Diet after hiatal hernia surgery

• After a hiatal hernia, it is common to suffer a slight loss of appetite due to the operation and the anaesthesia. 
• To avoid reflux, which is a typical symptom, it is recommended not to eat large meals and, above all, not to eat anything for at least 2 hours before going to bed. 
• When it comes to cooking after hiatal hernia surgery, the least fatty types of cooking should be chosen: boiled, boiled, steamed, poached, sautéed, grilled, baked and en papillote.

A hiatal hernia occurs when the upper part of the stomach protrudes through an opening in the diaphragm, called the hiatus. This opening is the orifice through which the oesophagus enters to become the stomach.

In many cases, this can be remedied in the early stages with lifestyle changes, medication or other conservative treatment, while in the case of a hiatal hernia that is too large or causes the severe symptoms mentioned below, the best option is to have a hiatal hernia operation performed laparoscopically.

One of the main problems of hiatal hernia is gastro-oesophageal reflux, and in many cases hiatal hernia surgery is considered to be anti-reflux surgery. Gastro-oesophageal reflux is a chronic problem that can cause very serious problems if left untreated.

It must be made clear that hiatal hernia and gastro-oesophageal reflux are not the same condition; hiatal hernia can favour gastro-oesophageal reflux and in a large number of cases it is related, but it can occur even if there is no hernia. 

Gastric reflux can appear with pregnancy or obesity, given the pressure that is exerted on the abdomen and stomach causing the appearance of reflux, but without the need to present a hiatal hernia.

The symptoms of this situation will be very similar, the most common being heartburn, dry cough and abdominal discomfort. The guidelines explained below can be valid for both cases for patients after hiatal hernia and for those suffering from gastro-oesophageal reflux.

In order to avoid the discomfort of the situation and to alleviate it, it is necessary to take a little more care of oneself. The following guidelines help to maintain healthier habits and help to re-educate the way of eating. 

Specialists usually give the following basic guidelines:

• Slim down whenever necessary. This is very important as it helps to improve symptoms by taking pressure off the abdomen.
• Avoid large meals. Large meals make proper digestion difficult, as the food remains in the stomach for longer and causes reflux. It is therefore recommended to eat lighter meals, with 5 meals a day. It is also preferable to eat these meals slowly and chew well.
• Try not to eat anything before going to bed, not even liquids. It is recommended to eat dinner at least 2 hours before going to bed.
• Gentler and healthier cooking, such as boiling, en papillote, steaming or baking. Above all, avoid battered or fried foods. In addition, grilled foods should be avoided, as they can cause stomach irritation if the food is burnt.
• Another key to avoiding stomach irritation is to be careful with very hot or very cold food, as extreme food temperatures can also affect the stomach after ingestion.

These indications to be taken into account should in any case be consulted with the doctor who is treating the case. They may vary and must be adapted to each patient.

Before showing the foods that can be consumed and are recommended after hiatal hernia surgery, allergies and intolerances must be taken into account, therefore, these nutritional guidelines should be consulted with a specialist.

Among the foods that are recommended to alleviate or prevent hiatal hernia are the following:

• Lean, low-fat meats: It is recommended to remove all visible fat before cooking.
• Fish: The most advisable is white fish, as it is more easily digested.
• Dairy products: Avoid all those that are fatty, choosing the skimmed or semi-skimmed ranges, such as yoghurts not enriched with cream, fresh cheese, creamy cheeses (low-fat), cottage cheese, curd, yoghurt mousse or kefir. In addition to reducing saturated fats, this dairy consumption promotes weight loss, improves symptoms and improves health status.
• Eggs: The most recommended preparations that facilitate digestion are scrambled, in omelettes, poached or soft-boiled.
• Cold meats: Chicken and turkey cold cuts can be consumed, eliminating any excess visible fat that may be present.
• Legumes: Consume in small quantities, well cooked and without fatty accompaniments, such as bacon or chorizo.
• Vegetables: All vegetables can be consumed except flatulent ones, such as cauliflower, Brussels sprouts, cabbage, artichokes, onions, raw peppers, etc.

• Fruits: When consuming them, make sure they are fresh, very ripe and not acidic. Apples, pears or pineapple are also recommended as long as they are very ripe, and can be prepared as a smoothie, roasted, stewed or pureed.
• Fats: Fats such as olive oil and seed oil can be consumed, they are easier to digest, however, it is not advisable to abuse their quantities. It is recommended to consume butter or margarine in raw form as they are better tolerated without cooking. As for the consumption of mayonnaise, it is better to use light mayonnaise, as it provides less fat than normal mayonnaise.

