What is the connection between diastis recti, hiatal hernia, umbilical hernia and gerd? Is a tummy tuck necessary?

The hiatal hernia and GERD are typically related as the hiatal hernia allows the stomach to slide up into the chest and weakens the lower esophageal sphincter which causes reflux. Neither of these has any relation to your diastasis and umbilical hernia. Repair of your hiatal hernia can be done without addressing your umbilical hernia or diastasis. It may be possible to repair all of them at once, but that depends on your body shape, amount of intraabdominal fat and your overall health. I would consult with a general surgeon and plastic surgeon to get opinions on treating.

Thank you for sharing your excellent question.  Based on your current findings I would say that umbilical hernia was most likely present from birth but was so small as to be asymptomatic.  As a result of pregnancy your stomach muscles stretched resulting in the diastasis and likely made the hernia symptomatic and evident with the small bulge.  The hiatal hernia is most likely causing your GERD and if large enough would need to be repaired to improve upon those symptoms.  You can elect to have just the hernia repaired and not have the diastasis  if you desire, or combine it with liposuction, depending on your current appearance and goal result.  Hope this helps.

The GERD and Hiatal hernia may be related but they are unrelated to an umbilical hernia and diastasic recti.