomach) emptying time include high-fat foods such as:

  • Bacon
  • Cream
  • Deep-fried foods
  • Full-fat cheese
  • Ice cream
  • Potato chips
  • Sausages

The report also suggests that those with GERD symptoms should be sure to eat plenty of high-protein foods. This may promote closure of the gastric sphincter (the ring of muscles that open and close to allow food into the stomach from the esophagus).

Not all studies support the theory that high protein foods can help GERD symptoms, however.

According to the Canadian Society of Intestinal Research, “Even though more recent studies do not support this belief, maintaining a diet with an adequate low-fat protein intake can still help in the healing of irritated mucous [the lining of the stomach] or ulcers.”

The esophagus has two openings (called sphincters) which are bundles of muscles that open and close. The upper esophageal opening keeps food from going into the windpipe during swallowing. 

The lower esophageal sphincter (LES) is a bundle of muscles at the lower end of the esophagus where food enters the stomach. When the LES closes, it keeps stomach contents and acid from traveling upward back into the esophagus.

Gastroesophageal reflux can occur when LES pressure is lower than stomach pressure.

Chocolate and coffee contain compounds thought to relax the LES sphincter in the stomach, and coffee is said to stimulate (and raise) stomach acid, which promotes gastric reflux and irritates the lining of the esophagus in some people.

The tolerance of coffee (either regular or decaffeinated) should be evaluated on an individual basis.

Alcohol, mint, citrus fruit, tomatoes and carbonated beverages may cause irritation and further damage to the lining of the esophagus in those with GERD, but these foods have not been proven to cause reflux.

How It Works

Generally, the hiatal hernia diet involves a process in which individuals eliminate foods from their diet that cause an increase in symptoms. 

Some foods, such as carbonated beverages, citrus fruits, and more, may increase symptoms in some people diagnosed with a hiatal hernia. Other foods, like fatty fried foods, are problematic to most people who experience symptoms of GERD.


The duration of the hernia diet depends on several factors such as if symptoms improve or worsen, if the hernia worsens, and if surgery is necessary. It’s important to consult with your healthcare provider to formulate a long-term plan regarding diet and lifestyle.

What to Eat

People diagnosed with a hiatal hernia should avoid foods that are highly acidic, those that are fatty, oily, rich, as well as processed foods with preservatives.

Compliant Foods
  • Almonds

  • Aloe juice

  • Artichokes

  • Carrot juice

  • Carrots and peas

  • Chicken and other lean protein sources

  • Fermented foods (such as sauerkraut)

  • Green beans

  • Green leafy vegetables (such as spinach and kale​)

  • Green tea (and herbal teas)

  • High fiber foods (such as oatmeal, whole grains, beans and legumes, as well as whole fruits and vegetables​)

  • Fruits and juices that are not considered citrus fruits such as apples, pears, various melons, and berries

  • Plant-based milk, such as almond or oat milk​

  • Sweet potatoes

  • Yogurt

  • Whole grains

Non-Compliant Foods
  • Alcoholic beverages

  • Carbonated beverages

  • Chocolate, cocoa

  • Citrus fruits, such as oranges and limes​

  • Coffee

  • Condiments, such as ketchup or mustard​

  • Doughnuts

  • Fatty/oily foods

  • Fried foods

  • Garlic

  • Mint (including peppermint and other types of mint​)

  • Onions

  • Prepackaged, highly processed foods​

  • Salty foods

  • Tomatoes and tomato-based foods (such as salsa, tomato sauce, and more​)

In a 2017 Korean study, 126 participants (51 of which had GERD and 75 of which had possible GERD) were observed. The study found that in 37.3% of the GERD cases and in 22.7% of the possible GERD cases, GERD symptoms were induced by specific foods.

The specific foods identified in the study that increased symptoms of GERD were:

  • Asian dishes with pork fried in lard
  • Breads
  • Coffee
  • Doughnuts
  • Fried foods
  • Hotdogs
  • Hot spicy stews
  • Pizza
  • Ramen noodles
  • Rice cakes (and spicy rice cakes)

Consider drinking cucumber water. A 2017 study conducted by Complementary Therapies in Medicine reported that “All test samples except lemon showed significantly higher (p<0.05 for cucumber) acid neutralizing effect than water.”

The study found that the “highest antacid activity was demonstrated by cold milk and broccoli, which was comparable with ENO and sodium bicarbonate.”

Other Lifestyle/Diet Changes

Being overweight has been associated with an increase in the incidence of GERD and hiatal hernia. 

Those who are overweight should combine the hiatal hernia diet with a weight loss diet. Other diet tips known to lower the symptoms of hiatal hernia include:

  • Eat frequent meals and snacks in small portions.
  • Drink plenty of fluids (particularly water) each day.
  • Keep a food log of triggers.
  • Chew your food thoroughly and eat slowly and drink lots of water during meals to promote proper digestion.
  • Do not eat right before exercising or bending over.
  • Eat foods high in probiotics (such as fermented foods) and consider taking probiotic supplements to promote healthy digestion.
  • Avoid excessive hunger (which increases the stomach acid level) or being too full.

Recommended Timing

The timing of meals is just as important as what is eaten or withheld from the diet. Tips for the recommended timing of the hiatal hernia diet include:

  • Do not eat late at night.
  • Finish the last meal/snack of the day at least three to four hours before lying down (for some people even longer).
  • Spread meals out throughout the day and eat frequent small meals avoiding large meals.

