Diet in the hernia of the esophagus

The role of nutrition in human life is difficult to overestimate. Useful foods give us strength and energy, and poor-quality food and various eating disorders cause a number of diseases, among which the pathology of the digestive system is at the forefront. It is not surprising that the treatment of such diseases implies correction of the diet and diet, which makes it possible to optimize the work of the digestive tract. So the diet with a hernia of the esophagus is aimed at relieving the stomach and intestines, normalizing the acidity of the gastric juice, reducing the intensity of the gassing process and intra-abdominal pressure, and minimizing the frequency of reflux episodes.

Is all this possible with the help of a single correction of nutrition? Everything depends on the stage of the disease. Initially, the disease is the main method of treatment, and then acts as an auxiliary, helping to reduce the dosage of the drugs taken and the frequency with which they are taken.

[1], [2], [3], [4]

Indications

Hernia of the esophagus is a disease of the digestive system, in which some organs located in the abdominal part penetrate the thoracic through the diaphragmatic opening. This may be the lower end of the esophagus, and with it the stomach, or only one stomach (sometimes with intestinal loops), while the esophagus remains in place. In the first case, we speak of an axial (sliding hernia), which, depending on the position of the body, can change its localization, in the second case it is about the parasophageal (fixed).

Diet in hernia of the esophagus is appointed regardless of the type and characteristics of the hernial sac, its location and the available symptoms, because in any case, there is a digestive disorder. While the hernia is small, it does not cause a person inconvenience, but once launched pathological process, characterized by the weakening of the diaphragmatic opening, will progress further, causing disruptions in the functioning of the digestive system. Especially when it comes to old age (according to statistics, most patients with a hernia of the esophagus have crossed a fifty-year boundary) or serious metabolic disorders that have affected the trophism of the tissues of the diaphragm and ligaments.

With a sliding hernia, the most painful symptom is the reflux of food from the stomach into the esophagus, which is associated with pain and burning in the epigastrium and along the esophageal tube. Displacement and compression of the stomach in the esophageal aperture of the diaphragm adversely affects its work, causing inadequate contractions (in the opposite direction) and slow progress of the food lump along the digestive tract. Stagnant phenomena in turn provoke a shift in the acid-base balance of the stomach towards acidification and the development of dyspeptic phenomena such as heartburn, bloating, bloating.

With paraphasegal and hernia and mixed its type, stagnant phenomena are provoked by an incorrect location of the stomach, which turns out to be turned upside down to a greater or lesser degree. In addition to pain in the abdomen and chest, patients also have symptoms of dysphagia (violation of the ingestion of food), stagnation in the stomach and intestines. Excruciating reflux and heartburn in these patients occur less often, but the risk of various complications in the form of peptic ulcer, perforation of the esophagus and hemorrhages, infringement of the hernia, life-threatening patient, is much higher than with a sliding hernia.

Bloating caused by increased gas production and difficulty, irregular bowel evacuation becomes a risk factor for increasing intra-abdominal pressure, which in patients with hernia of any kind is consistently higher than in healthy people. If nothing is done, under pressure, the stomach will push ever further into the thoracic cavity, the hernial sac will grow and interfere with other organs that are located in the chest cavity.

How does the sliding and paraeophagous hernia affect the heart? The heart is the organ located at the overwhelming majority of people in the thorax to the left. Immediately below it is the stomach. The organs are separated by a diaphragm plate and do not interfere with each other in the normal state. But if you just overload the stomach and begin to feel some heaviness under your heart, it becomes difficult to breathe, there are weak symptoms of hypoxia. And the reason for this is the pressure of the stomach on the diaphragm, which in turn squeezes a little and displaces the heart, making it difficult to work.

It is easy to imagine what will happen if the stomach is stably raised or even released into the chest cavity, where there is no place for it. It will press on the heart, and the larger the size of the hernia, the more influence it will have on the human motor. It is not surprising that a frequent reason for the appointment of surgery for a hernia of the esophagus is a violation of the heart (shortness of breath, heartbeat and pressure failures).

In this case, it is not about those chest pains in the hernia of the esophagus, which are so similar to the symptoms of angina pectoris, but about serious violations of cardiac activity, which in time can lead to the development of organ failure.

