I’ve been living with a hiatus hernia since 2018. For two years before that, I was suffering from continual bloating and constipation. I became so used to a burning throat that I incorporated it into my daily life.

In March 2019, I admitted defeat and went for a gastroscopy and colonoscopy. The tests revealed my diagnosis of a hiatus hernia. Determined to stay off medication, I researched all I could on the subject. I discovered three main areas contributing to my ill-health: Diet, Lifestyle and stress, and physical abnormalities.

My journey to recovery is a success story that I’m happy to share. With a few adjustments, you too can live a completely normal, acid-free life.

What Is A Hiatus Hernia?

Part of your stomach pushes up through your diaphragm muscle into your chest cavity. It does this through a small opening in your diaphragm that’s meant for your esophagus.

Pictures of Hiatus Hernia

To better treat a hiatus hernia, it’s important to understand what it is and how it looks. These pictures depict just that.  

What Does A Hiatal Hernia Attack Feel Like?

This very much depends on you, what you eat, and how severe your hernia is.

If you’re suffering from a hernia, you’ll have good and bad days. For example, you might experience bloating after eating and a burning sensation in your chest and throat. This is because stomach acid moves up into your esophagus (food pipe) and your throat.

Other symptoms include shortness of breath, irregular breathing patterns, and chest pains (1).

In an acute attack, you might mistake a hernia for a heart attack. Either way, if you’re experiencing chest pains, consult your doctor to be safe.

Hiatus Hernia Symptoms

These are the most commonly reported symptoms amongst Hiatal Hernia sufferers (2) :

1. Burning sensation in the chest area.
2. Bitter or sour taste in the back of the throat.
3. Bloating and belching after eating.
4. Pain in the stomach or esophagus.

What Causes A Hiatal Hernia Flare-Up?

It’s not always possible to work out the exact cause of a hernia. That’s if we’re assuming there’s only one cause, to begin with. Most digestive problems result from a combination of events that build up over time.

The most common cause of a hiatal hernia is an increase in pressure in the abdomen area. Reasons for increased pressure include pregnancy, obesity, and having excess fluid in the abdomen. Coughing or vomiting, constipation causing straining during a bowel movement, heavy lifting, and physical injuries are other causes.

Dysbiosis is a fancy word describing an imbalance in your gut flora. By having too many harmful bacterias in your gut, you’re at risk of suffering from serious gut issues. For example, dysbiosis might be the reason why you’re constipated or straining during a bowel movement. 

A flare-up in hernia symptoms is often caused by stress and what we eat. Acidic food and drinks weaken the band of muscles separating your esophagus from your stomach. This area is called the lower oesophageal sphincter. When this sphincter weakens, stomach acid flows back up into your esophagus.

1. Balance Your Acid Levels

Stomach acid, digestive enzymes, and beneficial bacteria break food down in your stomach. If you don’t have enough stomach acid, you’ll battle to digest food. If you can’t digest what you eat, you’ll put extra pressure on your abdomen, making the hernia worse.

Undigested food also weakens the valve between your stomach and your esophagus, the esophageal sphincter. As a result, stomach acid spills up into your throat every time you eat. This backflow of acid is what we refer to as reflux.

90% of people have too little acid in their stomachs. Not the other way around. But why are so many people on treatment to lower stomach acid levels? Overprescribing of PPIs (acid blockers) happens about 50% of the time (3). Like most things treated with ‘modern medicine,’ we treat the symptoms, not the root cause (4).

Antacids temporarily neutralize your stomach acid but don’t correct the underlying problem. Nevertheless, many reflux sufferers rely heavily on antacids.

Increasing your stomach acid could cure your struggle with acid reflux for good. And without needing long-term medication.

There’s a home test you can do to see if your stomach acid levels are low.

1. Mix 1 tsp of sodium bicarbonate, aka baking soda, into a glass of water.
2. Drink the entire glass and immediately set a timer for 3 minutes.
3. If you burp within the 3 minutes, you have high enough acid levels in your stomach.
4. If you burp much later or not at all, you could be suffering from hypochlorhydria (low stomach acid).

Stomach acid and sodium bicarb create a chemical reaction in your stomach. If you have enough levels of both components, you’ll release carbon dioxide gas, which causes a burp.

