DIET AND HYATAL HERNIA

Diet as a cause of hiatus hernia

Diet seems to represent a very important element not only in the correct management of hiatus hernia, intended as prevention of episodes of eructation and gastroesophageal reflux, but also in the origin of this widespread disease.

Since 1973, thanks to Burkitt's epidemiological studies, we know that the hiatal hernia is quite rare in developing countries and even unrecognized in rural societies that have maintained a simple and traditional lifestyle.

Dietary Risk Factors

Two factors are pointed out as the main ones responsible for the greater incidence of hiatal hernia in Westerners: the reduced intake of fiber in the diet and the constipation that follows.

In particular, elements such as the reduced intake of fibers and liquids, the need to ignore the urge to evacuate, the unnatural position taken on the toilet in some respects compared to the physiological one (Turkish style), determine an increase in pressure inside the toilet. "abdomen during evacuation"; this pressure increase, if perpetuated over time, would lead to a progressive relaxation of the anchoring structures of the distal esophagus, favoring the ascent of the stomach through the esophageal hiatus of the diaphragm (thus causing the hiatal hernia).

Explaining the different incidence of hiatal hernia between rural African populations and urban populations in Western countries simply on the intake of dietary fiber appears at least an understatement. For example, hyperalimentation itself, made up of frequent binges, by abnormally dilating the stomach walls can forcefully push them against the esophageal hiatus, favoring its herniation. The same goes for obesity or for the bad habit of wearing too tight corsets or clothes.

Finally, there is no doubt that the sedentary lifestyle is associated with a lower intestinal motility (which predisposes to constipation), but also with muscular hypotonia with a reduction in the elasticity and robustness of the muscle bundles and diaphragmatic tendons as well.

Diet in the treatment of hiatal hernia

Although the diet cannot in any way favor the resorption of the hiatal hernia, which if necessary can take place through surgery, it is undoubtedly useful for the control of associated symptoms and complications.

Although a good percentage of patients with hiatus hernia do not complain of any symptoms, observing the right dietary and behavioral rules is important to prevent the hernia from growing in size. In this sense, the correct diet for the treatment of hiatal hernia does not differ from that seen for the correct dietary management of patients affected by reflux esophagitis:

eat small and frequent meals, avoiding too elaborate and abundant meals, especially before bed

wait at least two or three hours after the end of the meal before going to bed for a night's rest. If acid reflux episodes occur during sleep, it is advisable to raise the head of the mattress to adopt a slightly elevated position of the chest.

associate regular physical activity with the diet, avoiding physical efforts upside down and excessively heavy loads, which can favor the onset and aggravation of the hiatal hernia

if overweight, adopt a low-calorie diet that helps you reach a healthy weight

limit the consumption of fats, especially if cooked, even in the form of added condiments, as they increase digestion times and reduce the tone of the lower esophageal sphincter, favoring reflux associated with hiatal hernia

avoid smoking, which similarly to fats can reduce the sphincter tone

prefer lean protein sources, such as fish or chicken, which appear to increase the tone of the lower esophageal sphincter, preventing acid reflux associated with hiatus hernia

prefer healthy cooking methods, such as steamed and baked, limiting roasts, fried and grilled (to be replaced with a sober griddle cooking, absolutely avoiding the formation of the classic lines in correspondence with the metal strips of the grill)

chew slowly and swallow with the same care, if possible eat in a relaxed environment

if possible, avoid rushing back to work after the meal

do not engage in strenuous physical activity shortly after an important meal (granted after the afternoon snack)

eat a hearty breakfast and get used to eating little at dinner

in case of frequent digestive problems, the basic rules of the dissociated diet can also help the patient suffering from hiatal hernia

when you eat too much, a 30-40 minute walk at a leisurely pace, a short distance from the end of the meal, can avoid the onset of acidity and heartburn

limit the consumption of tea, coffee and alcohol

reduce the presence of spices such as pepper, chilli, curry and nutmeg in the diet: they could worsen gastric acidity

follow a diet rich in dietary fiber and fluids to prevent constipation; if necessary take laxatives, but avoid chronic use

avoid the use of belts and clothes that are too tight at the waist

Hyatal Hernia Diet Example