Diet in the hernia of the esophagus is primarily an opportunity to stop the progress of the disease, so it is prescribed even with hernia 1 degree, when symptoms of the pathology of the gastrointestinal tract is not yet. In the initial stage of the pathology, nutrition correction is the main and often the only method of its treatment.

At 2 and 3 degrees of hernia of the esophagus diet food is prescribed in conjunction with drug therapy, exercise therapy, physical therapy. It helps to more effective treatment of the disease, restoring the normal natural process of digestion.

In severe cases of axial hernia and in the case of its parasophagial variety, it is often resorted to prompt intervention. The diet in this case is prescribed both at the stage of preparation for the operation and during the rehabilitation period, which helps a quick recovery of the body and optimizes the work of the digestive tract, reducing the risk of postoperative complications.

General information of the diets with hernia of the esophagus

Hernia of the esophagus is considered a progressive disease, which can be completely handled only by surgical intervention, which, however, also does not exclude relapses of the disease. In the treatment of hernia of the esophageal opening of the diaphragm, doctors use various methods of treatment: medicamentous and manual therapy, physical exertion, exercise therapy, surgical treatment, the use of alternative methods of combating pain and heartburn, which must necessarily be combined with diet.

Thus, a diet with a hernia of the esophagus is a key point that ensures the effectiveness of other therapeutic methods. For patients, dietary nutrition is indicated not only at the stage of acute symptoms withdrawal. It should become part of the changed lifestyle of the patient, which will help to prevent the exacerbation of pathology and live a normal, full life.

In theory, a diet with a hernia of the esophageal aperture of the diaphragm is not something excruciatingly heavy, because it does not imply strict limitations and half-starvation. Principles of a diet with a hernia of the esophagus are built on the requirements of a healthy, balanced diet.

When drawing up a diet, you need to consider some important points:

• The basis of the diet is a fractional diet, shown for any diseases of the digestive tract, as it reduces the burden on the organs and facilitates an easier and faster process of digesting food. The multiplicity of food intake in this case increases to 5-6 times a day (it is a question of the basic receptions and does not include snacks that are not forbidden).
• An increase in the number of meals with preserved or reduced caloric content and the total volume of products implies a decrease in the single portion. The size of the portion should be such that the saturation comes after 15-20 minutes after eating, and not while sitting at the table, which indicates overeating.
• The last meal should take place no later than 3 hours before going to bed.
• After eating, in no case should you take a horizontal position, especially with a sliding hernia of the esophagus, because this leads to a shift in the digestive system and disrupt the process of digesting food.
• Food should be as gentle as possible for the stomach and intestines, i.e. It is necessary to exclude heavy fried and smoked dishes, to limit the use of salt, causing an increase in body weight, to remove from the diet acute seasonings, sauces - foods that irritate the gastrointestinal mucosa.
• It is necessary to exclude from the diet all foods, sweat increase gas formation in the stomach and intestines and cause an increase in intra-abdominal pressure.
• Particular attention should be paid to the drinking regime. Limiting the use of fluid slows down metabolic processes in the body and is a risk factor for the development of constipation. Constipation is also dangerous both in connection with the increase in the size of the intestine, and in connection with straining during defecation. Both points provoke an increase in intra-abdominal pressure.
• When choosing products you need to focus on their nutritional value and chemical composition. The patient's body must receive in sufficient quantity the vitamins, minerals, amino acids, etc. Necessary for the normal functioning of various organs. Food should bring not only satiety, but also maximum health benefits.
• Before each main meal, half an hour before meals, it's a good idea to drink a glass of clean water that will purify the stomach of excess acid and mucus and start the digestion process.

Regardless of the type of hernia and accompanying pathologies, the patient's food should undergo sufficient heat treatment. Raw food in this case is a risk factor for exacerbation of the hernia of the esophagus, because raw vegetables and fruits are more easily digested in the digestive tract and can cause fermentation processes in it.

Features of the diet with concomitant diseases

Hernia of the esophagus is a pathology that rarely arises from scratch. Usually, the disease develops against the background of already existing disorders in the functioning of the digestive system. Therefore, it is often diagnosed quite accidentally during examinations about other gastrointestinal diseases.

