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Hiatal hernia, Prilosec, and Paleo

Answered on August 19, 2014
Created August 25, 2011 at 7:02 PM

I've had reflux since I was a kid, and been on Prilosec for 7 years or so now. After an endoscopy a few years ago I was diagnosed with a hiatal hernia (http://en.wikipedia.org/wiki/Hiatus_hernia). I've been moving to a Paleo diet over the last couple weeks, and I'd love to get off Prilosec, but I'm not sure if diet will be enough to fix the problem. Has anyone else with a hiatal hernia found their symptoms mostly disappear from switching to a paleo diet?

576dc803ed0dfa3616509e20f515d070

(75)

on December 05, 2013
at 06:53 PM

Just writing for my own reference. If anyone does happen upon this comment i was interested in the remark about fat, especially coconut oil, being bad for the lower esophageal sphincter. I realise FODMAPS may be bad for reflux etc but i was under the impression coconut oil may actually good for reflux, GERD etc, due to the anti-bacterial properties and whatnot. Does anyone have any information on why fat and especially coconut fat, would cause the lower esophageal sphincter to loosen please?

9cc813605b497e1a91dd2d85f97a6b9c

(40)

on November 05, 2011
at 05:38 PM

Nance - you are a Master! Took the words out of my mouth, was okayish till about 5pm and had a bit of acid, especially after years of having maybe 10 or more snacks a day to one is a bit hard, so cheated had some bread (yeah I know, not good) and yoghurt!

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on November 05, 2011
at 03:59 PM

Just remember--you should feel free to eat 2 or 3 times per day if you're physically hungry (vs. cravings.) You don't limit yourself to one meal until/unless your body is okay with that; it might take a week or two if it's going to happen.

9cc813605b497e1a91dd2d85f97a6b9c

(40)

on November 05, 2011
at 08:56 AM

Nance - welldone on your weightloss! We are told to eat small meal so that the acid in the stomach has something to munch on apart from it's own walls, but maybe the stomach gets the message and starts producing less as it reakises only one meal a day so no need to produce any more. If this works for me then you are a genius if it doesn't then you still are as it works for you. Will start today one meal at lunch and maybe water if I feel hungry later in the day, wow if I could reduce my losec in 2 weeks to half that would be great.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on November 04, 2011
at 11:37 PM

@Gerald: for me, the more frequently I eat the more I need/want to eat but thankfully, the opposite is also true. I am currently about 30 pounds down with 40 or so to go.

9cc813605b497e1a91dd2d85f97a6b9c

(40)

on November 04, 2011
at 10:00 PM

Thanks Nance, I've been on Prilosec for 15yrs as well, will try and follow example, may I ask did the diet help you lose weight, I am overweight at 34 BMI 109kg and should be 73kg, been joggin on the spot and will keep it up as long as my ancles can take it. Wow ONE large meal?? I thought many small meals would be better to shrink the stomach but if it works for you then great.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on November 04, 2011
at 09:38 PM

Oops! I forget to say I put oil & vinegar on the salad.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on November 04, 2011
at 09:17 PM

I'm sure the hernia is alive and well, but obviously the food I eat goes happily through my stomach and doesn't get bottled up which is apparently the underlying cause of GERD in many people. I eat one large 3-course meal per day; if I get hungry, I feel free to have a second but I rarely need it. My menu is very simple and I enjoy it so much I rarely use spices other than salt, pepper and tumeric. Typical menu: leaf lettuce salad, fatty meat and veggies in a 1-skillet meal and a piece of whole fruit for dessert. Once in a blue moon I'll have a can of sardines or about 5 pecan halves later.

9cc813605b497e1a91dd2d85f97a6b9c

(40)

on November 04, 2011
at 08:46 PM

Wow Nance that sounds great, can you tell me what you eat, maybe small meals and you avoid wheat and sugary foods, what foods do you eat? Any exercises or other things you do for the Hernia or which may have contributed to your success, thankyou Nance.

9cc813605b497e1a91dd2d85f97a6b9c

(40)

on November 04, 2011
at 04:35 PM

Kate that's great news about your father, did he lose surplus weight whilst changing dietary habits? This may help to alleviate pressure on the LES as well, once I can taper off the anti-depressants I will give the Melatonin a go, I did read somewhere that one man did experience auto immune problems after a year of Melatonin supplementation - something t possibly look out for. Also I think Folic acid could be substituted for Folate or a more benign version of Folic Acid?

Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on August 27, 2011
at 12:25 PM

Possibly. The b vitamins were just add ins. The Melatonin was supposed to be the main agent.

4781cf8ae1bfcb558dfb056af17bea94

(4359)

on August 25, 2011
at 08:32 PM

That Brazilian cocktail which contains the melatonin also contains a high dose of folic acid, which can cause cancer.

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8 Answers

3
9cc813605b497e1a91dd2d85f97a6b9c

on November 04, 2011
at 01:31 PM

Hi Nate,

I'm in the same boat, been on Omeprazole 20mg for 15yrs, about a year decided to listen to the alternative health guys on the net that say it's too little acid that is the cause for GERD and started changing the environment of my stomach from alkaline to acid and took apple cider vinegar and HCI Hydrochloric acid and stopped Omeprazole for a few days then BANG!!! Massive relfux and pain in my throat that didn't go away, went to hospital and was diagnosed via endoscopy of sliding hiatus hernia and inflammation of the esophagus (actually looked grey instead of pink) so was put on Nexium for a month to reduce acid and also Talcid which kind of soothes the esophagus, stops damage. So the pains went away.

My theory till now, is that if you have GERD but no Hiatus Hernia then it's easier to heal via low carbing or paleo or increasing acid etc, BUT a hernia is a bulge in the stomach that migrates to the sternum and open the LES, the opening of the stomach, the door as it were and so, what happens when you stop taking meds is that the normal amount or more acids are produced, right? That door is wide open, right? Acid is free to rise up and burn the esophagus and cause pain and if not stopped can lead to cancer.

But can low carb or paleo heal a Hiatus Hernia? I suppose by not eating refined carbs and sugars less gas may be produced and so less pressure moving upwards.

The Melatonin study I think dealt with normal GERD and didn't specify Hiatal Hernia. Taking Melatonin can give palpitations as well and should be used cautiously if you are taking anti-deressants which Iam and so took some for a short time only.

I found so far Paleo or low carb gives me palpitations in the evening, must be potassium/magnesium issue?

I would add, pressing down on the solar plexus area to push the Hernia down, abdominal breathing, hanging by a door frame to stretch the belly area, good posture, these are what I am trying now.

2
96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on November 04, 2011
at 07:53 PM

I had an upper GI and have a photo of my very own hiatal hernia!

3 weeks into primal, I realized I didn't need my Prilosec any more after 15 years of steady use.

Months later, I can tell you I never need it if I stay primal; one or 2 days of wheat- and/or sugary foods and I need it.

Hmmm.

9cc813605b497e1a91dd2d85f97a6b9c

(40)

on November 05, 2011
at 08:56 AM

Nance - welldone on your weightloss! We are told to eat small meal so that the acid in the stomach has something to munch on apart from it's own walls, but maybe the stomach gets the message and starts producing less as it reakises only one meal a day so no need to produce any more. If this works for me then you are a genius if it doesn't then you still are as it works for you. Will start today one meal at lunch and maybe water if I feel hungry later in the day, wow if I could reduce my losec in 2 weeks to half that would be great.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on November 04, 2011
at 09:38 PM

Oops! I forget to say I put oil & vinegar on the salad.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on November 04, 2011
at 11:37 PM

@Gerald: for me, the more frequently I eat the more I need/want to eat but thankfully, the opposite is also true. I am currently about 30 pounds down with 40 or so to go.

9cc813605b497e1a91dd2d85f97a6b9c

(40)

on November 04, 2011
at 08:46 PM

Wow Nance that sounds great, can you tell me what you eat, maybe small meals and you avoid wheat and sugary foods, what foods do you eat? Any exercises or other things you do for the Hernia or which may have contributed to your success, thankyou Nance.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on November 05, 2011
at 03:59 PM

Just remember--you should feel free to eat 2 or 3 times per day if you're physically hungry (vs. cravings.) You don't limit yourself to one meal until/unless your body is okay with that; it might take a week or two if it's going to happen.