There are other foods that can be consumed but care should be taken when doing so, as their nutrients are not always easily digested and may cause acidity or reflux. 

Therefore, it is recommended to have a moderate or low consumption of the following foods:

• Dairy products: whole milk, bearing in mind how it is tolerated by the body, other dairy products such as milk shakes (avoiding chocolate), custard, flan and rice pudding.
• Semi-fatty meats and oily fish.
• Cold meat: You can eat ham or Serrano ham, making sure that it is not too salty and that all visible fat is removed.
• Cereals: Sweetened breakfast cereals e.g. honey cereals, wholemeal cereals or muesli, always check tolerance.
• Beverages: Non-acidic packaged juices and fruit in syrup without juice.
• Other products: honey, industrial pastries, gelatine, ice cream or sherbet and dried fruit. They can be consumed, but care must be taken as they may cause discomfort due to acidity.

These foods should be consumed sporadically and in very small quantities, and are best avoided as they may not be good for the patient. The reasons for this are given below.

• Milk and dairy products: condensed milk, strong, fatty, very mature or fermented cheeses and dairy desserts with cream. This is because they slow down digestion, cause reflux and can cause other discomforts.
• Fatty, fibrous meats such as rabbit, twice-cooked or highly seasoned meat, fatty sausages and offal, hard-boiled eggs, pickled or salted fish such as cod or herring. As with dairy products, meat or fish of this type is very heavy on the body, so it is slower to digest and increases the likelihood of acidity.
• Cereals: Freshly baked bread should be avoided as it creates discomfort as it ferments inside the stomach. Cereals with chocolate, biscuits filled with chocolate or dipped in sugar are also products that cause discomfort when consumed after surgery or in cases of gastro-oesophageal reflux.
• Fruit: Unripe and raw fruit, acidic fruit, fruit in syrup, dried and candied fruit. They promote acidity, reflux and are difficult to digest.
• Drinks: Liquids such as coffee, even decaffeinated coffee, carbonated drinks, drinks with coffee extracts, chocolate drinks, tea and all alcoholic drinks irritate the gastric mucosa and increase acidity.
• Fats: cream, lard, bacon and tallow. These are heavy foods and therefore slow to digest, as well as being unhealthy fats.

Other recommendations for foods to limit or avoid are:

Acidic foods should be limited, especially at dinner time. This is due to the fact that after being consumed they can cause discomfort in the stomach, some cases present this discomfort after eating products such as: tomatoes, vinegar, citrus fruits, unripe fruit or yoghurt.

It is recommended not to eat this type of food at least until you have fully recovered from the hiatal hernia. Foods such as garlic, onions and peppers, especially when eaten raw, can cause discomfort.

To find out a little more about the correct diet after hiatal hernia surgery or if you still suffer from it, it is recommended as a general rule, to choose the least fatty cooking for the preparation of meals. The most important cooking methods are: boiled, boiled, steamed, poached, sautéed, grilled, baked and en papillote.

• Fruits: They are more digestive when they are prepared roasted, in compote, or in purée.
• The most suitable way to cook vegetables is in a stew, without adding stir-fry or sauces.
• Pulses: Pulses can be cooked in puree, making the texture lighter and easier to digest. You can also add a little cumin or fennel to the cooking, to make them less flatulent.
• Fried foods: Although these should be avoided as much as possible, if this type of cooking is carried out, it is recommended to do so with little oil and of a mild type.

There are numerous options for making changes to flavour dishes, which are healthier and help to improve digestion without losing flavour.

• Apple cider vinegar and lemon dressing can replace wine vinegar, which can be too acidic.
• Herbs can reduce acidity and flatulence and can replace strong spices. Herbs such as savoury, fennel, bay leaves, green anise and oregano.
• Swap ingredients that activate gastric juices such as garlic, onions or shallots for seasonings that strengthen digestive processes and facilitate digestion such as dill, capers, sage, rosemary, parsley, basil and thyme.

We insist that the recommendations are general, therefore, the diet to be followed after the intervention must be adapted to each case, given that the patient may have allergies or intolerances. Nutritional guidelines must therefore be consulted and adapted to the patient.

As a last indication, we advise you to consult a nutrition specialist, as for a diet to be successful, it must be adapted to the tastes and needs of each person and never established in a general way.

If you have a hiatal hernia and are thinking of having surgery with us, remember that you can request a free surgical assessment consultation with our specialist in General surgery and the Digestive System, so that you can get to know him, so that he can familiarise himself with your case and you can decide the best option to eliminate the symptoms of hiatal hernia once and for all.

You can request the surgical assessment consultation by clicking below: