An upset stomach, including nausea, heartburn, and constipation, is common during pregnancy, often in the first trimester but possible at any point. While normal, remedies require caution. Consulting a healthcare provider is important to ensure solutions are safe for both the pregnant individual and the baby.
Dietary and Lifestyle Adjustments
Dietary and lifestyle changes are often the first step in managing pregnancy-related stomach discomfort. Eating small, frequent meals prevents both an overly full stomach and the emptiness that triggers nausea. Bland foods like crackers, toast, rice, or plain baked potatoes are helpful, as they are easier to digest. Avoiding rich, greasy, spicy, or fatty foods also reduces symptoms.
Ginger, in forms like ginger ale, tea, or candies, is known to alleviate nausea. Staying well-hydrated is important; sip small amounts of water, clear broths, or diluted juices between meals to avoid overfilling the stomach.
Lifestyle adjustments also improve comfort. Remaining upright for two to three hours after eating helps prevent heartburn, and elevating the head of the bed during sleep can provide relief. Adequate rest is beneficial, as fatigue intensifies nausea. Light physical activity, such as a gentle stroll, aids digestion and overall well-being.
Approved Over-the-Counter Options
When dietary and lifestyle adjustments are insufficient, certain over-the-counter (OTC) medications can offer relief. For nausea, vitamin B6 (pyridoxine) is recommended, typically at 10 to 25 milligrams three or four times daily. Doxylamine succinate, an antihistamine in sleep aids, can be used alone or with vitamin B6 for pronounced nausea. Other antihistamines, like diphenhydramine, are also options.
For heartburn, calcium carbonate antacids, such as Tums, are generally safe and a first choice. They neutralize stomach acid and contribute to daily calcium intake, important during pregnancy. Avoid antacids with sodium bicarbonate or magnesium trisilicate due to potential risks like fluid retention or fetal complications with prolonged high-dose use. If antacids are ineffective, healthcare providers may suggest H2RAs like famotidine, which reduce stomach acid.
Constipation is often addressed with fiber supplements. Bulk-forming laxatives, such as psyllium (Metamucil) or methylcellulose (Citrucel), work by absorbing water and adding bulk to stool. Adequate fluid intake is important with these supplements to prevent worsening constipation. Stool softeners, like docusate sodium (Colace), are generally safe; they function by drawing water into the stool to soften it, with minimal body absorption. Osmotic laxatives, such as polyethylene glycol (Miralax) or magnesium hydroxide (Milk of Magnesia), retain water in the bowels to soften stool and are typically used for short durations.
Medications to Avoid
Certain medications should be avoided during pregnancy due to potential risks. Bismuth subsalicylate, in products like Pepto-Bismol, contains salicylates similar to aspirin. This ingredient risks bleeding, particularly in late pregnancy, and its safety is unconfirmed, so it’s not recommended.
Some magnesium-containing antacids, especially magnesium trisilicate or high doses of magnesium hydroxide, avoid in the third trimester. These can interfere with uterine contractions during labor.
While some laxatives are safe, stimulant laxatives (e.g., bisacodyl, senna) are used with caution and only short-term. They can lead to dehydration, electrolyte imbalances, or potentially stimulate uterine contractions.
NSAIDs, including ibuprofen and aspirin, are not advised during pregnancy, especially in the third trimester, due to potential risks to the baby. Many herbal remedies lack sufficient safety data for pregnancy and should be discussed with a healthcare provider before use.
When to Seek Professional Guidance
While many instances of upset stomach during pregnancy can be managed at home, some situations require medical attention. Contact a healthcare provider for persistent or severe nausea and vomiting preventing fluid or food intake for 24 hours or more. Vomiting three or more times daily, or vomit that appears brown or contains blood, also requires medical evaluation.
Signs of dehydration, such as decreased urination, dark urine, dizziness, fainting, or a fast heartbeat, require immediate professional assessment. Unexplained weight loss during pregnancy also requires reporting to a healthcare provider.
If home remedies and approved over-the-counter options fail, or if symptoms are accompanied by other concerning signs like severe abdominal pain or fever, seek professional guidance. A healthcare provider can offer personalized advice, diagnose underlying conditions, and ensure the safest and most effective treatment.