Pregnancy and Heartburn
Chances are good that you’re one of many pregnant women who experience the churning
and burning of heartburn or acid indigestion. It typically hits somewhere in the second
or third trimester, and it can be miserable. Heartburn doesn’t really mean your heart
is burning, but it’s a good description of the discomfort that begins behind the breastbone.
It then moves upward to the neck and throat. Officially, heartburn is known as gastroesophageal
reflux, when acidic stomach juices or food and fluids back up into the esophagus.
This is a hollow muscular tube between your mouth and your stomach.
Why does it happen in pregnancy?
Many women who have heartburn during pregnancy have never had problems before. Unfortunately,
if you had heartburn before becoming pregnant, you’re more likely to have symptoms
while you are pregnant. Although the exact reasons aren’t clear, most experts believe
that pregnancy hormones, particularly progesterone, play a role. Hormones cause relaxation
of the esophageal sphincter. This is a tight circular band of muscle at the top of
the stomach. This allows partially digested food and stomach acids to backflow, or
reflux, into the esophagus. In addition, progesterone also slows the digestive process.
This keeps food in the stomach longer. The pregnancy itself—the upward pressure of
the growing uterus—also may play a role.
What makes it worse?
Most spicy, greasy, fatty foods known for causing heartburn are also likely to cause
problems for pregnant women. Food doesn’t digest as well or move as quickly during
pregnancy. So, eating large meals or overeating in general can also increase the risk
for heartburn. Eating right before bedtime can cause problems, too. Smoking makes
heartburn worse and is another reason to quit, especially while pregnant.
What makes it better?
For most women, things that help reduce acid production or prevent reﬂux are helpful
in avoiding the discomfort of heartburn. Here are tips that may help:
Avoid classic spicy foods, as well as those with lots of fat or grease. Many people
recommend avoiding citrus and chocolate, as well.
Eat multiple, small meals spread throughout the day, much like “grazing,” instead
of three big meals.
Try elevating the head of your bed by several inches, and wait a while after eating
before going to bed or lying down.
Some women find that it’s better to drink fluids between meals, rather than with a
meal. This can increase the amount of contents in the stomach.
If your symptoms do not improve after the above recommended diet and lifestyle changes
are in place, talk with your healthcare provider about over-the-counter medicines.
Antacids are available as chewable tablets and liquids. They work by coating the lining
of the esophagus and stomach and neutralizing stomach acid. Heartburn medicines called
H2-blockers work by reducing the amount of acid made by your stomach. Although most
of these are considered safe in pregnancy, as with all medicines, these should be
avoided in the first trimester.
When will it end?
Heartburn symptoms are usually mild and manageable. Tell your healthcare provider
if your heartburn is severe, if you spit up blood, or have dark-colored bowel movements.
This is a sign of blood in your digestive tract. Fortunately, heartburn usually ends
with the birth of your baby and your body goes back to its nonpregnant state.