The hernia is very large and blocking reg food sizes from getting to the stomach. I can understand that it needs softer and or puree foods, but why a limitation of acid foods,or chocolate etc. make a difference for this? there is nothing raw or open as there might be with an ulcer. I also understand the necessity of small portions and more feeding times durning the day and the need to be upright for several hours after eating anything

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Is caused by part of the upper portion of stomach, where the esophagus is attached, --that part of the stomach pokes up through the stretched hole in the diaphragm, which causes food to regurgitate back up thru the esophagus, because the sphincter that usually prevents that, can't do it's job then.
When stomach acid is mixed with that food, it can burn the esophagus....just like GERD can. But the causes are very different.
So, eating small amounts, of blander foods, more often during the day, and making sure nothing is eaten less than 2 hours before reclining, helps.

This may be a concurrent condition, but cause is very different.
THIS ailment is most often caused, actually, by rapid overgrowth of the H.Pylori that over 70% of all people have living in the bottom of their stomach--kill that germ back to normal levels, and the GERD stops.
For that, mainstream medicine uses antibiotics;
Holistic practitioners generally use a single strong dose of Grapefruit SEED extract [GSE]; though some have used large doses of colloidal silver. Those work every bit as fast, and without the adverse consequences, of antibiotics, and since it only usually needs a single serving, those using drugs that need separated from grapefruit, usually can figure a way to separate the doses safely--or use the colloidal silver instead--and No, no one will turn blue using a single serving!

We don't entirely know why that germ suddenly grows very fast--
--to the point someone can get a GERD episode almost instantly after eating.... has something to do with eating foods the stomach can't handle; or, foods that are unhealthy or allergenic/sensitizing. Most folks finally figure that out, once they start paying attention to what they eat, and when they get GERD....unless it's happening with everything--then they really need professional food testing.
The same bacteria is implicated in Morning Sickness//Hyperemesis Gravidarum.
===The solution is still the same:
Use something to kill the bacteria back to normal levels, then give daily broad-spectrum probiotics to keep it normalized, and stop eating foods that cause it.

BUT...that will Not work on a hiatal hernia.
Wish it did.
Many years ago, someone invented a "donut" contraption that was surgically fitted around the hernia, to make the hole through the diaphragm smaller, which prevented the stomach from poking up into the thoracic cavity....fixed the problem.
Does mainstream medicine do that procedure anymore?
I seem to remember that just using sutures to reduce size of the hole in the diaphragm, failed--that's why the donut gizmo was used.
Anyone else hear of that? Is it still used?

Nutritional counseling is a very good idea. Docs RARELY have nutritional schooling...though more are getting a bit more, these's still a dicey proposition to think your Doc knows much of nutrition.
Most are still sucking into Pharmaceutical Co's hog-washing people into thinking acid causes reflux--it doesn't.
You can google the info about H. Pylori causing it, and causing Morning sickness and Hyperemesis Gravidarum.
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No, the diet for a patient with diagnosed hiatal hernia is different than a pt. with a peptic ulcer. Speak with a dietition, a primary care dr. or a nurse who speicializes in dietary needs.
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Hi Sharon43, 1st poster is correct, most people with hiatal hernia also have GERD. Not all, but most. Doc must have found evidence of GERD too? My sister had one, Mom has one, I don't, ...but I do have ulcers, so we all have had pretty much the same big "no no's for chowie.

Don't feel bad, you may be able to have moderate amounts of the "no no's" once you've got it under control. We all did trial and error after a long bout of being super good, per the Doc. If you absolutely love something and you've been super good and are not inflamed you can try a super moderate amount of just the one no no, be good on the other side for a couple days, assess how it went. I was able to add back in some orange juice now and then, limited coffee, like 1-2 SMALL cups per morning, even some french fries now and then, as long as I am mostly following along and not annoying things. Sis got to have some chocolate and her beloved cherry tomatoes moderately. Ha-not me, if I even look at a tomato things do not go well! Darn it. I also cannot "even look at" most salad dressing, (the vinegar), raw onions, a total thing of the past, and especially items that contain MSG, like commercial soups and gravies. Oh, really bad one was cheap "bratts", (pretty fatty I guess), but did find if we make the more expensive ones I get away with one now and then. Never cheat the size/texture rule with hernia though. Doc told me try sautee the onions, takes the sting out of them. If it's a small amount, he's right, but mostly have to avoid them now. :-( Carbonated beverages, I cannot have beer. Not a one. But if I've been good 98% of a week, I can have an 8 oz glass of soda pop, no effect. Pop does Mom in though, ha- even if she looks at it. You'll get it fine tuned. Make sure Doc says it's OK to see what you can or can't add back in. Our Doc was the one that suggested the trial and error method, after getting control. Somethings I dearly miss, other things, not so much surprisingly. Ha-have learned how to make lots of great homemade soups, chowders, and gravies that I never knew how to make before, so there's a bright side. That MSG is one of my biggest culprits! Good luck!
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I think the concern with hernia is acid reflux, which is different from an ulcer, but still requires avoiding or limiting certain foods, such as those cooked with a lot of grease, chocolate, coffee, carbonated beverages.
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