It’s Q&A Day at 10almonds!

Have a question or a request? We love to hear from you!

In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

So, no question/request too big or small 😎

❝How does diet impact hiatus hernias?❞

Short answer: indirectly

More useful answer:

• Diet that favors obesity is more likely to result in getting a hiatus hernia, because obesity is one of the risk factors for it.
• Once you have a hiatus hernia, one of the more likely consequences is gastroesophageal reflux disease (GERD).
• Diet that is high in acids, fats, and/or spices will tend to worsen the GERD symptoms, as will alcohol.

We’ll cover the relevant dietary decisions involved in a moment, but first, for anyone wondering:

What actually is a hiatus hernia?

• A hernia (in general) is when an organ, or more often just part of an organ, “escapes” from where it is supposed to be kept in place, and thus finds itself somewhere it shouldn’t. The result is not usually very dangerous (although some can be, depending on what and where it is), and/but it’s often painful.
• A hiatus hernia is a hernia in which part of the stomach finds itself above the diaphragm, sneaking up where the esophagus makes its way through. This is usually periodic in nature, i.e. it doesn’t go there and get stuck and stay there; it sometimes slips back down, but easily makes its way back up again in response to certain conditions. On which note…

Calming it down (and keeping it down)

Since obesity is a risk factor, losing weight is indicated if you’re carrying excess fat. We’ll keep it simple here for the sake of space, but the biggest dietary risk factor for obesity is excessive quick-release carbs without sufficient fiber to accompany them.

So, to reverse that, getting plenty of fiber is good, as is getting plenty of protein to increase satiety signals, and getting at least enough good quality carbs and fats to give you enough energy that your body doesn’t think starvation is at hand (which perceived threat it would respond to by slowing down your metabolism and storing fat wherever/however possible).

For a more comprehensive approach that’s easy* to apply, see: How To Lose Weight (Healthily!)

*Unless there are other factors, e.g. food poverty and/or comorbidities that make healthy eating more difficult. But even in those cases, it’s good to know what to aim for, to be able to make the best choices where choices are available.

As a quick aside, we’re focusing on the food-related side of things because the question was about diet, but please do understand there are other risk factors for hernia that are more important than diet, including:

• genetic risk factors that you can’t control at all, and can only really be aware of as an extra cause for caution (either by health genomics services or by knowing about a family history of hernia)
• aging which you technically can control somewhat because the pace of biological aging is not set in stone (but as it stands, old age is coming for us all sooner or later if something else doesn’t get us first)
• frequent/hard coughing, sneezing, and/or vomiting, which are not usually optional activities, and this means that other maladies can lead to an increased risk of hernia through no fault of our own

Now, let us assume you already have a hiatus hernia and would like it to kindly stop herniating.

One thing to do is the same as we ideally would have done to avoid it, which is (again) weight loss, if applicable.

Another thing to do is to tailor one’s diet to reduce the symptoms of GERD, which as we mentioned up top, is one of the common consequences of hiatus hernia.

GERD has no known cure once established, but its symptoms can be managed by:

• Healthy eating (Mediterranean diet is, as usual, great)
• Weight loss (if and only if obese)
• Avoiding trigger foods (acidic, spicy, fatty*)
• Eating smaller meals
• Practicing mindful eating
• Staying upright for 3–4 hours after eating

And of course, don’t smoke, and ideally don’t drink alcohol.

*about avoiding fatty foods when we told you above to get at least enough good quality fats: the trick here is to enjoy high-quality fats little and often**, and avoid unduly oily cooking. And certainly, deep-frying anything is not what you want here.

**about “little and often”: this is very important, because part of the problem that causes GERD, and this is exacerbated in hiatus hernia, is physical in nature. Your stomach is somewhat stretchy but still limited in size. How much it can expand does depend on some other factors, for example, if you have more abdominal fat, it will have less room to expand—because the fat is packing it inwards and the stomach contents must push against that, meaning that by the laws of motion and fluid mechanics, the weight of fat from the outside exerts a force that can squeeze the stomach contents (per GERD) and/or the stomach itself (per hiatus hernia) up in the direction of your esophagus. With this in mind, “little and often” means there is, at any given time, less in your stomach and thus less chance of having your stomach contents (or indeed the stomach itself) pushed so far up that it ends up making its way out.

You can read more about GERD (and the different ways it can go from there), here:

NICE | Gastro-oesophageal reflux disease

Note: this above page refers to it as “GORD”, because of the British English spelling of “oesophagus” rather than “esophagus”. It’s the exact same organ and condition, just a different spelling.

Take care!