Heartburn And Indigestion In Pregnancy
Heartburn causes a burning feeling in the chest or throat. Its uncomfortable, but is not usually harmful to pregnant women or their babies.
8 out of 10 pregnant women experience heartburn. You’re most likely to get heartburn in the third trimester of your pregnancy.
The symptoms of heartburn include:
- a burning feeling in your chest or throat
- acid coming up into your mouth
What Makes It Better
For most women, things that help reduce acid production or prevent reux are helpful in avoiding the discomfort of heartburn. Here are tips that may help:
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Avoid classic spicy foods, as well as those with lots of fat or grease. Many people recommend avoiding citrus and chocolate, as well.
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Eat multiple, small meals spread throughout the day, much like grazing, instead of three big meals.
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Try elevating the head of your bed by several inches, and wait a while after eating before going to bed or lying down.
Some women find that its better to drink fluids between meals, rather than with a meal. This can increase the amount of contents in the stomach.
If your symptoms do not improve after the above recommended diet and lifestyle changes are in place, talk with your healthcare provider about over-the-counter medicines. Antacids are available as chewable tablets and liquids. They work by coating the lining of the esophagus and stomach and neutralizing stomach acid. Heartburn medicines called H2-blockers work by reducing the amount of acid made by your stomach. Although most of these are considered safe in pregnancy, as with all medicines, these should be avoided in the first trimester.
Mild And Severe Allergies
Mild allergies may respond well to lifestyle measures. If you need some extra help, the following OTC oral antihistamines are generally considered safe:
- diphenhydramine
If your allergies are more severe, your doctor may suggest taking an OTC corticosteroid spray at a low dose along with an oral antihistamine. Options include:
You may also try the following lifestyle changes:
- Avoid going outdoors or opening windows on high pollen days.
- Take off clothing youve been wearing outdoors. Rinse off pollen from skin and hair with a quick shower.
- Wear a mask while completing outdoor chores or enlist the help of someone else for tasks like mowing.
- Rinse nasal passages with saline spray or a neti pot.
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Other Ways To Relieve Heartburn
Heartburn is one of the most common types of pain that pregnant women face and if you have had it in the past, you are more likely to get it when you are pregnant. Its believed that pregnancy hormones, such as progesterone, can relax the muscular valve in the stomach, which usually closes to prevent stomach acids from backflowing into the esophagus.
And as the baby grows, the fetus can create upward pressure, pushing on the abdomen. The food goes north rather than south, said Dr. Joel E. Richter, thedirector of the division of gastroenterology and nutrition at the University of South Florida who has studied the effects of heartburn medications taken during pregnancy.
If you are looking for relief, certain dietary changes such as avoiding spicy, acidic or fatty foods limiting caffeine and eating smaller, more frequent meals can help.
Its also best to remain upright for a couple of hours after eating.
If those changes do not make a difference, Dr. Richter said, the first line of defense during pregnancy is typically to use sucralfate , a prescription ulcer medication that is sometimes used for treating reflux disease or antacids that do not contain aspirin .
If these measures are not enough, doctors typically advise pregnant women to take histamine blockers like ranitidine to reduce the amount of acid in the stomach, or a different class of drugs called proton pump inhibitors, which inhibit the secretion of stomach acid, such as Prilosec .
What Are Some Alternatives For Treating Heartburn While Pregnant
While some heartburn medications might be safe during pregnancy, theyre not always a long-term solution to the problem. There are steps outside of medicine pregnant women can use to help their heartburn. Some lifestyle changes that may help heartburn while pregnant include:
- Try to eat at least two to three hours before lying down or going to bed. This can help food digest and leave the stomach. It will also reduce acid levels before lying down.
- Eat smaller meals as opposed to fewer large meals.
- Certain foods and beverages can be heartburn triggers. These can include onions, chocolate, caffeine tomatoes, citrus fruits, tomatoes, and foods that are spicy or high in fat.
- Increase water intake
- When lying down, try to keep the head and chest higher than the feet.
- Drink milk or eat yogurt
- Ginger is a natural remedy that can help with certain gastrointestinal symptoms.
- Dont bend over after eating.
- Try to sip liquids rather than drinking quickly.
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Can You Take Tums While Pregnant
Yes, Tums are safe to take during pregnancy. In fact, your first line of defense should probably be these chewable antacids made from calcium carbonate . Fast, portable, and effective, they may be all you need to handle heartburn. They even taste pretty good and double as a calcium supplement.
Antacids containing magnesium hydroxide or magnesium oxide like Maalox, Mylanta, and Rolaids are probably safe when used occasionally at the recommended dosage. But they’re not your best option while pregnant because they also contain aluminum hydroxide. Aluminum can be constipating and, in large doses, toxic.
