Indigestion, often described as heartburn or acid reflux, is a common and uncomfortable experience during pregnancy, typically causing a burning pain in the chest or stomach. While generally not harmful, these symptoms arise from physiological changes and the baby’s growth. Relief is often possible through lifestyle adjustments and carefully selected over-the-counter remedies.
Understanding Indigestion During Pregnancy
Indigestion symptoms frequently occur in pregnancy due to hormonal and physical changes. Elevated progesterone, a hormone abundant during pregnancy, relaxes muscles, including the lower esophageal sphincter. This muscular ring normally prevents stomach acid from flowing back into the esophagus, but its relaxation allows acid to reflux, causing a burning sensation.
As pregnancy progresses, particularly into later trimesters, the growing uterus places increased pressure on the stomach. This physical compression encourages stomach contents and acid to move upwards, intensifying indigestion. Common symptoms include a burning feeling in the chest or stomach, bloating, burping, a feeling of fullness, and occasionally nausea or food regurgitation.
Safe and Effective Remedies
Managing indigestion during pregnancy often begins with dietary and lifestyle modifications. Eating smaller, more frequent meals throughout the day, instead of three large ones, can help prevent the stomach from becoming overly full and reduce pressure. It is also helpful to eat slowly and chew food thoroughly for better digestion. Staying hydrated between meals, rather than drinking large quantities of liquids during meals, helps avoid overfilling the stomach.
Certain foods and beverages can trigger indigestion and are best limited or avoided. These commonly include spicy, fatty, or fried foods, acidic items like citrus fruits and tomato-based products, caffeine, and carbonated beverages. Chewing sugar-free gum after meals can also be beneficial, as it increases saliva production, which helps neutralize stomach acid.
Beyond dietary adjustments, several lifestyle changes can alleviate discomfort. Avoid lying down immediately after eating; remain upright for at least an hour, or ideally two to three hours, to allow gravity to assist digestion. Elevating the head of the bed by six to eight inches can help prevent acid reflux during sleep. Wearing loose-fitting clothing, especially around the abdomen, can also reduce pressure on the stomach.
If lifestyle and dietary changes are not enough, certain over-the-counter medications are generally considered safe for use during pregnancy, though consultation with a healthcare provider is always recommended. Calcium carbonate, found in antacids like Tums, is a commonly preferred option because it quickly neutralizes stomach acid and provides the added benefit of calcium, which is important for both mother and baby.
For persistent symptoms, histamine-2 blockers (H2 blockers) such as famotidine (Pepcid AC) are often considered. These medications work by reducing the amount of acid the stomach produces. If symptoms remain severe, proton pump inhibitors (PPIs) like omeprazole (Prilosec) or lansoprazole (Prevacid) may be prescribed by a healthcare provider. Omeprazole is generally the preferred PPI in pregnancy due to more extensive safety data.
Medications to Avoid
Certain medications should be avoided for indigestion relief during pregnancy due to potential risks.
Antacids containing sodium bicarbonate (e.g., Alka-Seltzer) are not recommended. Their high sodium content can lead to fluid retention and swelling, and may contribute to metabolic alkalosis in both the mother and the fetus.
Aspirin-containing medications should also be avoided unless specifically prescribed by a healthcare provider. Aspirin carries risks during pregnancy, including fetal kidney problems and potential bleeding issues. Pepto-Bismol, which contains bismuth subsalicylate (related to aspirin), should not be used.
Antacids combining aluminum and magnesium may warrant caution. High doses or long-term use of aluminum can cause constipation and affect calcium absorption. Magnesium trisilicate has been associated with fetal concerns with long-term or high-dose use. Always discuss any antacid containing these ingredients with a healthcare provider before use.
When to Consult a Healthcare Provider
While indigestion is common during pregnancy, seek medical advice if symptoms are severe, persistent, or do not improve with dietary changes, lifestyle adjustments, or over-the-counter remedies, or if they frequently recur.
Seek medical attention if indigestion is accompanied by other concerning symptoms, such as significant pain, difficulty swallowing, unexplained weight loss, black or tarry stools, or vomiting blood. Heartburn-like pain below the ribs can indicate a more serious condition like preeclampsia, especially if accompanied by high blood pressure, swelling in the face or hands, severe headaches, or vision changes. Your healthcare provider can accurately diagnose the issue and recommend the safest and most effective course of action.