The hernia of the esophagus quite often becomes a companion of gastrointestinal diseases such as gastritis, stomach ulcer, reflux disease, pancreatitis, cholecystitis, atony and inflammation of the intestinal walls, which are inflammatory and characterized by stagnation in the digestive system. Frequent symptoms of such pathology are heartburn, dyspepsia and constipation, which increase pressure in the abdominal cavity and push the stomach and esophagus up.

In addition, with various disruptions in the work of the gastrointestinal tract, absorption of nutrients deteriorates, which causes disturbances in metabolic processes in the body, which adversely affect the state of various tissues of the body, including muscles and ligaments of the diaphragm.

Diet in the hernia of the esophagus, which develops against the background of other diseases, is at the same time a method of their treatment. But it has its own characteristics. Diet with gastritis and hernia of the esophagus implies the most sparing diet. The patient is allowed a thermally processed food, which is recommended to thoroughly grind (grind or chew well). Food should in no case irritate the stomach and esophagus mucosa, be too acidic, salty or spicy, hot or cold.

Dishes should be consumed mainly in a warm form, in small portions up to 6 times a day, in the early period, preferring liquid and semi-liquid foods.

It is especially important to adhere to a diet with a hernia of the esophagus with high acidity of the gastric juice. It is with her that I connect the appearance of heartburn in patients. Especially dangerous is the high acidity of the stomach in combination with reflux disease, i.e. Throwing food back into the esophagus.

The higher the acidity of the gastric juice, the more irritating effect the food will have on the walls of the stomach and esophagus. The latter are even more sensitive to acid, because they do not have a sufficient protective layer and are not designed for such aggressive effects, so the hernia of the esophagus is very quickly complicated by reflux-ephofagitis (inflammation of the esophagus).

Diet with hernia of esophagus and esophagitis is even more severe, because it must simultaneously regulate the acidity of the stomach and reduce the frequency of reflux. In cicatricial changes and narrowing of the esophagus caused by long-term inflammation of the walls of the body and their weakening, preference is given to semi-liquid and liquid, well-ground food.

With increased acidity of gastric juice in the diet of the patient must necessarily be present dishes with enveloping action that will protect the walls of the stomach and esophagus from irritation with aggressive substances in food and gastric juice and thereby reduce the severity of the inflammatory process.

It is necessary to exclude both mechanical or chemical, and thermal damage to the esophagus during meals. Ideal is a warm food with a low content of salt, sugar, acid. In esophageal and gastrointestinal bleeding, foods that increase hemoglobin and prevent the development of iron deficiency anemia should be included in the patient's diet.

[5], [6], [7], [8], [9], [10]

Benefits

Axial hernia of the esophagus due to regular displacement of the stomach in the diaphragmatic opening is characterized by frequent episodes of reflux, especially in stages 2 and 3. Regular feeding of food with aggressive digestive enzymes from the stomach to the esophagus causes irritation and chronic inflammation (reflux-esophagitis), resulting in the formation of fibrous tissue, shortening and diminishing the lumen of the esophageal tube. Such complications, accompanied by pain, heartburn, belching, hiccups and difficulty swallowing, significantly worsen the quality of life of patients and can lead to exhaustion of the body.

Paraphaseogal hernia of the esophagus, although less likely to develop reflux, as well as accompanying painful and rather long heartburn episodes, stagnation in the gastrointestinal tract can provoke such an outcome. In addition, they are the cause of increased pressure in the peritoneum, which in this case can cause a hernia entrapment, accompanied by severe pain and dangerous for human life, if it does not provide qualified assistance in time.

As we see, in the absence of effective treatment, both the axial hernia and the paraeophagous present a certain danger to the life and health of the patient. And since it is a question of the digestive system, the treatment of which without dietary nutrition is impossible, the use of a diet with a hernia of the esophagus becomes indisputable.

Correction of the diet and diet regimen can reduce the workload on the digestive organs, facilitate their work, which will prevent stagnant phenomena and improve metabolism. Stabilization of metabolic processes, along with the use of products that have a rich composition of vitamins and minerals, will help improve the nutrition of diaphragm tissues, which in turn will have a positive effect on the characteristics of muscle and connective tissue (their strength and elasticity, resistance to stretching).