Make sure you take the test first thing in the morning before you eat or drink anything. Then, repeat the test for one week to make sure.

I have been both the pharmacist and the patient in this scenario. I treat thousands of people with over-the-counter antacid medication for their reflux. And with my hiatus hernia, I’ve suffered from reflux and treated it myself. I can assure you that living on antacids is not the way to treat your condition successfully.

If you’re suffering from reflux caused by a hiatal hernia, I wouldn’t recommend taking pure hydrochloric acid (HCL) pills. Instead, the goal is to increase your stomach acid levels naturally. This will optimize your digestion to heal your esophageal sphincter and decrease pressure on your abdomen.

How do you correct low stomach acid levels?

• Stop taking antacids and acid-blocker medication.
• Eat slower and chew properly.
• Eat more plant-based meals. Reduce the processed foods.
• Drink more water. It’s essential for acid production. Read my article on Detox Water for all the benefits of drinking more water.
• Eat less sugar. Try sugar alternatives like my awesome Date Syrup. It’s easy to make and packed with fibre.
• Drink apple cider vinegar diluted in water.
• Try my Homemade Sour Gummies– they help stimulate gastric juices.
• Drink fresh lemon water. It’s acid neutralizing.
• Check your zinc levels. Zinc is essential for the stomach to make HCL.
• Treat an infection. Helicobacter Pylori bacteria causes low stomach acid (5).
• Address a chronic illness—hypothyroidism (6) as well as stomach and pancreatic cancers.

Increase and normalize your stomach acid levels by eating more healthier, plant-based foods. Chew slowly and eat mindfully. We touch on this again in the section on scrutinizing your relationship with food.

2. Regulate Your Fiber Intake

If you’ve got digestive problems, make sure you get enough fiber in your diet. Hiatal hernia is rare among populations eating high-fiber diets (7)

Your gut flora needs adequate fiber (also called prebiotics) as its food source to survive. High fiber foods include most fruits, vegetables, salads, ground flaxseeds, beans, and lentils.

You can’t simply supplement with fiber tablets or powders. Research shows that their effect is not the same as getting fiber from your diet (8). Instead, use a nutrient/calorie tracker app to see if the food you eat gives you the daily recommended amounts.

When trying to mend your gut and introduce more fiber into your diet, do it slowly. A sudden increase in fiber will cause temporary cramping, bloating, and gas. Start with small portions and increase them over time. Try not to overeat raw foods. Fry/steam your veggies and cook your oats. Rinse legumes and beans before cooking them.

3. Correct Gut Flora Imbalances

Your gut is filled with trillions of bacteria. Between 300 to 500 species, to be exact (9). It sounds gross, but without them, you wouldn’t be able to function. Your digestion, immunity, and mental health all depend on their presence (10).

On occasion, your beneficial gut flora levels decline. When this happens, harmful bacterias increase, and you have an imbalance (dysbiosis).

An increase in harmful bacteria occurs if you have poor dental hygiene. Bacteria levels increase in your mouth and carry it down to your gut. Unprotected sex is another way of introducing harmful bacterias.

A decrease in your beneficial bacteria also happens for many reasons. Some include taking antibiotics, overdoing alcohol, sugar, or processed food. Even how much you sleep, exercise and stress affect your flora levels.

It might take some time to build up excellent flora levels in your digestive system. For a more immediate effect, take a good probiotic capsule every day. Just remember, you’ll need to keep your gut bacteria alive by feeding them with prebiotics (fibrous food).

4. Improve Nutritional Imbalances

We’ve already established how vital gut flora is to one’s general health. What you eat has a massive impact on the type, quality, and quantity of flora you carry.

Research studies have shown that changing to a plant-based diet can positively increase your intestinal bacteria (11) (12).

My goal is not to convince you to turn vegan but to encourage you to eat a diverse diet filled with plant-based foods.
Over 75% of what we eat comes from only 12 plants and 5 animal species. Our western way of eating has diminished diet diversity to dismal numbers (13). Even sticking to a gluten-free diet can negatively impact your gut flora (14).

Drinking alcohol, smoking cigarettes, and eating artificial sweeteners kill certain gut floras. Foods high in sugars and fat also harm them. These foods also feed bad bacteria and cause gut inflammation. High-fat meals also cause higher acid levels in the esophagus within the first few hours after a meal.

