Acid reflux, often described as heartburn, is a common and uncomfortable experience during pregnancy. This burning sensation in the chest or throat arises when stomach acid flows back into the esophagus. While unrelated to the heart, this irritation can cause significant discomfort. Though it can occur at any point, it frequently becomes more noticeable as pregnancy progresses. Fortunately, various effective strategies exist to manage and quickly alleviate these symptoms.
Why Acid Reflux Happens in Pregnancy
Physiological changes during pregnancy contribute significantly to increased acid reflux. Hormonal shifts play a primary role, particularly rising progesterone levels. This hormone relaxes smooth muscle tissue, including the lower esophageal sphincter (LES), the muscular valve between the esophagus and stomach. A relaxed LES can allow stomach acid to leak upward.
Physical changes also contribute as pregnancy advances. The growing uterus expands, placing increased pressure on the stomach. This mechanical pressure can force stomach contents and acid back into the esophagus, intensifying reflux symptoms. Reflux often worsens during the second and third trimesters, when the uterus and fetus are largest.
Quick Relief Strategies
Implementing specific non-pharmacological adjustments can often provide rapid comfort from acid reflux during pregnancy. Eating smaller, more frequent meals, rather than three large ones, helps reduce stomach pressure and supports easier digestion. Eat slowly and avoid lying down immediately after eating, allowing two to three hours for digestion before resting or going to bed.
Certain foods and beverages are known to trigger acid reflux and should be limited or avoided. Common culprits include spicy, fatty, and fried foods, as well as acidic items like citrus fruits and tomatoes. Caffeine, chocolate, and peppermint can also exacerbate symptoms by relaxing the LES. Maintain good posture, especially sitting upright while eating, to prevent acid flow.
Lifestyle modifications can further aid in managing symptoms. Elevating the head of the bed by six to eight inches, perhaps by placing blocks under the bed frame or a foam wedge under the mattress, uses gravity to keep stomach acid down. Wearing loose-fitting clothing, particularly around the waist, can alleviate abdominal pressure. Chewing sugar-free gum after meals stimulates saliva, which helps neutralize stomach acid. Sipping water or mild herbal teas like ginger tea can also soothe the digestive system.
Safe Over-the-Counter Medications
If lifestyle and dietary changes are insufficient, certain over-the-counter (OTC) medications can alleviate acid reflux. Antacids, such as those containing calcium carbonate or magnesium hydroxide, work by neutralizing stomach acid. Calcium carbonate (like Tums) is often recommended and contributes to daily calcium. Magnesium hydroxide (like Maalox or Mylanta) is also generally considered safe, though some sources suggest caution due to absorption concerns or potential for constipation.
It is important to avoid antacids that contain sodium bicarbonate or magnesium trisilicate during pregnancy. Long-term or heavy use of any antacid has not been extensively studied in pregnancy, so it is best to use them as needed and under guidance. For persistent symptoms, healthcare providers may suggest H2 blockers, which reduce stomach acid production. Famotidine (Pepcid) is generally considered safe during pregnancy, with studies showing no increased risk of adverse outcomes. Always consult a healthcare provider before taking any medication, including OTC options, to ensure safety for both you and the developing fetus.
When to Consult a Healthcare Provider
While acid reflux is a common pregnancy discomfort, certain symptoms warrant immediate medical attention from a healthcare provider. Seek professional advice if severe or persistent symptoms do not improve with lifestyle adjustments and OTC medications. Difficulty or pain swallowing, unexplained weight loss, or signs of bleeding (black stools, vomiting blood) require prompt evaluation.
Additionally, any symptoms that worsen or are accompanied by other unusual signs should be reported to a doctor. Heartburn-like pain, especially under the ribs, can mimic conditions like preeclampsia, a serious pregnancy complication. When in doubt about symptoms or medication safety, always consult a healthcare provider.