If sometimes after eating, an expectant mother has a feeling of burning sensation or pressure behind the breastbone, then this is heartburn. During 9 months of pregnancy female’s body undergoes whole list of physiological body changes.
Heartburn is one of the most common issues encountered during pregnancy. About 50% of expectant mothers report symptoms of heartburn mostly during 2nd and 3rd trimesters.
What is heartburn?
Heartburn – also known as Gastro-esophageal reflux, is when acidic contents, that should stay in the stomach to digest food, come up the esophagus – a tube connecting the mouth to the stomach, where the acid is not supposed to be. It happens mostly because, the sphincter that acts as a doorway between the two compartments, is relaxed, thus not doing its job properly, or because the stomach is under pressure.
How does it present?
The gastroesophageal sphincter is located at the same level as the heart, that’s why we have a burning sensation right where the heart is located. Symptoms commonly experienced are retrosternal burning pain, regurgitation, nausea, bloating, typically after a meal. Aggravating factors can be certain foods and beverages or lying down shortly after meals. Sounds quite unpleasant and dangerous but most of the time it’s a harmless condition that is also be pretty easy to relieve. Nevertheless, you should always consider consulting with your doctor if you notice any alarm features like – difficult or painful swallowing, feeling light-headedness, weight loss, bloody stools or if the above-mentioned symptoms are disproportionally uncomfortable.
Why do pregnant women get heartburn?
Etiology can multifactorial. In general population risk factors are diet consisting of fried, spicy food, chocolates, sodas. Also unhealthy lifestyle with cigarettes and alcohol, being overweight, stress, certain medications, etc. Although in pregnancy there are additional components like:
a) Hormonal changes – progesterone causes GE sphincter to relax
b) Physical changes: position of a growing fetus presses against stomach causing acid to reflux into the esophagus. Females can have this uncomfortable feeling throughout the whole pregnancy, which can be quite annoying, but on the bright side, there are various types of simple remedies for it. According to Pubmed study
It’s always a good idea to start management of heartburn with lifestyle modifications, instead of medications. Let’s go through the steps of what we can do to relieve and prevent heartburn
1. Change the position
It’s extremely important in what position you eat and stay in, sometimes after a meal. If you think about it, it makes sense, being upright while eating is necessary for food content to reach the stomach, by gravitational forces. The more horizontal position in your esophagus the more likely will gastric juices come up and irritate esophageal linings, causing heartburn. So what you should do is: A) Try to sit upright while and after taking a meal, taking 30 minutes to 1-hour walk after eating is perfect.
B) Try to minimize bending or leaning motions. Do not lift weights, do not make strong and frequent bends of the torso, or overextend the abdominal muscles.
C) Heartburn usually occurs in the first two hours after a meal, so do not lie down immediately after eating. Do not sleep in a strictly horizontal position, it is necessary to raise the head end of the bed or place another pillow.
2. Change your eating habits
Taking smaller meals will be a huge relief. Since smaller content goes into your stomach, less likely it is to regurgitate and less acid will be secreted. Therefore it is better to eat small meals and in case they are not fulfilling to you, then increase the frequency of them rather than size, like 4-5 times a day but make sure to have 1.5-2 hour intervals between. Eating slowly and chewing food thoroughly is recommended. Since the stomach will have to do less work for digestion, thus secrete less acid.
3. Change your diet
There is a list of foods you should certainly remove from your diet to prevent heartburn. Avoid any spicy, fried, and fatty food, chocolates, tomatoes, citrus fruits, caffeine, and sodas (gas beverages)! All these foods provoke additional relaxation of the esophageal sphincter. On the other hand, there are types of foods that can help you relieve the discomfort. Try to enrich your diet with ginger, healthy fats, vegetables, whole grains bananas, pears, peach and you will see some improvement. Although never forget to use them in moderation. You can also get rid of heartburn by eating nuts (walnuts, hazelnuts, almonds), but they rather prevent heartburn than eliminate the already existing one.
Also switching to liquified food like yogurts, soups, smoothies will help, since less solid contents will need less gastric juice for digestion. Try low-fat milk, just a few sips – and heartburn goes away or significantly decreases. Ice cream works the same way. Freshly squeezed carrot juice is a panacea for heartburn for pregnant women. The vegetable contains vitamins and minerals that will not only cope with heartburn but also saturate the mother’s body with useful nutrients. The burning sensation might immediately disappear after drinking mineral water. However, pay attention to the label: the water must contain alkaline elements (sodium, potassium): it is they who suppress the acid and relieve unpleasant symptoms. Before drinking mineral water, it is better to release gas from it.
4. Try safe medications
Unfortunately, eating well and following your lifestyle recommendations will not always help you get rid of heartburn. With minor heartburn, these activities may well be sufficient. In cases of severe heartburn, or the appearance of other symptoms of GERD, adequate therapy should be carried out.
Traditionally, in gastroenterology in the treatment of GERD, three main groups of drugs are widely used: proton pump inhibitors (PPIs), histamine H2 receptor blockers, and antacids, which provide effective control over acid production. It’s noteworthy that, especially during pregnancy, additional caution is necessary when choosing safe drugs. Antacids, histamine-2 receptor antagonists, and proton pump inhibitors can be used safely during pregnancy, as large studies have been published with no evidence of adverse fetal effects.
During pregnancy, the most commonly used medications are antacids (Maalox, Tums, Rennie, Gaviscon). They contain magnesium, calcium and aluminum salts, which neutralize gastric acids, form a protective film on the stomach wall, and increase the tone of the lower esophageal sphincter. Although it is better to avoid magnesium during the last trimester, near the due date, since it can interfere with contractions during labor. If antacids don’t work for you, there are other over-counter medication options like Histamin 2 channel antagonists or Proton pump inhibitors, the choice should be reviewed by your doctor.
Heartburn during pregnancy is quite common, although if you stick to a healthy lifestyle and proper nutrition, you can face minimal symptoms of heartburn or not even know what it is. However, if you do suffer from the symptoms, now you know how to deal with them. The material is for informational purposes only make sure to review medication choices with your doctor.