I noticed I was eating far too much sodium and drinking far too little water. As a result, I hardly ever get reflux anymore, but if I do, it’s generally because of this.

When trying to mend your gut try not to eat raw foods. Lightly fry/steam your veggies and cook your oats. It’s easier on your digestion. Also, remember to eat whole foods instead of drinking smoothies.

5. Analyze Your Relationship With Food

80% of what you’ve learned from this post centers around good nutrition. By eating the right foods at the correct times, you’ll be solving most of your hernia-related symptoms. Eating correctly doesn’t have to be complicated; it takes some planning and focus. Below are a few steps you can take to help you along the way.

• Get rid of all processed foods in your house. Examples are crisps, sweets, chocolates, sodas, and biscuits. Once you’ve removed these items, the temptation is gone.
• Plan your meals ahead of time. Make a five-day menu for breakfast, lunch, and dinner. Then, go out and buy all the ingredients needed for these meals.
• Work out how much time you’ll need each day to prepare your meals. For example, you might consider using a slow cooker in the morning. You could also make and freeze dishes ahead of time.
•  Avoid eating or drinking acidic foods. For example, tomato sauce, coffee, chocolate, and fruit juice can irritate the esophageal lining.

How you eat is equally as important as what you eat. Ever heard the phrase mindful eating? Keep these steps in mind when eating a meal.

• Control the size of your meal.
• Eat slowly, chew your food correctly, and take your time.
• When you eat, focus on the meal itself. Don’t be distracted by the tv or your phone.
• Stop eating when you’re full. It would be best to eat because you’re hungry and not out of boredom or because you need to finish what’s on your plate.
• Eat meals two to three hours before lying down.
•  Avoid snacking before bedtime.

6. Repair Physical Abnormalities

As soon as I received my hiatus hernia diagnosis, I started researching. Within minutes I was watching a youtube video that later changed my life. This video explains how to pull your stomach back down into your abdomen from your chest. After trying it out, I experienced almost instantaneous relief. I continue to use this technique when I have a flare-up, which is hardly ever now.

There are many free videos online showing you how to fix your hernia (15)(16). You don’t have to do them forever, but you’ll keep your stomach where it should be until the hernia repairs.

If you don’t have time to watch the videos, I’ve included the steps below:

1. As you wake up, stand up and drink a glass of warm water.
2. Rise on your toes, with your arms raised above your head.
3. Take a deep breath in, making sure to expand your diaphragm.
4. Quickly drop down onto your heels as you breathe out.

The breathing, and the weight of water in your stomach, force your stomach back down into your abdomen.

Once your stomach is in the correct position, work on strengthening your diaphragm. Take a few short quick breaths with your mouth open and your arms up high. The panting tightens the diaphragm, closing the hole.

Go to the Chiropracter and check your alignment. Because you’re so active, you may be unaligned and need some physical adjustments too. There’s a significant link between alignment /vagal nerve/hernia problems (17).

Try as much as possible to decrease the pressure on your abdomen. For example, don’t wear tight belts or clothing, and make sure you empty your bladder if it’s full.

7. Manage Your Stress

Stress is arguably one of the most important influences affecting your health. Your digestive system is no exception to this (18). Worrying too much can decrease your gut flora levels and change your digestion speed.

Everyone deals with stress differently. First, you’ll need to find what works for you. Below are some of the steps others take to relieve stress.

• Remove the stressors from your life.
• Meditate or do yoga.
• Exercise regularly
• Practice being mindful. Enjoy all the small positive things that happen in your life.
• Take a relaxing bath or get a massage.
• Sleep for at least 7 hours each night.
• Distractions help, start a new hobby.
• Meet with friends or family.
• Eat more nutritious food; you’ll feel better.
• Change your surroundings, get outside and enjoy the sun or fresh air.

8. Diminish Candida (yeast) overgrowth

Thrush occurs when there’s an overgrowth of the candida fungus. It’s your body’s way of telling you that you have an imbalance.

Treat thrush by working on these main points.

• Boost your gut bacteria levels.
• Decrease your sugar intake to starve the fungus.
• Strengthen your immune system to fight candida.

9. Destroy Unwanted Parasites

If you suffer from stomach issues, you’re more prone to having unwanted parasites. For example, gut parasites create an acid environment in your stomach, which gives you more reflux.

