Heartburn and Indigestion in Pregnancy

October 06, 2008

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Heartburn and Indigestion in Pregnancy

by Marjorie Greenfield, M.D.
reviewed by Marjorie Greenfield, M.D.

Most pregnant women experience burning in the middle of the chest, belching, or the taste of acid in the throat at some point. Heartburn and indigestion are extremely common in pregnancy.

What causes heartburn?
Heartburn is caused by stomach acid passing up into the esophagus (food tube), a process called "reflux." The pregnancy hormone progesterone causes delay in the stomach emptying after meals. At the same time it allows the muscle at the top of the stomach to relax. With the stomach full of food and acid and the valve at the top not staying shut, it can be a real double whammy. Lying down when the stomach is full makes the reflux even worse.

What can you do about it?

Diet: Eat small amounts of food at a time so the stomach has less to empty. Avoid peppermints, caffeine and alcohol. Try to finish dinner early in the evening, and don't lie down after eating.

Activities: Sleep propped up in a semi-sitting position, or raise the head of your bed by putting the two legs up on cinder blocks.

Medications:
- Calcium-based antacids (like TUMS™) are not very useful as antacids; while they provide a great source of calcium, they cause your stomach to increase its production of acid an hour after they are taken.
- Mylanta™, Maalox™, and other magnesium-based antacids seem to give longer lasting relief of symptoms. Many women find that the liquid form works best. In healthy women, the dosage of these medications is not critical. It is fine to keep a bottle by the bed and take a gulp or two during the night when necessary. If you get diarrhea, which is the most common side effect of Magnesium-based antacids, you will need to decrease the amount you are taking or try a different treatment.
- Over-the-counter H2-blocker antacids (such as Pepsid™, Tagamet™ and Zantac™) are also safe in pregnancy. Do not exceed the recommended dose without checking with your doctor.
- Prescription medications are also available. Sucralfate (Carafate™) liquid is an excellent choice since it is not absorbed into the body. It simply coats the stomach and esophagus. Its one drawback is that is can be constipating. Ask you doctor or nurse-midwife if it would be a good choice for you.

Acid reflux and indigestion are not dangerous, just annoying and sometimes very uncomfortable side effects of being pregnant. Luckily, most women get good relief with proper treatment. If your symptoms don't respond to a change in your habits and/or over-the-counter therapies, talk to your practitioner about what else can be done.


RELATED INFORMATION

			Morning Sickness in Pregnancy
			Principles of Healthy Eating During Pregnancy
			Sleep Problems in Pregnancy
			GI Symptoms in Pregnancy

Created August 10, 2000
Reviewed April 07, 2003

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