Diet and Hiatal Hernia


“Diet and Hiatal Hernia” In terms of preventing
acid reflux heartburn, I’ve talked about how high fat meals
cause dramatically more acid exposure in the esophagus in
the hours after a meal, but why does high fiber
intake decrease the risk? One typically thinks of fiber helping
out much lower in the digestive tract. A systematic review and meta-analysis found a highly significant
protective association between esophageal adenocarcinoma
and dietary fiber intake, suggesting that individuals
with the highest fiber intakes have an approximately
30% lower risk of cancer. This could be because
of the phytates in high fiber foods
slowing cancer growth. It could be the
anti-inflammatory effects. Fiber could be removing carcinogens. But those are all generic anti-cancer
effects of whole plant foods. Specific to this type of acid
irritation induced esophageal cancer, fiber may decrease the
risk of reflux in the first place. But how? Hiatus hernia occurs
when part of the stomach is pushed up through the diaphragm
into the chest cavity, which makes it easy for acid to reflux
up into the esophagus and throat. It affects more than
1 in 5 American adults. In contrast, in rural
African communities that were eating their
traditional plant-based diets, it wasn’t 1 in 5; it was closer to
1 in a 1,000 — almost unheard of. It’s almost peculiar to those
who consume western-type diets. Why are plant-based
populations protected? Perhaps because they
pass such large soft stools, three or four times the
volume as Westerners. What does the size and consistency
of one’s bowel movement have to do with hiatal hernia?
A simple model may help illustrate the mechanism producing
upward herniation of the stomach through the hole in the diaphragm
that separates the abdomen from the chest called the
esophageal hiatus; that’s the opening. If a ball with a hole in it is filled
with water and then squeezed, the water is pushed
out through the hole. The abdominal cavity
may be likened to a ball, the hole in the ball corresponding to that esophageal hiatus
in the diaphragm. So abdominal straining during
efforts to evacuate firm feces corresponds to squeezing the ball and may result in gradual expulsion
of the upper end of the stomach from the abdominal cavity
up into the chest. It’s like when you squeeze
one of those stress balls. Straining at stool raises pressures
inside our abdominal cavity more than almost any other factor. When we bear down and strain at
stool, it’s like squeezing our abdomen, and may herniate part
of our stomach up. Consistent with this
concept is the observation that in Africans the lower
esophageal sphincter is entirely sub-diaphragmatic,
whereas it usually straddles the diaphragm in Westerners
and is above the diaphragm in the presence of hiatus hernia. And the same abdominal
pressure from straining that may cause hiatal hernias may
cause a number of other problems. The straining can cause herniations in the wall of the colon itself,
known as diverticulosis. And that same pressure
can also backup blood flow into the veins around
the anus, causing hemorrhoids, and push blood flow back into the legs,
resulting in varicose veins as well.

30 thoughts on “Diet and Hiatal Hernia

  1. Hmmm i was eating vegan diet for a year now. whole winter i was eating cooked foods like potatoes lentils beans etc… not a lot of greens or fruits though. and in spring i started feeling acid reflux  or heartburn after every meal i eat… also didnt buy b12 supplement yet but will do in comming month. I dont know how i messed that up… i drink at least 2l of water a day.

  2. Old wise man saying.  Good food goes in easy, comes out easy.  Bad food goes in difficult, comes out difficult.

    Eating good food, not necessarily vegan, won't give you the constipation and grunting pressures forcing food-concrete from your bowels.  Also, having the proper daily amount of fluids will make sure that you properly digest and move your food-fuel down the highway without bunching-up and clogging your speed lane, and all later food traffic.

  3. Without thinking, once the video ended I exclaimed 'S***.' Aaaand started laughing to myself. Anyways, great video, it helps explain alot. Will be sharing this with others.

  4. You talk about all the positive of a vegan diet. Why not talk about the negatives? Low testosterone, short lifespan, non existent vegans who are 100+ years old.

  5. why are you are talking about central africa regarding their great health? They die before reaching age 60…

  6. Another comment challenged longevity of vegans. My curiosity led me to internet searches and eventually this website. What impressed me is not that there are so many 100 year old vegans, but the quality of life of many still very active and physically fit. Enjoy.
    https://www.flickr.com/groups/[email protected]/discuss/72157626391777857/

  7. I suffered from a hiatal hernia and severe constipation for a long time at the age of 19. It wasn't until I started eating a vegan diet (high in fruit too!) That I cured my hernia, constipation and my severe acid reflux!! I seriously looked everywhere on the internet and never found the answers until I traveled to Costa Rica and worked on an organic farm. We ate loads of fruit veg rice and beans. NEVER GOING BACK TO ANIMAL PRODUCTS AGAIN!!!

