Your diet may significantly impact acid reflux and other symptoms associated with a hiatal hernia. Avoiding citrus fruits, fatty foods, and carbonated beverages may prevent irritation. Eating foods high in fiber, probiotics, and whole grains may also help.

A hiatal hernia involves a part of your stomach extending or pushing through a small opening (hiatus) in your diaphragm. The diaphragm is a parachute-shaped muscle that extends along the rib cage, under the lungs, and helps you breathe in and out. Your food pipe passes through the muscle to connect to the stomach.

The main symptom of a hiatal hernia is acid reflux, which is when acid and other stomach contents flow back up the food pipe. You may experience heartburn (burning sensation in the chest), sore throat, belching, and epigastric pain, among others.

Chronic acid reflux may also lead to gastroesophageal reflux disease (GERD).

What you eat may soothe or worsen these symptoms. In fact, dietary adjustments and other lifestyle changes are often the first line of management for acid reflux, GERD, and hiatal hernias.

Read more about heartburn relief.

Hiatal hernia diets are similar to those recommended for GERD. The first step is usually identifying triggers (foods that cause symptoms to worsen) and then avoiding these foods. Not everyone has the same trigger foods, so it may be worth paying close attention to the relationship between what you eat and your symptoms.

Foods to avoid for GERD and hiatal hernias may include:

  • onions and garlic
  • citrus fruits like limes and oranges
  • tomatoes and tomato-based foods, such as salsa, bruschetta, and spaghetti and pizza sauce
  • spicy foods
  • fried and fatty foods
  • sugary foods
  • foods high in sodium
  • chocolate
  • peppermint and mint
  • alcohol, such as wine, beer, and spirits
  • coffee
  • caffeinated teas
  • carbonated drinks, such as seltzer water and soda
  • whole milk

In general, you want to add foods that reduce inflammation, neutralize stomach acid, and prevent tissue irritation. If you have severe symptoms, you may want to go with a liquid diet until you find relief.

Foods that may help with GERD and hiatal hernia symptoms may include:

  • non-citrus fruits, such as:
  • fresh vegetables, such as:
    • artichokes
    • carrots
    • sweet potatoes
    • asparagus
    • squash
    • green beans
    • leafy greens
    • peas
  • whole grains
  • nuts and seeds, like:
    • almonds
    • chia seeds
    • sunflower seeds
  • lean proteins
  • low fat yogurt
  • probiotic foods, like:
    • sauerkraut
    • kombucha
    • kimchi
  • honey
  • plant-based milks (preferably low in sugar), like:
    • soy milk
    • oat milk
    • almond milk
  • certain natural juices, such as:

Try to choose fresh and whole foods over processed ones whenever possible.

The way you cook and eat your food can make a difference. For example, fried sweet potatoes may trigger heartburn, while baked or boiled sweet potatoes may soothe it.

Also, eating too much food at one time or too fast may also make your hiatal hernia and acid reflux symptoms worse.

To reduce the chance of acid reflux, consider these tips:

  • Cook with healthy fats, like avocado, coconut, and olive oils.
  • Eat whole foods instead of processed foods whenever possible. The fiber content of fresh foods should help with your acid reflux.
  • Eat small meals every few hours instead of three large meals during the day.
  • Add probiotic foods to your diet. Cultured vegetables, like pickles, are a tasty option. Yogurt, kefir, and kombucha are other good choices. Taking a probiotic supplement is also an option.
  • Drink plain water. Drinking 8 glasses of water per day may help. Try adding lemon to your water for additional acid-lowering power. Lemon is a fruit that, although acidic outside the body, is metabolized to have alkaline byproducts.

Other strategies to prevent and manage GERD, acid reflux, and hiatal hernia symptoms may include:

  • walking after eating and avoiding going to bed shortly after a meal
  • elevating the head of your bed so your chest is slightly higher than the legs
  • sleeping on your left side
  • managing your weight so it’s optimal for your age and height
  • stopping tobacco use if you smoke
  • skipping tight-fitting clothes, which can make your heartburn worse
  • asking a healthcare professional about over-the-counter (OTC) medications that may reduce acid in your stomach
  • taking probiotics and digestive enzymes
  • eating your meals in a calm and relaxing place
  • eating slowly and chewing well
  • avoiding standing up while eating

Diet may impact the frequency and severity of acid reflux symptoms related to hiatal hernia. If you have a hiatal hernia, you may want to follow dietary protocols used to manage GERD.

If your symptoms persist, you may want to discuss them with a healthcare professional. OTC and prescription medications may help you find relief.