9cc813605b497e1a91dd2d85f97a6b9c

(40)

on November 05, 2011
at 05:38 PM

Nance - you are a Master! Took the words out of my mouth, was okayish till about 5pm and had a bit of acid, especially after years of having maybe 10 or more snacks a day to one is a bit hard, so cheated had some bread (yeah I know, not good) and yoghurt!

9cc813605b497e1a91dd2d85f97a6b9c

(40)

on November 04, 2011
at 10:00 PM

Thanks Nance, I've been on Prilosec for 15yrs as well, will try and follow example, may I ask did the diet help you lose weight, I am overweight at 34 BMI 109kg and should be 73kg, been joggin on the spot and will keep it up as long as my ancles can take it. Wow ONE large meal?? I thought many small meals would be better to shrink the stomach but if it works for you then great.

96bf58d8c6bd492dc5b8ae46203fe247

(37227)

on November 04, 2011
at 09:17 PM

I'm sure the hernia is alive and well, but obviously the food I eat goes happily through my stomach and doesn't get bottled up which is apparently the underlying cause of GERD in many people. I eat one large 3-course meal per day; if I get hungry, I feel free to have a second but I rarely need it. My menu is very simple and I enjoy it so much I rarely use spices other than salt, pepper and tumeric. Typical menu: leaf lettuce salad, fatty meat and veggies in a 1-skillet meal and a piece of whole fruit for dessert. Once in a blue moon I'll have a can of sardines or about 5 pecan halves later.

2
4781cf8ae1bfcb558dfb056af17bea94

(4359)

on August 25, 2011
at 07:51 PM

I would be surprised if a hiatal hernia could be easily fixed through dietary measures. But, you can eat in a manner that reduces reflux. There are a few things that seem to work but I think the best is to pay attention to, and to significantly limit, consumption of FODMAPs (google it). Particularly troublesome FODMAPs (for me) include onions and lactose.

Other things that help reduce reflux include eating in a way that strains the lower esophageal sphincter as little as possible, resulting in a tighter squeeze. To that end, note that the following loosen the LES: fat (especially coconut fat), dense/glutenous carbs (like oatmeal, dense breads, etc), stomach distention, especially as a result of liquids (i.e., don't overeat and if you do, don't drink liquid for a bit), smoking, peppermint, chocolate (though note that chocolate is a great source of copper - see below). Things that tighten the LES include: protein, betain HCL (in my experience at least), marijuana (even small amounts), melatonin (at least in my experience), and rest. You can still eat things like fat and chocolate provided you combine them with offsetting factors. For example, I eat a fairly high-fat diet but make sure to include protein at night (when I am not rested). I also only eat dark chocolate in the morning (and never before exercise). If I eat really wrong and don't want to suffer through the heartburn, a little weed prevents reflux for hours and hours. Btw, I don't take any acid suppression any more, apart from an occasional tums.

At a more fundamental level, it is not clear what causes hiatal hernias to form. If nutritional deficiencies are involved, my money is on vitamin K, copper, zinc, and collagen/gelatin (i.e., nutrients that are involved in forming/strengthening connective tissue). There is some support for this in the literature (but it is scant).

Perhaps if you avoid LES relaxations P& reflux for a long enough time, during which you eat in a manner that provides your body with what it needs to build strong connective tissue, you can repair a hiatal hernia. That's what I've been trying to do for the past 6 months.

576dc803ed0dfa3616509e20f515d070

(75)

on December 05, 2013
at 06:53 PM

Just writing for my own reference. If anyone does happen upon this comment i was interested in the remark about fat, especially coconut oil, being bad for the lower esophageal sphincter. I realise FODMAPS may be bad for reflux etc but i was under the impression coconut oil may actually good for reflux, GERD etc, due to the anti-bacterial properties and whatnot. Does anyone have any information on why fat and especially coconut fat, would cause the lower esophageal sphincter to loosen please?