Removing from the diet products that cause excessive gas formation, will help reduce the likelihood of increased intra-abdominal pressure caused by food intake. The increased pressure in the abdominal cavity is the main factor that ensures the progress of the hernia of the esophagus.

The same goals are pursued by dividing the daily ration into small portions with a higher frequency of eating than usual. And limiting the reception of dishes that stimulate increased production of gastric enzymes and increase the acidity of gastric juice, will reduce its irritating effect on the walls of the esophagus during reflux.

If you correctly coordinate the diet and diet of the patient, the frequency of unpleasant symptoms of the disease will be significantly reduced, which means that the amount and dosage of drugs taken in connection with the disease can be reduced. Normalization of metabolism and regular exercise therapy will help strengthen the diaphragm and stop the development of the disease, which is the goal of treatment procedures.

What can and what can not?

You can talk for a long time about the benefits of proper nutrition with a hernia of the esophageal opening of the diaphragm, but for a person who is not initiated into his basics, this will not give anything. After all, the basis of the patient's diet is the allowed products, cooked in the appropriate way: cooking, baking, quenching. But what products can be considered allowed, and which ones should be excluded from their diet?

Permitted in any diet are those foods and dishes that are able to improve the condition of the patient or at least not harm his health. Consider that in this regard, you can eat with a sliding hernia of the esophagus, in the treatment of which diet plays a decisive role?

The products useful for hiatal hernia are:

• Bananas, which can be eaten raw and preferably before taking other food, because these fruits are able to protect the inner shell of the stomach and esophagus due to the high content of mucous substances.
• Apples used in food in baked and wiped form (with increased acidity of the stomach, you should avoid the use of too acidic or excessively sweet varieties, which equally contribute to the production of hydrochloric acid). Before eating, apples should be cleaned from hard peel.
• Soft varieties of pears and peaches.
• Any type of cereal cooked on the water with a slight addition of salt (skim milk is allowed), except for those that contain coarse fiber, which can mechanically damage the esophagus and stomach. Preference is given to oatmeal, buckwheat, barley and millet cereal, which must be carefully boiled. True millet is not recommended for gastritis with high acidity, so it is useful for a limited range of patients.
• Vegetable soups, which, when exacerbating the hernia, are recommended to be wiped through a sieve, which will facilitate their assimilation, prevent injuries of inflamed tissues with slices of vegetables, and facilitate an easier process of digesting food.
• Boiled, stewed or baked vegetables, except cabbage, which increases the acidity of the stomach in any form and can cause increased gas production. Especially useful are carrots, boiled beets, potatoes. It is useful to say puree from vegetables, which can be slightly flavored with sour cream or cream.
• Low-fat varieties of meat and fish, which can be boiled, baked, stewed and even cooked on the grill, but a hard crust in this case will need to be removed.
• Light meat and vegetable broths are especially useful in the postoperative period and with stenosis of the esophagus.
• Dairy and sour-milk products of low fat content (the possibilities of their use are strictly individual and depend on the acidity of the gastric juice, the reaction of the organism, the age of the patient). With normal acidity of the stomach, kefir, yogurt, ryazhenka, cottage cheese, yogurts without artificial additives will be useful, but with increased - their use will have to be minimized.
• Vegetable oil.
• Boiled eggs (especially protein) and a steam omelet.
• Vegetable oils, which can be added to salads and eat little by little in a pure form for more comfortable bowel emptying.
• Baking based on rice flour, biscuit biscuits soaked in water or milk during acute periods of illness with reflux-esophagitis.
• Among the drinks, preference should be given to green tea, purified water, sweet freshly prepared juices, which are recommended to be diluted, herbal decoctions and infusions. With increased acidity of the stomach it is useful to regularly use alkaline mineral water without gas. If milk does not cause bloating and diarrhea, it can also be included in the diet.
• Sweets with a hernia of the esophagus are not prohibited, but this applies only to certain types of favorite dessert. Patients are allowed to use marshmallows, jelly, gelatin-based products, pastilles.

