In the case of a hiatus hernia, a gap forms at the opening to the diaphragm where the food pipe (oesophagus) joins the stomach, allowing part of the stomach to push through. Most small hernias don't cause problems, but larger ones can lead to severe acid and pain. Occasionally, a hiatus hernia can lead to Barrett's Esophagus--where cells similar to those in the stomach develop in the lower oesophagus--which can in turn lead to cancer. To treat symptoms of these conditions and prevent complications, you will need to alter your diet.
In addition to dietary changes, switch to five to six small meals spread throughout the day and avoid eating large meals at any time, since they can distend your stomach, pushing it into your chest. You should also sit up after eating, waiting at least three hours before lying down, and avoid participating in strenuous activity after a meal. Although some people may find relief from a bland diet, it's not necessary for most patients. A better idea is to keep a food diary to determine which foods trigger your symptoms and simply avoid those.
Foods to Watch
In general, all patients with a hiatus hernia and Barrett's Esophagus should cut back or eliminate soft drinks, caffeine and alcoholic beverages. Even decaf coffee can be irritating to an inflamed oesophagus. Spicy foods are also frequent trigger foods, as are foods with a high acid content like citrus fruits, tomato and tomato products, chocolate, onions, spearmint and peppermint. Fatty foods can be problematic for many patients, since they relax the lower esophageal sphincter and increase the amount of time acid backs up into the oesophagus. These include deep fried foods, full-fat dairy products, refined sugar and high-fat pastries like doughnuts and brownies. You may also find symptoms improve if you avoid extreme food temperatures, hot or cold, so allow hot beverages to cool and avoid iced products.
Foods that Heal
Drink water after eating, to wash food particles from the esophageal tissues, but avoid drinking beverages during meals that can interfere with digestion. As a substitute for coffee, try soothing herbal teas like Rooibos or chamomile tea that contain no colours, additives or preservatives. Banana and apple are considered safe and acid-reducing by most patients, as are avocados. Other good fruit choices include pineapple and papaya which neutralise stomach acid, peaches, grapes and various berries (in moderation), as well as most fruit juices. High fibre foods are also quite helpful, including all vegetables except for tomatoes and onions and starches like yams, potato, rice and high-fibre grains. A particularly helpful breakfast is oatmeal, which can significantly reduce heartburn symptoms (just make sure it doesn't have a lot of additives). In general, try to make 50 per cent of your diet fruits and vegetables and the remaining 50 per cent low-fat protein, whole-grain carbohydrates and good fats like olive oil.
Aloe vera can promote healing of the lining of the entire digestive tract. Drink 1/4 cup aloe vera juice in the morning and again at night, added to herbal tea if desired. Mucilaginous herbs like slippery elm or comfrey can be purchased in tea form or added to herbal tea to help absorb the digestive secretions and prevent them from travelling back up the oesophagus and burning it.