Hiatus hernia living in pregnancy

Overview

A hiatus hernia is when part of your stomach pushes up through your diaphragm (the muscle that separates your chest from your belly) into your chest. During pregnancy, this can happen or get worse because the growing baby puts extra pressure on your stomach.

Yes, hiatus hernia is fairly common, especially in later pregnancy when the uterus is largest.

It affects pregnant women, particularly those in the second or third trimester. Women who are overweight, older, or have had multiple pregnancies may be at higher risk.

Symptoms

Common symptoms

• Heartburn – a burning feeling in the chest or throat after eating.
• Acid reflux – stomach acid coming back up into the throat, causing a sour taste.
• Burping or feeling bloated after meals.
• Chest discomfort that is not severe.

Symptoms in children

• Hiatus hernia in pregnancy is not a condition that affects children. This article is about pregnant women.

Symptoms in older adults

• Older women who are pregnant may experience similar symptoms, but age itself does not change the condition. The main cause is the growing uterus.

Causes

Main causes

• The growing uterus pushes against the stomach, increasing pressure in the belly and forcing part of the stomach up.
• Pregnancy hormones relax the muscles in the body, including the diaphragm, making it easier for the stomach to move.

Risk factors

• Being overweight or obese before pregnancy.
• Having had a previous pregnancy.
• Age over 35.
• Having a large baby or multiples (twins, triplets).

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number right away.
• If you have severe chest pain or difficulty breathing.

Book a routine appointment if:

• If heartburn or reflux is bothering you regularly, talk to your midwife or GP.
• If you are worried about your symptoms or they affect your sleep.

Diagnosis

Doctors usually diagnose hiatus hernia based on your symptoms and medical history. They may also do a test called an endoscopy after pregnancy if needed.

Tests that may be done

• An endoscopy: a thin, flexible tube with a camera is passed through your mouth into your stomach to look for a hernia.

What to expect at your appointment

During pregnancy, doctors often avoid invasive tests unless symptoms are severe. They will listen to your symptoms and may recommend lifestyle changes first. If an endoscopy is needed, it will usually be after your baby is born.

Treatment

Treatment for hiatus hernia during pregnancy focuses on managing symptoms because the hernia often gets better after delivery. You can try simple lifestyle changes first. If needed, your doctor may recommend medicines to reduce stomach acid.

Self-care at home

• Eat smaller, more frequent meals instead of large ones.
• Avoid lying down right after eating – wait at least 2 to 3 hours.
• Elevate the head of your bed by about 15 to 20 cm using pillows or blocks.
• Avoid foods that trigger heartburn, like spicy, fatty, or acidic foods.
• Wear loose, comfortable clothing that does not press on your belly.

Medical treatments

Your doctor may suggest antacids or other medicines that neutralise stomach acid. These are generally considered safe in pregnancy. Do not take any medicines without checking with your doctor or pharmacist first.

When is surgery considered?

Surgery for hiatus hernia is rarely needed during pregnancy. It is only considered if there are serious complications, such as a strangulated hernia (when blood supply is cut off). In most cases, surgery is postponed until after the baby is born.

Living with this condition

Living with hiatus hernia during pregnancy means managing heartburn and reflux day by day. Most women find their symptoms improve with simple changes and feel better after their baby is born.

Lifestyle tips

• Eat slowly and chew food well.
• Avoid bending over or straining when lifting.
• Stay upright after meals – sit or walk gently.
• Get enough rest, but avoid lying flat on your back.

Diet and exercise

Eat a balanced diet with plenty of fruits, vegetables, and whole grains. Avoid trigger foods like citrus, chocolate, garlic, and onions. Gentle exercise like walking can help digestion and reduce pressure on the stomach. Avoid vigorous exercise that involves bending or jumping.

Mental health and emotional wellbeing

Dealing with ongoing heartburn can be frustrating and affect your sleep, which may add to pregnancy stress. It is normal to feel worried. Talk to your partner, midwife, or doctor about how you are feeling. They can support you.

Prevention

You cannot always prevent a hiatus hernia during pregnancy because it is partly due to hormone changes and the growing baby. But you can reduce your risk by maintaining a healthy weight before pregnancy and eating well.

Vaccines

No vaccines are related to hiatus hernia.

Screening programmes

There is no routine screening for hiatus hernia. It is usually diagnosed when symptoms occur.

Complications

If left untreated

• Chronic heartburn and acid reflux that may damage the lining of the food pipe (esophagus).
• Inflammation of the esophagus (esophagitis).
• Rarely, a strangulated hernia where part of the stomach gets trapped and blood flow is cut off – this is a medical emergency.

Long-term outlook

The outlook is very good. Most women find that symptoms of hiatus hernia go away or get much better after giving birth. With simple lifestyle changes and safe treatments during pregnancy, you can manage the condition well and have a healthy pregnancy.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.