And now let's talk about what you can not eat with a hernia of the esophagus. Prohibited products and dishes include:

• All kinds of citrus, as well as the dishes, the components of which they are.
• Fatty grades of meat and fish in any form.
• Fried vegetables and meat products, as well as the dishes in which they are added.
• Vegetables cabbage, radish, radish, red salad and hot pepper, onions and garlic. The latter in a thermally processed form can be added to the dishes in a minimal amount to improve the flavor of the food. With a high acidity of the stomach, care should be taken with tomatoes, adding them to the dishes in small quantities or completely refusing to use them. But green and yellow salad pepper does not fall into the category of banned, although in fresh form from the best not to use.
• Any sharp spices and condiments, mayonnaise, ketchup, which stimulate the production of hydrochloric acid and themselves are able to irritate the inflamed walls of the esophagus and stomach.
• Pickles and marinades.
• Mushrooms in any form.
• Fatty milk and sour-milk products, including butter.
• Fresh pastry made of white flour. Especially dangerous is the yeast dough, provoking the processes of fermentation in the intestine, as well as sweet pastries on margarine or butter, which is difficult to digest in the digestive tract.
• Any too hard, hot or cold food, ice cream, which you can eat in minimum quantities after melting.
• Grapes that cause fermentation processes.
• Beans (beans, lentils, beans, peas) and corn. Only green beans and a little green peas are allowed. But you should not abuse such products.
• Any types of smoked products.
• Chocolate and any dishes with the addition of cocoa.
• Not soaked biscuits.
• Seeds, nuts, bran and any other food that contains coarse fiber.
• Among the drinks, sweet and unsweetened soda, kvass, pickles, coffee, cocoa, strong tea, any kinds of alcohol fall under the ban.

Diet in the hernia of the esophagus provides an impressive list of both allowed and prohibited foods and dishes. But if you look closely, you can see that it is hard to call it hard. As such, there are not so many absolute restrictions in food. Fatty meat can be replaced with lean meat, vegetable oil, sour cream yogurt, etc.

The same goes for cooking. It is necessary for the time of treatment, and better forever, to forget about fried dishes of meat, fish and vegetables, change preferences in choosing baking in favor of bezdozhzhevyh types of bread, give preference to natural sweets in small quantities for dessert.

Some products can be called controversial with this diet. Such a product is, for example, a cucumber, which is not recommended for patients with high acidity of gastric juice in connection with the claim that for its digestion the stomach produces a large amount of hydrochloric acid. Another theory claims that the cucumber has an alkalinizing ability and, conversely, can reduce the inflammation of the stomach tissues, and its soft fiber can not harm the inflamed organs.

With a hernia of the esophagus, the cucumber is not included in the list of prohibited foods. It can be included in the salads or used for making sandwiches, pre-cleaning from coarse skins. Just with acid reflux, you need to be more careful with such dishes, and if possible do without cucumbers or limit their number as much as possible, reacting sensitively to the reactions of your body.

You should not eat freshly baked bread, get involved in a chewing gum that promotes throwing air into the digestive system, drink carbonated and alcoholic beverages, including beer and "low alcohol", take food in a hurry. The latter is very important for reflux disease and inflammation of the esophagus, because poorly chewed pieces of food can injure inflamed organ tissues and cause pain. In addition, they inhibit the process of digestion of food, which is undesirable in the hernia of the esophagus.

Drinking beverages for this disease is recommended between meals. Swallowing the dishes leads to overstretching of the stomach. During the main meal, you can drink no more than half a cup of any drink or water, but you need to do this after eating. During snacks you can drink a glass of liquid. The amount of water and drinks between meals is unlimited.

Drinking beverages through a straw with a hernia of the esophagus is undesirable, because in this case, again, there is an ingestion of air, which will later result in the eruption.

Contraindications

Diet with a hernia of the esophagus is not just a way to get rid of the unpleasant symptoms of the disease. This is a full-fledged treatment and prophylactic measure that helps restore the normal position of the digestive system by normalizing intra-abdominal pressure and prevent recurrence of the hernia.

A low-calorie diet with a hernia has practically no contraindications, because it includes products that allow maintaining a normal balance of fats, proteins and carbohydrates. Fractional nutrition is perceived by the body very well, because in this case the digestive process proceeds easily and without hiccups, while rare meals can provoke stagnant phenomena and constipation.

