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Heartburn And Indigestion During Pregnancy

Heartburn And Indigestion During Pregnancy

Do you feel the burn? Nobody knows heartburn like a pregnant woman. And it doesn’t just happen in the chest or throat – pregnant women often feel that nagging discomfort and burning all the way through their digestive system during pregnancy.


Indigestion and heartburn are common in pregnancy. In fact, half of pregnant moms know the struggles of heartburn and indigestion in pregnancy. According to some sources, as many as 8 out of 10 women experience indigestion at some point during pregnancy.


In this article:


When Does Heartburn And Indigestion Begin In Pregnancy?

Heartburn in pregnancy is often one of the earliest symptoms expectant mothers deal with. It often begins rearing its ugly, unwanted head around month two. The bad news is, unlike morning sickness that often dissipates after the first trimester for many women, heartburn may get worse.


Some studies have shown the prevalence of heartburn to increase from 22% during the first trimester to 39% in the second. During the third trimester, women have been found to experience an increase of 60% to 72%. There is good news too, however: one cohort study found that gastrointestinal symptoms, including nausea and heartburn, were less common in subsequent trimesters of pregnancy. So, it really depends.


What Causes Heartburn And Indigestion During Pregnancy?

Getting technical, indigestion is also known as dyspepsia, which refers to pain or discomfort in the upper abdominal region. Heartburn is a common type of indigestion. But what causes this problem in pregnant women?


During the normal digestion process, food is chewed in the mouth and then travels down the esophagus, which is a tube that runs between the mouth and stomach. Food then passes through a small muscular valve, known as the lower esophageal sphincter (LES), on its way into the stomach. The LES acts as a sort of doorway that separates your esophagus and stomach, which opens up to allow food to pass through, then it closes back up to keep anything, including stomach acids, from making its way back up.


With heartburn or acid reflux, the LES “door” gets a little lazy, relaxing just enough for stomach acid to pass back through the wrong way and into the esophagus. This stomach acid comes into contact with more sensitive regions of the digestive system, leading to symptoms, such as burning and pain in the chest region.


During pregnancy, hormones, including progesterone and a special hormone known as relaxin, cause muscles within the body to be looser, or relaxed. This change is beneficial as it slows the movement of food through your digestive system, which affords the body better absorption of nutrients into the bloodstream, subsequently giving more to the placenta and baby. Although this relaxation of the digestive process has its benefits, it also has its costs.


The digestive changes in pregnancy also can cause the esophageal muscles to relax more often, resulting in acids seeping back up. It is more common when pregnant women eat a large meal or lie down.


Additionally, as a woman’s pregnancy progresses and the fetus grows during the second and third trimesters, the expanding uterus and baby within can put more pressure on the stomach. This can also result in acid and food being forced back upward into the esophagus.


Symptoms Of Heartburn And Indigestion During Pregnancy

Pregnant women who battle indigestion and heartburn during pregnancy often experience the same symptoms as anyone else who is not pregnant.


The primary symptom of heartburn or indigestion is the feeling of discomfort in the chest or stomach. It typically occurs soon after drinking or eating something but there can sometimes be a delay. Along with pain, pregnant women with indigestion or heartburn may experience the following symptoms:

  • Belching
  • A burning sensation
  • Feeling full, heavy or just uncomfortable
  • Nausea
  • Vomiting
  • Regurgitation (or food coming back up)


Remedies For Indigestion And Heartburn During Pregnancy

There are many remedies you can try to treat indigestion and heartburn during pregnancy, from medications to steps you can take to treat or prevent the condition.


Medication may be able to help keep irritable symptoms of heartburn and indigestion at bay, including Maalox, Rolaids or Tums. Over-the-counter antacids may help you to deal with occasional symptoms of heartburn. Those made of magnesium or calcium carbonate may be good options – but check with your doctor before taking these or any other medications during pregnancy. Your doctor may advise against taking medication containing magnesium in your third trimester as the nutrient may interfere with labor contractions. 


It is important to note that some antacids should be avoided during pregnancy. Steer clear of antacids that contain high levels of sodium, including those that contain ingredients on the label like “aluminum carbonate” or “aluminum hydroxide.” These antacids can contribute to constipation or can cause it to develop. Also do not take medications like Alka-Seltzer during pregnancy as they may contain aspirin, which may be harmful to your growing baby.


Finding relief from heartburn and indigestion during pregnancy may involve a little trial and error. One of the safest and best ways to reduce symptoms of heartburn during pregnancy is to make lifestyle changes. Below are some tips that may help to relive pregnancy-induced heartburn and indigestion:

  • Eat slower and be sure to chew each bite completely.
  • Do not eat right before bed. Try to keep from eating a few hours before you go to sleep.
  • Eat smaller and more frequent meals.
  • Avoid drinking when you are eating food. Instead, drink water between meals.
  • Avoid any drinks or foods that may trigger your heartburn, including spicy foods, acidic foods, fatty foods, citrus-based and tomato-based items, caffeine and carbonated beverages. Some sources also say to avoid chocolate, which is hard for a pregnant mama!
  • Wear clothes that are comfortable – not those that hug your baby bump tightly.
  • Sit upright for the first hour after a meal.
  • Take a walk after a meal to aid with digestion.
  • Sleep on our left side to keep your stomach in a higher position, above your esophagus, to prevent heartburn.
  • Use wedges or pillows to keep your body upright when sleeping.
  • Eat a small amount of yogurt or drink milk to keep symptoms from getting worse after they start.
  • Some women have reported that drinking apple cider vinegar helps to keep symptoms from worsening – just take a deep breath and chug a shot!


When To See A Doctor

If your heartburn keeps you up at night or comes back quickly after your antacid wears off, it is time to reach out to your doctor. Other symptoms that require a call to your physician include coughing, difficulty swallowing, black stools or weight loss. These symptoms may point to a more serious problem that requires medical attention. Your doctor may prescribe a medication to help reduce your symptoms, to keep you feeling better while keeping your baby safe as well.


Office On Women's Health, Body changes and discomforts, January 2019.

National Institutes of Health, National Library of Medicine, Heartburn in pregnancy, September 2015.

American College of Obstetricians and Gynecologists, Problems of the Digestive System, January 2014.

National Institutes of Health, National Library of Medicine, Treatment of Gastroesophageal Reflux Disease During Pregnancy, November 2012.

American Academy of Family Physicians, Over-the-Counter Medications in Pregnancy, June 2003. 

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  • Courtney Cosby
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