Bear in mind that swallowing any liquid, even the liquid you need to wash down a tablet, will cause your stomach to do what it does naturally: produce digestive juices including acid, the very thing you’re trying to reduce. So it’s best to swallow or chew tablets with as little liquid as possible when you’re having trouble with heartburn.
All of these antacid medicines work by neutralizing the acid that’s already in your stomach and causing you pain. Chewable and liquid antacids act much more quickly than tablets because they’re already dissolved. You can experiment to see which you prefer and what works most effectively for you.
If you’re regularly taking the recommended dosage and aren’t getting relief from heartburn, talk to your doctor or midwife about whether you can take additional or different medications.
What Are The Types Of High Blood Pressure During Pregnancy
There are various types of high blood pressure during pregnancy. The most common types include:
- Chronic hypertension: High blood pressure begins before pregnancy or early during the pregnancy . This type of high blood pressure may continue after the babys birth.
- People with chronic hypertension may develop chronic hypertension with superimposed preeclampsia. Chronic hypertension causes pregnancy-related high blood pressure to worsen. Protein in the urine and other complications may occur.
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Can I Take Tums While Pregnant
Pregnant women may experience heartburn for the first time.
We know there are many surprises along the road to motherhood like heartburn. More than 50% of all pregnant women report symptoms of heartburn, particularly during their second and third trimesters. Pregnant women may experience heartburn because of changes to diet, fluctuating hormone levels, and crowding of the abdomen.1
Or Inquire About Proton Pump Inhibitors
If other medications don’t help, there are also proton pump inhibitors , such as Prevacid. These have a more powerful acid-suppressing effect than H2 blockers, and most are available over the counter.
Although PPIs are, in general, safe for pregnant women, animal studies have raised concerns that omeprazole could harm a developing fetus, Dr. Richter says. “My recommendation to patients would be to avoid that one because there are about five or six out there on the market, with the H2 blockers,” he says. “All of them look to be safe during pregnancy.”
Be sure to discuss any medications with your doctor.
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Change Your Eating And Drinking Habits
You may be able to control your indigestion with changes to your eating habits.
It can help to eat small meals often, rather than larger meals 3 times a day, and to not eat within 3 hours of going to bed at night.
Cutting down on drinks containing caffeine, and foods that are rich, spicy or fatty, can also ease symptoms.
Herbal Supplements And Vitamins
Some alternative therapies have been found to safely and effectively alleviate some of the uncomfortable side effects of pregnancy but natural doesnt always mean these herbal supplements are safe. As with any over the counter medication, its important to talk with your doctor about every supplement or vitamin you take while pregnant.
Prenatal vitamins are also an important part of a healthy pregnancy. Multivitamins that include folic acid are safe and important before and during the first few weeks of pregnancy because they can help prevent some birth defects. Your doctor or midwife can advise you about which type of multivitamin with folic acid you should take. Medical providers sometimes prescribe extra folic acid or iron supplements, depending on your specific situation.
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Heartburn Acid Reflux And Gerd During Pregnancy
Its called heartburn, although that burning feeling in your chest has nothing to do with the heart. Uncomfortable and frustrating, it bothers many women, particularly during pregnancy.
The first question you may have is how to make it stop. You may also wonder if treatments are safe for your baby. Learn what causes heartburn during pregnancy and what you can do about it.
Talk To Your Doctor About Alginates
Antacids are the most commonly bought heartburn medicine/ medications, but you can get some that also have alginates. These medications help to line the esophagus to eliminate the pain and discomfort that you feel, giving you immediate relief.
At the same time, they create a barrier over the top of your stomach acid. This foamy barrier stops the acid from getting through, preventing the reason for the heartburn in the first place. Its a long-term option.
If you suffer from bad acid reflux during the night, you will want to discuss these as an option during pregnancy with your doctor. They can give the lining throughout the night to help you sleep and then you stick to immediate or other options during the day.
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Safely Taking Heartburn Medication During Pregnancy
Medications that block gastric acid secretion , such as Tagamet, Zantac and Pepcid seem to be safe to take while pregnant and fall into the green light category.
However, even safe heartburn medication during pregnancy should not be taken without a doctors advice.
Over-the-counter antacids, such as Tums, Mylecon, Milk of Magnesia and Maalox are all safe to take during pregnancy and are also in the green light category. Because it contains aspirin, Alka Seltzer is not safe to take during pregnancy, although Alka Seltzer brand compounds that do not contain aspirin are safe.
Are Other Heartburn Medicines Safe During Pregnancy
Talk with your healthcare provider before taking other types of OTC medications to treat heartburn. Some OTC options can go through the placenta and reach the baby. Other medications dont have as many studies backing up their safety in pregnancy.