  8. Oh hey! Did you considered – Fini Weekly Diet (search on google)? Ive heard some superb things about it and my brother had only finest words about with this program.

  9. I have a hiatal hernia and reflux. I'm on Protonix, but still wake up short of breath with belching in the middle of the night. I try not to eat within 4-5 hours of laying down, yet I still lose sleep 4-5 nights a week. If I increase fiber intake and cut out fatty foods, when could I notice  relief? I'm in fairly good shape by the way. Not fat at all, and I exercise. Scares me that at 27 I'm struggling with this, and have been for 5 years.

  10. Dr. Greger when are you making a video about Helicobacter Pyloris or GERD? thanks!! Im a post VSG and new vegan low fat patient and im suffering with this two issues. Will love to get your findings on these.

  11. I have been suffering from GERD/acid reflux for 20yrs and taking prilosec for that time, recently started the mcdoughall diet which is vegan mostly starches and my reflux seemed to get worse (2weeks) so then I started my own paleo version (1 week) and seems to work for my GERD, the answer isnt a simple one, like eat this or that, I wish it was, for example I eat meat but find it tough to digest cause prilosec reduced stomach acid so sai acid doesnt travel up the esophagus, but I eat raw (scalded) meat and no problem digesting it, but feel more nervous on it seeing as carbs make me relax more.

    The Hiatus Hernia/GERD solution in my opinion is one that attacks the problem/disease from many angles.
    1. Diet – low carb diet seems to cause less bacteria build up and less pressure pushing up against a weakened LES, High fibre diet relieves this upward pressure by a faster transit time etc, so who is right??? High fibre foods are going to be carbs, like friuts, cereals like wheat bran and of course veggies! I can't eat gluten so bran is out for me!

    So I suppose I can eat only veggies like lettuce, cucumbers, spinach, etc. and avoid high carb foods and no meat.

    2. The studies don't touch on what happens in a few thrid world countries i.e. squatting when defecating, THAT could be the main reason why for example in africa they would have less GERD/Hiatus Hernia cause this practise causes less pressure on the LES??

    3. Relaxation, raising the bed 8 inches, taking certain supplements, losing weight, various exercises, chiropracter sessions etc should be also taken into account when trying to fix the HH and GERD.

  12. I have a question, I can't get health insurance for various reasons, and at one point I had a endoscopy scheduled but due to issues with insurance I haven't been able to get it done. I've had horrible heart burn for about 10 years and just in the last 6 months I've started regurgitating just about everything I eat. I notice it gets worse when I eat certain things like dairy, esp ice cream, red sauce, tomato, pepper, onion, citrus fruits. Etc. But I still regurgitate food either way. Is this a symptom of a hiatal hernia? Or have any of you experienced this? My doctors just gave me a raised eyebrow and no ideas as to what is causing it. About the only thing I saw online for regurgitation besides just GERD was a hernia or cancer. I don't want to freak myself out but I'm not getting anything done about it at this time so I'm left to suffer and wonder. It's literally getting in the way of everyday life, I can't do some basic functions because I'm too busy puking all the time. I'm miserable. Help!!

  13. My mother suffers from hernia. Can she overcome it with diet and if so what type of diet ? Just whole food plant based one or some special modiciations are needed ?

  14. hiatal hernia is a mechanical problem. When somebody tells you, it's all because meat and animal fat consumption, take caution. There will be a day when they'll blame it to meat consumption if the sun doesn't show up in the horizon.

  15. If this theory is true then how come many people are recovering fron gerd by eating a very low carb diet and are fine eating fats as they dont ferment in the stomach causing gas putting pressure on the les??????

  16. On this thought…aside of meals habits, I guess people with hiatal hernias should refrain themselves from working out with weights…. Straining would be out of the question?

  17. I have been vegan for 6 months. My gastric reflux has got less and less and has now virtually disappeared. I no longer take PPI s to stop acid, and lack of acid prevents intrinsic factor needed for b12 absorption.

  18. I have a hiatal hernia but eating too much fibre in a meal makes my symptoms worse! I eat whole foods plant based, 5 small meals a day and I finally feel better!

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