Improve your gut flora levels and eat nutritious food to destroy these parasites. Add parasite-killing foods to your diet. Things like garlic, coconut oil, pumpkin seeds, and probiotics will help get rid of them.

If you think you’re harboring parasites, you can do a stool sample to find out. But be warned; you might get a false negative which is common with these tests.

Hiatus Hernia Exercises

The right kind of exercises can be very beneficial for a hiatus hernia. But keep in mind, intense exercises could make things worse. So instead, you need to focus on gentle exercises that strengthen your diaphragm.

Deep, controlled breathing used in yoga is a great way to strengthen your diaphragm.

Diaphragm strengthening exercise:

Lie down with one hand on your belly and the other on your chest. Breathe in deeply so that your stomach presses against your hand. Hold your breath and then exhale. On the exhale, you’ll feel your stomach move back down. Do this a couple of times in the morning and at bedtime.

Weight loss Exercises

If you’re overweight, try light running, swimming, and low-impact aerobics to burn fat. In addition, losing a few pounds could improve your hiatal hernia symptoms. It does this by reducing excess pressure on your abdomen area and strengthening your stomach muscles and diaphragm.

Whenever you’re exercising or lying down, keep your head raised a few inches higher than the rest of your body. Gravity will help keep your stomach’s contents in your stomach.

Hiatus Hernia Treatment

If you have a hiatus hernia, but you’re symptom-free, you might not need treatment at all. But, If you have frequent flare-ups, it’s best to treat them as soon as possible.

The 3 Treatment options included

• Diet and Lifestyle Changes
• Medication
• Surgery

We mentioned lifestyle and dietary changes you can make to treat your hernia. These changes could make a big difference and prevent your symptoms from coming back. For more immediate and short-term relief, medication is also an option.

Antacids and Alginates

Antacids neutralize stomach acid, and alginates form a barrier against excess acid. You can find both options in the grocery stores as well as pharmacies. However, these drugs offer short-term relief only.

Antacids contain magnesium, calcium, aluminum, or a mix of them all. Side-effects range from diarrhea, constipation, kidney stones, and even osteoporosis. In addition, antacids can affect your electrolyte levels, causing potentially big adverse effects long term. For this reason, it’s best to use them sparingly.

H2-receptor blockers

These drugs reduce acid production. You’ll find them behind the dispensary in pharmacies. They’re for short-term use only. They include ingredients like cimetidine, famotidine, and nizatidine.

These drugs specifically decrease nighttime acid production. This is helpful for people suffering from peptic ulcers which occur mostly at night. They’re not the best for controlling acid reflux, though (19).

PPI’s (proton pump inhibitors)

This group of drugs has gained immense popularity. Once on prescription only, PPI’s are now available over-the-counter in weaker strengths. They completely block acid production in the stomach. This gives your esophagus a break from all the acid reflux, allowing it to heal. They’re very effective against acid reflux, with effects lasting over 24 hours.

Ingredients include lansoprazole, omeprazole and pantoprazole.

Chronic use of these drugs can lower calcium and magnesium levels in your body. These lowered mineral levels aren’t easily remedied with supplements. For this reason, PPIs may cause bone fractures, kidney disease, and dementia. In addition, PPIs have the ability to reduce your gut bacteria diversity. This can result in pneumonia, Clostridium difficile diarrhea, and vitamin B12 deficiency (20),(21).

Surgery

If you can’t control your symptoms with lifestyle changes or medication, surgery might be for you. It’s also considered when there’s almost irreversible damage to the esophagus. You’ll need to discuss all the pros and cons with your doctor before taking on such a big decision.

Hiatus Hernia Diet

For a detailed report on the types of foods to eat or avoid, please refer to points 2-5 above.

In a nutshell

• Eat more fiber and foods beneficial to your gut microbiome.
• Get rid of processed foods and ‘junk food’ items.
• Eat more fruit and vegetables every day.
• Drink at least 1,5 liters of water every day.
• Stop stomach and drinking excessive amounts of alcohol.

Conclusion

You might be at the start of your journey and are daunted by the amount of ‘work’ you still have to put in. But, if you break it down and tackle one thing at a time, you’ll find it to be more manageable.

The best part is, you’ll reap the rewards with every positive change you make. Nothing motivates better than seeing results and feeling better.