1
8916e8dc95fe5f744c09bfcbe0d65056

on July 15, 2012
at 06:29 AM

My name is natasha and I also have a hiatal hernia. I'm only 16. It's been almost 2 years since i was diagnosed. I can't yawn at all and get enough oxygen. In the heat I can't even hardly stand up because my arms/shoulders ache and I feel like I can't breathe. I can't stay bent over long enough to tie my shoes or I'll get light headed and dizzy and not be able to breathe. I was on omeprozole 20mg for a few months, then my doctor put me on nexium 60mg because the omeprozole was doing nothing. That didn't help at all either so they switched me back to omeprozole. Now I have ear infections in both my ears (have had them a little over a year) and really bad headaches every day from the time I wake up to the time I go back to sleep. I am in band and color guard (the flag spinners) is what I do. It's hard for me to continue with it though. I have to take way more breaks than anyone else and I can't even do most of the warm ups we do because then I'd be too tired and out of breath to do the marching. I haven't found anything that helps but peanut butter and jelly sandwiches are one of the very few things I can eat without feeling sick and breathless. (I don't like peanut butter or jelly though).

1
93ae9f2d376e5426e891a9b58d8302fa

(2936)

on November 04, 2011
at 05:20 PM

I've had symptoms of, guess you would call it incipient hiatal hernia, just very occasionally, when I was eating SAD. Yes, it went away completely since I went paleo. I can wolf down my food like a - well, like a wolf. Once or twice I feared it was coming back because a long stringy piece of gristle wants to straddle the epiglottis or whatever, but no, it's just because I'm being a pig - er, wolf.

My older sister has full-blown symptoms, I think she'd panic attack even from gristle.

1
072fd69647b0e765bb4b11532569f16d

(3717)

on August 26, 2011
at 05:48 PM

I've never had a hiatal hernia, but I used to take a daily Prilosec, Tagamet before meals and Tums "as needed" after meals (all the time). My gut was a mess and reflux raging despite all of these. About 2 years ago, I started transitioning to the Paleo diet. I don't eat perfectly "clean" now, but I am pretty close. My only regular "cheat" would be one nightly light beer. Sometimes, I will have some ice cream.

What sticks out during my transition to Paleo was the effect grains had and have on my reflux. I kicked the pills and grains about the same time two years ago and have not taken Prilo, Tagamet or Tums since then. On occasion, I will say "what the hell" and eat some bread or other grain (e.g. hamburger actually on the bun). Boom. Reflux.

My advice is to get clean on your diet, and in your circumstances, "clean" means strict, at least until things heal. Drop the drugs asap and don't look back. It might lead to a week of discomfort, but you will be far better off in the long run. Best wishes.

1
Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on August 25, 2011
at 08:05 PM

My 80 year old dad had a hiatal hernia and took prilosec everyday. He went primal and tried to get off the meds and was miserable. We tried enzymes, probiotics, did not help. I can't find the link right now, but it is somewhere on this site, possibly under "gerd". It was a link to some research done in Brazil with melatonin and some other supplements. The melatonin dosage was 6mg every evening. Bottom line was this helped my dad tremendously. He only takes prilosec occasionally now.

4781cf8ae1bfcb558dfb056af17bea94

(4359)

on August 25, 2011
at 08:32 PM

That Brazilian cocktail which contains the melatonin also contains a high dose of folic acid, which can cause cancer.

Bad3a78e228c67a7513c28f17c36b3cf

(1387)

on August 27, 2011
at 12:25 PM

Possibly. The b vitamins were just add ins. The Melatonin was supposed to be the main agent.

9cc813605b497e1a91dd2d85f97a6b9c

(40)

on November 04, 2011
at 04:35 PM

Kate that's great news about your father, did he lose surplus weight whilst changing dietary habits? This may help to alleviate pressure on the LES as well, once I can taper off the anti-depressants I will give the Melatonin a go, I did read somewhere that one man did experience auto immune problems after a year of Melatonin supplementation - something t possibly look out for. Also I think Folic acid could be substituted for Folate or a more benign version of Folic Acid?

0
D3326d4e4fa1c91e269ffefe66675c87

on May 24, 2014
at 11:46 PM

I've been curious of this as well. Now in my late 20s, I've been taking some form of acid meds for twenty years now due to a hiatal hernia. If I miss my meds, or something I eat decides to fight back, I basically have to curl into a ball and wait for the burning and pain to pass—sometimes a day or two before I'm pain free. I've been unable to find much info about hiatal hernia treatment as it correlates with Paleo, and sadly, most GI docs just keep pushing medicine or surgery.

I look forward to hearing more about others' experiences with this. Best wishes, everyone!

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