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HEARTBURN AND ACID INDIGESTION DURING PREGNANCY
Indigestion, heartburn, constipation, gas and bloating are some of the most common complaints during pregnancy, especially in the later months. One in four pregnant women report heartburn daily at some point in their pregnancy. Acid indigestion is almost as common.
High levels of estrogen and progesterone circulating in the body during pregnancy cause these annoying conditions. The hormones relax smooth muscle tissue in the gastrointestinal tract, slowing digestion. Slower food processing improves the absorption of critical nutrients, but also causes gas and bloating.
Another factor contributing to digestive problems is that the sphincter muscle relaxes during pregnancy and allows some food and digestive juices from the stomach to back up into the esophagus, resulting in heartburn. In addition, the enlarged uterus also presses on the stomach, pushing it and its contents up towards the esophagus, also resulting in heartburn. The uterus also presses on the bowel, inhibiting normal activity and causing constipation.
Heartburn
Heartburn is the burning feeling in the middle of your chest caused by acid leaking upward from the stomach into the esophagus. This condition is called reflux esophagitis. Because your esophagus does not have a protective lining like the stomach, it can be burned by acid, causing pain and sometimes damage. Night-time cough, wheezing, and in some cases difficulty in swallowing food due to scaring of the esophagus are results of heartburn.
Heartburn Prevention
Preventing heartburn during pregnancy may be as simple as staying upright long enough to let food and acid empty out of your stomach. Other ways to minimize discomfort are:
- Never lay down after a meal. Remain upright for at least 30 minutes after a meal.
- Allow 2-3 hours between eating and bed-time.
- Try propping up the head of your bed 2 or 3 inches with books or blocks under the legs of the frame. It's hard for stomach acid to go uphill into your esophagus.
- Avoid clothing that restricts your waist.
- Bend from the knees rather than the waist to avoid pressure on your abdomen.
- Avoid fatty foods, spicy and greasy foods, and caffeine (colas, tea, chocolate, coffee).
- Relax and eat slowly.
- Do not smoke.
- Eat small, frequent meals rather than large meals to avoid overfilling your stomach.
- Ask your physician about the use of an antacid. Some antacids can be harmful for pregnant women so be sure to get your provider's permission before using any medicinal remedy.
Certain high blood pressure medicine, some tranquilizers and anti-depressants, and female hormones also cause heartburn. Check with your doctor if you are currently taking prescription drugs.
Acid Indigestion
Acid indigestion is a similar burning discomfort in the pit of your stomach, caused by acid irritating the stomach lining or duodenum. It is believed that too little protection from the mucus lining the stomach, as well as too much acid, cause acid indigestion. Acid indigestion can burn so deeply into your stomach or duodenum that a canker sore-like crater forms (peptic ulcer disease).
Acid Indigestion Prevention
Protecting the stomach lining and avoiding activities that increase stomach acid help to prevent acid indigestion. To help maintain the protective layer:
- Don't take aspirin, ibuprofen, or other anti-inflammatory drugs. They can directly damage your protective stomach lining (acetaminophen products do not cause such damage).
- Don't smoke or use any tobacco products. Nicotine and other substances found in tobacco both weaken the stomach's protective layer and increase acid production.
Avoid These Acid Producers:
- Coffee (regular or decaf)
- All caffeinated products (including chocolate)
- Carbonated drinks (such as soda pop)
- Citrus fruits and juices
- Milk (may actually aggravate your acid indigestion, not soothe it)
Treatment Options
Antacids and H2blockers are both proven to work against heartburn and indigestion. They reduce the acidity of stomach juices, which reduces the irritation of the stomach, duodenum and esophagus. Antacids are inexpensive and work quickly, offering relief in minutes. H2 blockers reduce acid production in the stomach. Since they work much longer than antacids (6-12 hours compared to 1-3), they are only dosed once or twice daily.
Heartburn and acid indigestion should cause fairly mild pain. If the discomfort is severe enough to interfere with work, home or school you should see your physician. What may seem like simple acid indigestion or heartburn can actually lead to serious conditions like peptic ulcer disease or cancer of the esophagus. These conditions require diagnosis and more intensive treatment by a physician.
| Warning Signs | Cause |
| Black stools or stools with tar-like consistency | Blood from an ulcer mixes with stomach acid, turning the stools black. |
| Frequent nighttime cough, or awakening at night with a choking sensation or foul taste in the back of the throat. | Stomach acid leaking into the esophagus is a common cause of chronic cough and even asthma. It can awaken people at night, and chronic daytime fatigue may result. |
| Difficulty swallowing or sensation that food becomes "stuck" part way down. | Scarring or swelling of the esophagus from acid causes narrowing and blockage; the esophagus may have to be stretched for relief. |
Thomas G. Stovall, M.D.
Dr. Stovall is a Clinical Professor of Obstetrics and Gynecology at the University of Tennessee Health Science Center in Memphis, Tennessee and Partner of Women's Health Specialists, Inc.
Date Published: 2004-03-09
7800 Wolf Trail Cove, Germantown, TN 38138
Phone: (901) 682-9222; Fax: (901) 682-9505