Pregnancy and Heartburn

In most cases, acid reflux is easily treated, even in pregnancy. If there are symptoms that don’t respond well to treatment, that can result in complications such as gastrointestinal bleeding, difficulty swallowing, or weight loss. If this happens your midwife or obstetrician may refer you to a gastroenterologist. Also be aware that other conditions such as gallbladder disease, pancreatitis, or even cancers of the esophagus and stomach can mimic gastroesophageal reflux disease, although these are far less common.

Antacids are commonly used. A medicine which prevents your stomach from making acid may be prescribed if symptoms remain troublesome. Most pregnant women have symptoms of gastroesophageal reflux disease (GERD), especially heartburn, at some point. These symptoms may start at any time during a pregnancy. And they often get worse throughout the pregnancy.

“But a woman’s level of suffering is really important to take into consideration. Maternal suffering is not good for baby either.” The research shows that if you’re taking a PPI for your acid reflux once a day so you can sleep, the potential for harm is very low. 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.

The fuller your stomach is, the more pressure on the valve in your esophagus. For the same reason, avoid filling up on liquids while eating — consume your fluids between meals.

Women may also have a difficult time distinguishing the difference between GERD and symptoms of pregnancy, like morning sickness, particularly in the first trimester. The best course of action is to try to prevent the heartburn from occurring in the first place. So, eat smaller meals and avoid fatty foods, carbonated beverages, caffeine, acidic foods (like tomatoes) and spicy foods. “This will help decrease the amount of acid in your stomach,” explains Selk.

Eat small, frequent meals. Avoid greasy, spicy foods, especially close to bedtime. And avoid milk. It might seem like milk’s a good idea, but it actually increases stomach acid, making things worse.

It is not known if the contraction (motility) of the esophagus above the sphincter, a common contributor to GERD in women who are not pregnant is impaired in pregnancy, and is responsible for delaying the clearance of acid from the esophagus back into the stomach. What makes pregnancy different is the distortion of the organs in the abdomen and the increased abdominal pressure caused by the growing fetus.

Doing so for about half an hour after meals increases saliva production, which can neutralize excess acid in your esophagus. Concerned about artificial sweeteners during pregnancy?

Don’t eat close to bedtime. Give yourself three hours to digest food before you lie down (CKS 2017, NHS 2014) .

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. Avoid other heartburn medications during pregnancy unless they’re prescribed by your doctor. However, if your heartburn is persistent, your doctor may suggest that you try an over-the-counter heartburn medicine that controls acid production, like proton-pump inhibitors (PPIs) or H2 blockers.

Ask your GP or midwife for advice if symptoms of heartburn persist. Your heartburn may not be completely relieved by medication but your doctor or midwife can prescribe an antacid that is safe during pregnancy. Heartburn can show itself as a discomfort (especially after eating), bloating, wind, burping and nausea.

The usual suspects are carbonated drinks; alcohol (which is better avoided anyway during pregnancy); caffeine (which you’ll want to limit during pregnancy); chocolate; acidic foods like citrus fruits and juices, tomatoes, mustard, and vinegar; mint products; processed meats; and spicy, highly seasoned, fried, or fatty food. More than two-thirds of women suffer from heartburn or acid indigestion in the second half of pregnancy. The burning sensation often extends from the bottom of your breastbone to your lower throat. Drink less while eating.

Alginates help to protect the gullet (oesophagus) from stomach acid. They form a protective raft when they come into contact with stomach acid and block the acid from entering the oesophagus. Some alginates are specifically licensed for use in pregnancy. For many women (especially if they have mild symptoms), making some lifestyle changes as above is enough to ease dyspepsia. However, if lifestyle changes do not help, medication may be needed to treat dyspepsia in pregnancy.

Pregnancy Care Guidelines

More than half of all pregnant women will experience acid reflux. In later pregnancy, your growing baby pushes your stomach upwards.

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