Patients can consume almost all vegetables and non-acid fruits (with rare exceptions), so they do not have to worry about the lack of vitamins and trace elements. True, most products are recommended to be heat treated, which destroys some vitamins. But the problem is helped to solve bananas, peaches and soft varieties of apples, which can be included in the menu even in fresh form.

Risks associated with diet, mainly reduce to a decrease in the patient's body weight, after all, the diet is low-calorie. But under the impact fall mostly extra pounds. Until the depletion of such food does not allow to reach, because the permitted dishes and foods contain almost all components that have high nutritional value and are necessary for the normal existence of the organism.

The situation with curative fasting is somewhat different. If the usual low-calorie diet and fractional meals are suitable for almost all patients, the refusal to eat even for one day can not always be. Even on the first day after the operation, patients with a hernia of the esophagus are prescribed a meal, although this is only about liquid foods. For those who do not see the need for surgery yet, it is possible to adhere to a medical starvation if it allows concomitant diseases. Otherwise, complications can not be avoided.

The duration of such fasting, which certainly would help reduce the inflammation of the walls of the esophagus, because the main irritant factor is food entering the esophagus from the outside or as a result of reflux from the stomach. In the absence of food, the problem is solved by itself. If there are no irritating factors, the processes of tissue regeneration are much more active and effective.

But, for example, with acute gastritis, when it is possible to prescribe a therapeutic starvation, the patient can not give up food for more than a day. Further starvation can lead to the fact that the inflammation will increase, a hungry person at the sight of food will make out gastric juice and eat away mucous. Especially dangerous is with gastritis with high acidity of gastric juice.

Among the possible complications of a diet with a hernia of the esophagus with a relatively low fiber content, which stimulates the processing of the food lump in the intestine and its outlet outward, are constipation. But they suffer mainly those who neglect the requirements of moderate physical activity. A good prevention of constipation is jogging, which is not prohibited with a hernia of the esophagus. 10-15 minutes of evening jogging and a sufficient amount of water drunk during the day provides a comfortable emptying of the intestines in the morning.

Diet in the hernia of the esophagus provides for the restriction of sugar, but does not provide for a complete refusal to consume carbohydrates, which are sources of energy, so patients rarely complain of weakness and fatigue due to a change in diet and diet (except in the early days). But the decrease in salt intake will only benefit the hand, especially those who have problems with the heart and kidneys, which is expressed by edematic syndrome and increased pressure. It is only necessary to reduce the amount of salt consumed and we can expect stabilization of arterial and renal pressure, reduction of edematous syndrome, improvement of the general condition of patients.

Diet in the hernia of the esophagus is considered curative. Fractional meals in small portions, low caloric content of dishes and ease of their assimilation in this case are considered a plus, because this facilitates the work of the digestive system, digestion is normal, the frequency of reflux decreases and the inflammatory process in the esophagus decreases. In addition, symptoms that promote increased intra-abdominal pressure and expulsion of the esophagus and stomach to the other side of the diaphragm go away.

But it is necessary to take into account the fact that low caloric content does not contribute to energy support of the body. With bed rest, this diet is ideal. With moderate physical activity is quite acceptable, although patients can complain about a small weakness and rapid fatigue. But for people engaged in heavy physical labor, it will be a half-starved existence leading to fainting. Although, if you think about it, people with a hernia of the esophagus are not able to do heavy physical work, and those who are worried about their health, first of all, will take care of changing their activities.

[11], [12], [13], [14]

Eating after operation of hiatal hernia

One of the effective methods of treatment of hernia of the esophagus, undertaken in severe cases of pathology or in the event of dangerous complications, is considered a surgical operation. In most cases, it involves laparoscopic intervention and does not require large incisions in the peritoneum. The case is limited to five small punctures, so the patient's recovery usually goes quickly and without complications, despite the fact that he can leave the hospital for the second day.

Despite the low traumatism of the operation, some restrictions on nutrition after it still exist. For example, on the first day after an operative intervention on the hernia of the esophagus, pure water without gas is preferred, which can be drunk no more than 300 g.

