Reflux, Silent Reflux & Hiatal Hernia: When Less Is More in Hypopressives
Hypopressives are designed to reduce intra-abdominal pressure — but if you've felt a wave of reflux, heartburn, or a tightening in your throat after a session, you're not alone. It can be surprising when a pressure-reducing technique seems to cause digestive pressure.
But this doesn’t mean the practice is wrong for you. It simply means your system is sending feedback, and when we respond with curiosity (not criticism), we unlock new layers of healing.
What Are Reflux, Silent Reflux & Hiatal Hernia?
Gastroesophageal Reflux Disease (GERD): Stomach acid moves back up into the oesophagus, causing burning, bloating, belching, or discomfort after meals.
Silent reflux (LPR): A “silent” form of reflux that affects the throat and voice box without heartburn. Symptoms include hoarseness, chronic cough, or the sensation of a lump in the throat.
Hiatal hernia: When part of the stomach pushes through the diaphragm at the hiatus, weakening the pressure barrier that usually prevents reflux.
Hiatal hernias can go undiagnosed, yet still contribute to symptoms — especially during breathwork, exertion, or if the diaphragm is tight.
When Hypopressives Feel Like They’re Making Things Worse
Hypopressives aim to reduce pressure and stimulate reflexive core and pelvic floor activation. But if performed without adequate breath awareness, softness, or fascial release, they can unintentionally increase intra-abdominal pressure — especially in the early stages.
Here’s why that might happen:
🔍 Why Hypopressives Might Cause Acid Reflux
Improper Apnoea or Pressure Management
If you hold your breath forcefully or "suck in" too much during the vacuum:The diaphragm may not fully relax on the exhale, and the apnoea creates a pressured environment instead of a release.
This can push stomach contents upward, especially if the lower oesophageal sphincter (LES) is already compromised.
Hiatal Hernia (Diagnosed or Undiagnosed)
The lifting and vacuuming effect of Hypopressives:Can tug at the diaphragm and stomach, especially if the hiatus is already sensitive.
May reveal symptoms of a previously unnoticed hernia.
Overuse of Upper Abdominals
Especially common in beginners:Instead of creating a true vacuum, there’s gripping or subtle bearing down.
This creates a pressurised canister, pushing everything upward.
Postural Compression
Certain postures (like deep forward leans in Gaya or poorly stacked standing poses):Compress the thoracic cavity, increasing tension around the diaphragm.
May impair vagal tone and digestion.
Timing of Practice
Practising too soon after meals:Interferes with active digestion
Increases the risk of reflux or bloating
A Real-World Example
Let’s say you try Hypopressives an hour after lunch, in a seated fold, after a stressful day. You grip your upper abs (thinking it’s part of the technique), skip the softening breath, and launch straight into apnoea.
It feels intense, but after the session, you get that burning sensation — or an upward push in your chest.
This doesn’t mean the technique is wrong — just that your timing, tension levels, and breath mechanics need adjusting.
🔧 How to Reduce Reflux Risk with Hypopressives
✅ Ensure true 360° rib expansion during the inhale and a soft, complete exhale before the apnoea
⏰ Wait at least 90–120 minutes after eating before practising
🧘♀️ Start with gentler poses like supine Demeter or semi-supine Demeter or Selene, avoiding compressive positions at first
🚫 Watch for overactivation of rectus abdominis — the goal is decompression, not gripping
👃 Cue gentle rib lift, not aggressive pulling or bearing down
📋 If reflux is persistent or worsens, consider screening for a hiatal hernia, or working with a trained practitioner
How Hypopressives Can Still Help
Let’s not forget: Hypopressives can improve reflux and support hernia healing when approached with care.
They train the diaphragm to move well again — improving its relationship with the oesophagus
They support fascial hydration and elasticity, especially around the phrenoesophageal ligament
They can enhance vagal tone, calming the nervous system and supporting digestion
They restore pressure balance — when performed with softness, release, and alignment
What the Research Says
🔬 Diaphragmatic breathing & GERD:
A Mayo Clinic study showed that diaphragmatic breathing improved LES tone and reduced post-meal reflux by 80% in participants with GERD. (PubMed)
🔬 Fascial Release Reduces Reflux Symptoms:
In a 2019 RCT, patients receiving myofascial diaphragm release had significant reductions in reflux symptoms, better sleep, and reduced reliance on PPIs. (PubMed)
🔬 Hiatal Hernia Mechanics:
Research confirms that weakened diaphragmatic tone and fascial integrity are linked to the development of hiatal hernias — and that strengthening the diaphragm via breath-based methods may support recovery. (Nature)
Gentle Is Powerful: A Plan for Progress
StepWhat to Do
1Start with apnoea at 50% effort, building gradually over 4–6 weeks
2Use gentle poses — supine or semi-supine — that don’t compress the torso
3Wait 1.5–2 hours after meals before practising Hypopressives
4Use myofascial release techniques before and after sessions
5Watch for subtle signs of gripping or bearing down — and cue release instead
6If symptoms persist, explore gentle diaphragm breathing and vagus nerve support (e.g. humming, gargling, soft singing)
7Work with a practitioner to assess for hernia, breath patterning, or fascial restrictions
Final Thoughts
Your body is wise. Reflux, discomfort, or hesitation during Hypopressives isn’t a sign to give up — it’s a reminder to slow down and tune in.
We don’t always need to push harder to heal faster. In fact, with breath, fascia, and pelvic health, less is often more. The beauty of Hypopressives lies in their ability to support and regulate — when we meet them with presence instead of performance.
🌿 Ready to Reclaim Gentle Strength?
Download my free mini-guide:
“Foundations of Gentle Hypopressives & Diaphragm Support”
→ Learn how to safely start, release fascial tension, and support digestion.
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