Antacids should usually be tried first before moving on to stronger medications. But if you do need something stronger, your healthcare provider can help you weigh the risks and benefits. Studies suggest that histamine-2 antagonists and proton pump inhibitors can be used safely with guidance from a healthcare provider.
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Why Acid Reflux Occurs During Pregnancy
In gastroesophageal reflux, or acid reflux, the lower esophageal sphincter doesnt work properly. Early in pregnancy, hormone levels increase. Higher levels of the hormone progesterone can cause the valve to relax. This allows foods and stomach acid to flow backwards from the stomach up the esophagus. This can lead to bouts of heartburn , indigestion and other bothersome symptoms. Hormones can also cause the digestive process to slow down during pregnancy. Later in pregnancy, your growing baby pushes on the stomach. This can also cause stomach contents to come up into the esophagus.
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How Do I Treat Heartburn During Pregnancy
When youre growing a human being, you dont have time for that yucky acid reflux. But your usual go-to methods for treating it may not be safe for your unborn baby.
Instead, here are some of the safest and best ways to get rid of heartburn when youre pregnant:
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Are Heartburn Medications Safe During Pregnancy
Q& A with Dr. Manny: Is it safe for pregnant women to take heartburn medications?
Most moms-to-be suffer from heartburn at some point during their pregnancies, but are medications safe to take?
Dear Dr. Manny, Can pregnant women take heartburn medications? Thanks, Beth
Heartburn is very common during pregnancy. In fact, more than half of all pregnant women report having symptoms of severe heartburn during their second and third trimesters.
Heartburn often occurs during pregnancy because of the change in hormone levels. An increase in the hormone progesterone relaxes the stomach valve that keeps acid out of the esophagus.
Its important for you to remember that antacids can interfere with the absorption of certain vitamins like iron, which is essential during pregnancy, because it aids in the production of hemoglobin used to carry oxygen to the placenta.
There are two types of heartburn drugs one kind neutralizes acid, and the other kind decreases acid production. Both are generally safe to use as long as they are not abused. But these medications should only be used in conjunction with alternative therapies including:
- Drinking coconut water or ginger tea
- Taking a teaspoon of apple cider vinegar
- Using natural herbs like slippery elm
- Sitting or standing after meals
- Elevating the head and chest in bed
- Keeping a food journal to identify triggers
Do you have a health question for Dr. Manny? Please send it to [email protected].
Learn What Causes Heartburn For Youthen Avoid It
Fat, caffeine, chocolate, citruspregnant women with heartburn have been advised to avoid all of the above at one time or another. But what causes reflux in one woman might not be a trigger for another.
Rather than tell his pregnant patients to avoid a specific food, Dr. Richter says he advises them to stay away from foods that specifically aggravate them. Everybody’s different, Dr. Richter says. Some pregnant women can chow down on spicy Mexican food or a plate of spaghetti and meatballs with no ill effects.
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Is It Safe To Take Gerd Medications During Pregnancy
Antacids, H2 blockers, and proton pump inhibitors are safe during pregnancy. Always consult your physician before taking any type of antacids as some of them may contain sodium, causing more water retention. Some also have aluminum, which isnt considered safe during pregnancy.
Promotility agents should be considered with extreme caution during pregnancy. They should be taken if the benefits outweigh the risk during pregnancy.
How Can I Prevent Heartburn During Pregnancy
They say prevention is the best medicine, so knowing common heartburn triggers can help you keep the acid at bay.
Of course, pregnancy itself is a major trigger for heartburn. As your growing uterus puts pressure on your stomach, this pushes stomach acid up your throat.
Those lovely hormones are no help either. They tend to relax the valve between your stomach and esophagus, which makes it easier for acid to make its way upward.
While theres nothing you can do to stop this entirely, there are a few things that can help prevent heartburn from flaring up during pregnancy:
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Where Can I Learn More About Safe Medicines During Pregnancy
If you have a question about the safety of any medication during pregnancy, talk with your healthcare provider.
An excellent online resource for evidence-based information on medication safety is the MotherToBaby website, a service of the Organization of Teratology Information Specialists. This is a professional scientific organization of experts who study teratogens, which are chemicals or substances in the environment that can cause birth defects. The website provides fact sheets on drugs and exposures that might affect your baby as well as a list of teratogen information services that you can contact for more information.
Learn more:
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Briggs G, et al. 2008. Drugs in Pregnancy and Lactation, 8th ed. Philadelphia, PA: Lippincott Williams & Wilkins.
MotherToBaby. 2020. Acetaminophen.
MotherToBaby. 2019. Chlorpheniramine.