The following day, the patient's diet can be slightly varied, including fruit and berry juices and compotes (not acidic, citrus juices under prohibition), loose broths from chicken or beef, vegetable broths (we do not use cabbage), weak black, green and herbal teas . Dishes should be liquid without the inclusion of solid lumps. It is also allowed to eat a little jelly.

Postoperative diet with hernia of the esophagus differs little from dietary nutrition after other abdominal operations. Preferred are easily assimilated dishes. On the third day in the diet of the patient may already be wiped semi-liquid soups. In the future, the food ration becomes more diverse: soups, purees and viscous porridges, dairy products (yogurt, ryazhenka, puddings, milk porridges and casseroles). If the body reacts negatively to milk, it can be replaced with soy products.

Food should be as close as possible to body temperature. After surgery, swelling of the operated organs and tissues in puncture sites is possible, and hot and cold food will be additional factors of their irritation, delaying the recovery process.

You should not rush with solid food, because the swelling of the esophagus after surgery causes a decrease in the lumen of the organ and the associated disturbances of swallowing (dysphagia). It is desirable to boil the porridges strongly, soups, boiled and baked vegetables at first grind, use meat only in the form of minced meat, puddings or mashed potatoes (for example, to use meat baby food), boiled eggs and omelette chew well.

A good help to the usual meat, vegetable and sweet dishes will be casseroles (without a hard top crust), puddings and mousses. When preparing sweet desserts, you can use milk, vanilla, fruit and berry fillers, but not coffee, cocoa, chocolate, coconut chips.

Multiplicity of meals after the operation at least 6 times a day. Portions should be small and leave behind a slight feeling of hunger, which runs after 20 minutes. On the second and subsequent days after the operation on the hernia of the esophagus, you can consume up to 2 liters of water per day, but you do not need it during meals.

It is very important not only what and when the patient eats, but also how he does it. You need to eat slowly, concentrating on the very process of digestion and chewing even small lumps in the dishes. It is very important to monitor your posture. The back with food should be straight, so that the digestive organs do not experience any pressure at this time and for at least half an hour after eating.

Yes, after eating, you should try to keep the vertical position for 30 or more minutes. It's not forbidden to sit, but it's better to move a little without much physical exertion, slopes, lifting weights, etc. The last meal should be no later than 3 hours before going to bed, and within 2 hours after meals to take a vertical position is not recommended.

Like fresh yeast bread, and biscuits are not considered the best choice after surgery on the hernia of the esophagus. It is best to eat a small amount of yesterday's bread or other pastries cooked without yeast. Crackers are prohibited because of the ability to mechanically damage the inflamed walls of the esophagus, but in the soaked form they can be consumed (for example, adding to the soups roasted in the oven or toaster small pieces of sliced bread).

Such a diet patients should adhere to for 6-8 months. Further, at will, you can gradually include in the diet the usual dishes and drinks, including soda, which until that time was taboo. But as practice shows, not all return to the old way of life. It is believed that the habit is formed in 21 days, it is clear that for a few months the patients are so used to the new diet and diet that they no longer have a passion for previously beloved heavy, fatty, fried dishes.

[15]

Fasting with a hernia of the esophagus

Diet with hernia of the esophagus is a full-fledged medical procedure that helps to avoid all unpleasant symptoms of the disease: heartburn, belching, pain in the thoracic and abdominal parts, dysphagia. In this case, all the nuances of dietary nutrition need to be discussed with the attending physician, which takes into account the type of pathology, the degree of its development, the characteristics of the patient's organism and the presence of concomitant diseases.

One of the variants of a diet for this pathology is therapeutic starvation, which has been used for gastrointestinal diseases for several years already and shows good results, allowing the organs of the digestive system to rest and recover. But fasting with a hernia of the esophagus does not have such a high value if the disease is not accompanied by abnormalities of the digestive tract. In addition, it can be practiced only with the permission or on the recommendation of the attending physician, because this method has many contraindications. In particular, it is not recommended for elderly patients and children.

The duration of curative fasting can be different. So for acute diseases of the esophagus, stomach and intestines are limited to daily restriction of food intake, which makes it possible to effectively stop the inflammatory process without causing serious harm to the gastrointestinal tract. After all, gastritis, stomach ulcer, colitis and other pathologies of the digestive system require regular food intake, and prolonged starvation can only harm, presenting a serious strain not only on the digestive tract, but also on the whole body weakened by the disease.