Cooking Tips

The way food is prepared can make a difference for those with GERD symptoms. For example, frying foods can trigger gastric reflux for most people. 

Cooking tips for people on the hiatal hernia diet include:

  • Use healthy oil to sauté foods (such as olive oil, grapeseed oil, and avocado oil).
  • Avoid deep-frying.
  • When cooking with high heat, be aware that some oils (such as olive oil) break down. Coconut oil and avocado oil are healthy oils that can maintain their non-saturated fat content when cooking with high heat include.
  • Avoid pre-packed processed foods and ingredients. Use whole fresh foods whenever possible. These foods contain more fiber which is thought to help reduce symptoms of GERD.
  • Include fermented foods in the preparation of foods such as sauerkraut, pickles, yogurt, and kefir.


Those who are in search of a heart-healthy diet may be interested in learning about one study, published in 2017, that discovered the Mediterranean diet was effective in decreasing the risk of GERD symptoms in 817 study participants.

The Mediterranean diet is the most studied diet, compared to most other eating plans. It consists of a high intake of vegetables, beans, legumes, fresh fruits, whole grains, fish, and olive oil, along with limited amounts of red wine and dairy products. 

Note: Those with GERD may opt to forgo the red wine. Alcohol has been found to irritate the lining of the esophagus.


A 2017 report, published by the journal Current Options in Gastroenterology, suggests that acidic foods, such as citrus fruits and tomatoes, may trigger reflux symptoms. 

For example, citrus fruit juices were found to take longer to drink, requiring a higher number of swallows as compared to other liquids (such as water). Frequent swallowing can cause an influx of air, which can exacerbate (worsen) GERD symptoms in some people. 

Often, those with GERD symptoms of a hiatal hernia self-modify their diet, decreasing the foods that seem to worsen reflux symptoms. 

Those in the study with GERD symptoms were found to adjust the foods that worsened their symptoms, but they did not eliminate all foods traditionally linked with exacerbating reflux.

It’s important to keep in mind that some foods (such as high fat foods) do not immediately seem to cause an increase in symptoms, but rather, create problems long after they are ingested.

Those who are on a vegetarian diet may be pleased to know that foods containing animal fats are found to lend themselves to worsening symptoms of hiatal hernia, compared to vegetarian protein options such as high fiber beans and legumes.

Overall, the hiatal hernia diet restricts many foods that are not healthy, in favor of whole, natural foods and low-fat foods that are more health-promoting. 

Dietary Restrictions

For those with hiatal hernia combined with other gastrointestinal disorders, such as Crohn’s disease, restricting fiber may be an issue. 

While a high fiber diet is thought to lower the symptoms of GERD, those with inflammatory diseases of the bowel may need a low residue/fiber diet of no more than 15 grams of fiber per day (ideally, 25 to 38 grams of fiber is recommended daily for a typical adult diet). 

It’s best to consult with a healthcare professional regarding the intake of fiber and foods such as dairy products, certain types of carbohydrates (to lower the incidence of abdominal cramps and diarrhea) and fiber for those who have more than one condition of the gastrointestinal system.

Frequently Asked Questions

Can hiatal hernias go away on their own?

It depends. A small sliding hernia may come and go and may return to normal when you are standing. A large hiatal hernia will usually not go away without medical or surgical intervention.

When is hiatal hernia surgery necessary?

Surgery may be necessary when GERD symptoms are severe and not relieved by non-surgical treatments. Also, surgical repair is necessary in severe cases in which the hernia is blocking the blood supply to the stomach.

A Word From Verywell

As with any type of new diet, if you are diagnosed with hiatal hernia you should consult with your healthcare provider before implementing new dietary restrictions or changing your eating pattern. 

Keep in mind that gastric reflux (GERD) symptoms can cause serious complications such as inflammation of the esophagus (esophagitis), esophageal ulcers, bleeding, or scarring. 

Surgery may be required to correct a hiatal hernia in those who have chronic (long-term) unrelieved symptoms of esophageal reflux that do not improve with diet or medication. It’s vital to seek ongoing medical attention and keep your provider updated about your response to the hernia diet.

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8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. GI Society. Canadian Society of Intestinal Research What is the Treatment of GERD? Updated in 2019.

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  5. Sethi, S, Richter, J. Diet and Gastroesophageal Reflux Disease: Role in Pathogenesis and Management. Lippincott Williams & Wilkins. Curr Opin Gastroenterol. 2017;33(2):107-111. doi:10.1097/MOG.0000000000000337

  6. Owczarek D, Rodacki T, Domagała- R, Cibor D, Mach T. Diet and nutritional factors in inflammatory bowel diseases. World J Gastroenterol. 2016;22(3):895-905. doi:10.3748/v22i3895

  7. Cleveland Clinic. Hiatal hernia. Updated January 9, 2020.

  8. Cleveland Clinic Health Library. Hiatal Hernia: Management and Treatment. Updated August 17, 2019.

Additional Reading
  • New York Presbyterian Hospital/Columbia University Irving Medical Center, Columbia Surgery, ESOPHAGEAL DISORDERS PROGRAM. Hiatal Hernia. Updated 2019.