Pregnancy and Heartburn

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 preventing the discomfort of
heartburn. Here are tips that may help:

  • Don’t eat classic spicy
    foods, as well as those with lots of fat or grease. Many people advise not having
    citrus and chocolate, as well.

  • Eat multiple, small meals
    spread throughout the day, much like “grazing,” instead of 3 big meals.

  • Try raising 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 don’t improve
after the above advised 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 often 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 often ends with the birth of your baby and
your
body goes back to its nonpregnant state.