Unlike the balanced diet recommended for hernia of the esophagus on an almost permanent basis, fasting should not become a lifestyle. Its goal is to help the body to regain its strength, and not to bring it to full exhaustion.

[16], [17]

Reviews

Diet in the hernia of the esophagus is one of the methods of treating the disease. It is clear that patients will not feel special enthusiasm from her, especially in the first days and weeks, while the body will get used to the new diet and diet. But the situation changes as the person understands all the advantages of such changes and develops new eating habits.

Pain is a good stimulant to action. Usually a person is ready to do much to get rid of it. And the diet is not such a great sacrifice. Moreover, about 50% of patients experience pain in the hernia of the esophagus, and as the disease progresses, this percentage increases. The rest may complain of discomfort and a feeling of heaviness in the epigastrium, which is also not particularly pleasant and is an obstacle to getting pleasure from eating.

Many patients note that already in the first days of dietary nutrition they begin to feel light after eating. True, this is somewhat overshadowed by the constant sensation that there is not enough of a couple of spoons in a serving to eat well. But after 15-20 minutes the desired saturation comes and the negative dissipates.

The big plus of such a diet is the opportunity to gradually throw a few extra pounds. According to statistics, most people who have a hernia of the esophagus, and have excess weight. But in all diseases of the gastrointestinal tract, strict diets for weight loss are not available, so even if it is necessary to reduce body weight (and it is with a hernia of the esophagus!) In conditions of moderate physical activity, it is extremely difficult to achieve worthy results. A low-calorie diet with a hernia of the esophagus is great for weight correction.

There are, of course, a diet and a small minus - the inconvenience associated with eating at the workplace. Not every enterprise has dining rooms, where a dietary table is provided, so often special food has to be carried to work from home. In addition, the food should be warm, but it is not always possible to warm it up. And fractional food can cause ridicule among colleagues and discontent of leaders.

However, these difficulties can be understood or reconciled, if it comes to health. And many elderly patients, who often diagnose a hernia of the esophagus, are no longer tied to the workplace. When they receive a pension, they can afford to be treated at home, where cooking and eating are much more convenient.

The ratio of patients to a diet with a hernia of the esophageal opening of the diaphragm is in most cases positive, because almost everyone notes relief, just not everyone likes that it is necessary to give up previously loved foods, experience difficulties with eating during working hours, get used to the feeling of hunger after eating, arising during the first days of a diet.

Sometimes, patients break down, unable to deny themselves a fragrant slice of roasted meat or spicy seasoning, so appetizingly changes the taste of lean dishes. And then again they come across boring heartburn, belching, weight in the abdomen. This leads many to understand that when they are ill, a diet is the main condition for a comfortable diet and normal well-being. It is difficult to survive the first days of a diet, and then it becomes a part of the patient's life, which makes it possible to feel normal, to avoid recurrence of the disease and its progression, and reduces the need for surgery on the hernia of the esophagus.

It is most difficult to reconcile with the need to follow a diet to patients with 1 degree of hernia of the esophagus, who practically do not have unpleasant symptoms. And while a person does not have anything to hurt, it is difficult for him to accept the idea of the need to prevent pain. Refusing the diet, which during this period is the main method of treatment, a person eventually comes to the fact that the hernia continues to grow and cause the appearance of heartburn, belching, pain in the sternum and abdomen, etc. But now along with the diet will have to take a bunch of different medicines and attend physical therapy.

Doctors to the diet are only positive, understanding that without adjusting the diet and diet is simply impossible to effectively treat diseases of the digestive system. But to medical starvation the attitude of doctors is ambiguous. Few gastroenterologists practice such methods of treatment, although they do not reject the use of starvation for healthy people to cleanse and discharge the body.

A diet with a hernia of the esophagus is a way to relieve the patient's condition and slow down the development of the disease. The best results are given in combination with drug treatment and exercise therapy, because only changing the diet and diet can not restore the lost function of the muscles and ligaments of the diaphragmatic aperture. But on the other hand, without diet, the rest of the treatment procedures will yield weak results. And the sooner a person realizes the necessity and value of dietary nutrition, the more effective will be his treatment.