Heartburn During Pregnancy

 

Many women complain of heartburn during pregnancy. Heartburn during pregnancy is in fact one of the most common side effects of pregnancy. If you're one of the lucky few who has never experienced heartburn or indigestion, you are in for an unpleasant surprise during pregnancy.

Heartburn, indigestion, and other gastrointestinal discomforts are common in the second and third trimesters. Even if you've never experienced these symptoms before, they may plague you from this point onward.

What is Heartburn?
Heartburn is the burning feeling that you get in your chest, right behind the breastbone. Sometimes the burning sensation comes from your stomach and it rises up toward your neck. Heartburn can be accompanied by a sour taste in your mouth, or the sensation that vomit is coming up your throat.

What's Indigestion?
During pregnancy, indigestion can occur with heartburn. You have indigestion if your stomach is upset, or if you're feeling bloated, gassy, or very full.

Causes of Heartburn and Indigestion in Pregnancy

Heartburn and indigestion can be uncomfortable and even painful, but they are both normal pregnancy symptoms. They are caused by the physical changes in your body, accompanied by elevated pregnancy hormones.

Normally, food travels down your esophagus into your stomach. A circular valve near the bottom of the esophagus separates the two. When you swallow down food or take a sip of water, the valve relaxes so that the food can travel to your stomach.

When you're not eating, the valve closes shut so that stomach acid can't rise back up. However, if the valve happens to relax and you aren't eating or drinking, stomach acid can flow back up the esophagus, causing a burning sensation. This is heartburn.

When you're pregnant, your hormones (especially progesterone) relax all the muscles in your body, including this valve in your esophagus. As a result, heartburn becomes a very common occurrence during pregnancy.

In addition, the elevated levels of pregnancy hormones can also slow down your digestion, making it more likely for you to feel bloated, gassy, and full.

Another reason that indigestion and heartburn are so common in the second trimester has to do with your growing baby and expanding uterus. As you pack on the pounds, your uterus pushes upward, pushing against your abdominal cavity and abdominal organs. This can push food and stomach acid back up into your esophagus.

Pregnancy Health Section

How to Prevent Heartburn and Indigestion

Throughout pregnancy, you'll learn that certain things can contribute to heartburn and indigestion. For example, greasy or fattening foods can make you feel gassy and uncomfortable. Say goodbye to Mexican food – onions, garlic, and other spicy foods can be heartburn triggers.

You may not be able to completely eliminate heartburn or indigestion during pregnancy, but you can take steps to prevent it. Consider the following tips:

• Avoid eating large meals.
  Eating smaller meals throughout the day and chewing your food thoroughly can make it easier for your digestive system to break everything down.


• You should avoid any foods that trigger heartburn.
  Food triggers include spicy, greasy, and fatty foods. You may want to avoid chocolate and caffeine-laced foods. They can trigger heartburn and indigestion during pregnancy.


• Don't drink when you're eating.
  Try to drink water and other fluids after your meal. When you drink, you should sip from the cup or glass. Stay away from straws during pregnancy – straws can make you gassy.


• Resist the temptation to lie down.
  Wait an hour or two after eating before you lie down. Why not do light house work, or a walk around the neighborhood? You want to give your body time to digest your food. Lying down immediately after eating may trigger heartburn.


• Chew a piece of gum after you eat your meal.
  Your saliva is a base, and it can actually neutralize your stomach acid.


• Gain the recommended pregnancy weight for your body size.
  Extra pounds places increased pressure on your belly, which will cause you to feel even more abdominal discomfort. (The recommended weight gain for the average sized woman is 25 to 35 pounds.)

Treatments to Reduce the Symptoms of Heartburn

The three main medicines to reduce heartburn symptoms are:
Antacids

• Calcium carbonate (sample brand name: Tums®)


• Aluminum hydroxide, magnesium hydroxide, and simethicone (sample brand name: Maalox®).

Histamine blockers

• Ranitidine (brand name: Zantac®)


• Famotidine (brand name: Pepcid®)


• Cimetidine (brand name: Tagamet®)

Proton pump inhibitors

• Omeprazole (brand name: Prilosec®)


• Esomeprazole (brand name: Nexium®)


• Pantoprazole (brand name: Protonix®)


• Lansoprazole (brand name: Prevacid®)


• Dexlansoprazole (brand name: Dexilant®)


• Rabeprazole (brand name: AcipHex®)

All three of these medicines reduce or block the production of stomach acid. Doctors usually recommend that pregnant women first try antacids to see if this helps reduce the burning sensation and discomfort. You can buy antacids without a prescription and they are considered relatively safe to use during pregnancy,

When antacids don’t help your doctor will have you try a histamine blocker or proton pump inhibitor. These medicines work better than antacids and most can be bought without a prescription.
Before you use any over-the-counter medicines for acid reflux, check in with your healthcare provider first. Most of the medicines are considered relatively safe to use during pregnancy, but you should always check the label and ask your healthcare provider if you have any questions.

Pregnant women commonly develop heartburn, a disorder that involves a burning feeling in the chest.
Up to 50 percent of women experience heartburn at some point during pregnancy. Although it can happen at any point during pregnancy, heartburn tends to occur more frequently in the third trimester.
Find out more in this article about heartburn during pregnancy, how to treat and prevent it, and how to tell if it's time to see the doctor.

Contents of this article:

1. What is heartburn?
2. Why do pregnant women get heartburn?
3. Prevention
4. Treating heartburn

What is heartburn?

Pregnant women may suffer from heartburn as the growing uterus can put pressure on the stomach.

One of the main symptoms is a burning sensation in the middle of the chest. It happens when the valve that connects the esophagus, or food pipe, to the stomach weakens and stomach acid and contents flow back into the food pipe.
The stomach acid is irritating, and this causes the burning feeling in the chest.
Apart from burning in the chest, other symptoms of heartburn include:

• Burping
• Regurgitation
• Bloating
• Nausea

These symptoms tend to occur soon after eating, although not always immediately.

Why do pregnant women get heartburn?

Pregnant women are more likely to get heartburn for a number of reasons.
First, during pregnancy, the hormone progesterone is secreted in higher amounts to support the pregnancy. Progesterone causes the valve that separates the food pipe from the stomach to relax, causing heartburn.
In addition, the growing uterus starts to put pressure on the stomach and other internal organs in later pregnancy. That pressure can also push food and stomach acid back into the food pipe.
Indigestion and heartburn are more likely in women who had heartburn before pregnancy and in those who have been pregnant before.

Prevention

Preventing heartburn is the best way to manage it. Certain foods or beverages tend to trigger the symptoms. Avoiding those foods can help to prevent the discomfort associated with heartburn. Foods that tend to trigger heartburn include:

• Citrus fruits, such as oranges, grapefruits, and pineapple
• Caffeine
• Carbonated drinks, or sodas
• Fatty and greasy foods
• Spicy foods
• Tomatoes
• Chocolate

As well as avoiding these foods, it can be helpful to eat smaller meals more often. Instead of three big meals per day, five or six smaller meals may be better.
Staying upright for at least 20 to 30 minutes after eating can prevent the stomach contents from backing up into the food pipe.
At night, it is better not to eat within 3 hours of going to bed. Propping up the head of the bed or using extra pillows to keep the head elevated can help prevent heartburn that occurs at night.
It is also important to avoid smoking cigarettes and drinking alcohol. Neither is healthy during pregnancy, and they can both contribute to heartburn.
Anyone who finds it difficult to quit should speak with a doctor.
Drinking a glass of milk can help to reduce symptoms. Low-fat or nonfat milk is better because whole milk is rich in fat, and this can worsen heartburn.

Treating heartburn

If these lifestyle changes do not help to prevent the symptoms of heartburn, it may be time to consider medications.
The following is general information about antacids and other over-the-counter remedies for heartburn.
As always, it is best to speak with the doctor before taking any medications, especially during pregnancy.

Calcium carbonate tablets may be used to treat heartburn.

• Tums: Also known as calcium carbonate. It is considered safe during pregnancy. Calcium carbonate neutralizes the stomach acid so that it is less irritating if it backs up into the food pipe. People should be sure to read the instructions on the bottle for the safe dose in pregnancy.
• H2 receptor antagonists: Also considered safe in pregnancy. They include famotidine, cimetidine, and ranitidine. They are available both over the counter and by a doctor's prescription. These drugs decrease the amount of acid produced by the stomach.
• Proton pump inhibitors: Proton pump inhibitors (PPI) prevent the secretion of stomach acids and work well in the treatment of heartburn. Common PPIs include pantoprazole and lansoprazole. They are also available over the counter and by prescription.

Most proton pump inhibitors are considered to be safe in pregnancy. However, one PPI called omeprazole is not recommended for use. Too few studies have been done to confirm that it is safe.
People should always tell their healthcare provider about all drugs and herbs that they take during pregnancy.

GERD

Heartburn, acid reflux, and gastroesophageal reflux disease (GERD) are often used interchangeably, but they are not quite the same.
Acid reflux is the regurgitation of stomach acid back into the food pipe, causing the symptom of heartburn. GERD is a more serious form of acid reflux and heartburn.
Additional symptoms of GERD can include:

• Chronic cough
• Wheezing
• Chest pain
• Difficulty swallowing
• Regurgitation of food or stomach acid

GERD is estimated to affect 40 percent of Americans on a monthly basis. The treatments for GERD are very similar to the treatments for acid reflux or heartburn.
Avoiding triggers, basic lifestyle changes, and medications can be effective for managing the symptoms. However, in severe cases of GERD, prescription medication or even surgery may be needed to relieve the condition.

When to see a doctor

It is important to see the doctor regularly as part of good prenatal care. Heartburn that is not relieved by lifestyle or diet changes should be mentioned to the doctor at a routine prenatal visit. If medication is recommended, make sure to mention whether or not it is effective in managing the symptoms.
Even though heartburn is common in pregnancy, it is especially important to mention symptoms if they are severe or interfere with daily life.

Written by Nicole Galan