Heartburn and indigestion during pregnancy

Heartburn and indigestion are both unpleasant - and, unfortunately, all too common during pregnancy

Dr Zoe Langridge, GP from Doctor Care Anywhere, offers advice to pregnant women on how to identify and treat heartburn and indigestion.

pregnant woman heart tattoo eating doughnut

What causes heartburn or indigestion in pregnancy?

The hormone you release during pregnancy (progesterone) causes your muscles to relax, to allow your baby to pass through your pelvis during delivery. Unfortunately, it has the effect of relaxing all your muscles - including the one at the top of the stomach that normally prevents acid from travelling up the oesophagus to the mouth. So now it’s easier for that acid to come sneaking back up and cause heartburn.

On top of all that, progesterone can also slow down your digestive system as it tries to move and break down food.

Later in pregnancy - particularly after Week 30 - your baby and womb (uterus) get bigger, pushing the stomach further up into the chest and putting pressure on the digestive tract, which can make matters worse.

Will heartburn affect my baby?

No, it doesn't affect your baby in any way.

What are the symptoms of heartburn and indigestion?

Heartburn occurs when acid from the stomach leaks into the oesophagus (the pipe between your stomach and your mouth) and rises upwards. 

Symptoms include:

  • A sour taste in the mouth that creeps up the throat 
  • A feeling of burning in the chest 
  • Pain in the throat or neck 

Indigestion (dyspepsia) is a general term for pain or discomfort felt in the stomach or under the ribs. 

The most common symptoms of indigestion include:

  • Feeling uncomfortably full during or after eating 
  • Stomach pain 
  • Frequent burping 
  • Feeling sick or vomiting 
  • Having heartburn 
  • Feeling bloated 

What's the difference between heartburn and indigestion?

Both heartburn and indigestion describe symptoms that often occur after you eat, caused by eating foods that trigger these symptoms or by eating too much or too quickly. Indigestion is not related to stomach acid, but you can get heartburn as a symptom of indigestion.

woman suffering with heartburn

How common are heartburn and indigestion during pregnancy?

Both are very common during all stages of pregnancy, with symptoms usually getting worse in second and third trimesters. So - if it's any consolation for feeling gassy and bloated - you're certainly not alone: around 80% of pregnant women are affected. 

You're more likely to suffer during pregnancy if you have had problems with indigestion or heartburn previously, or if you have been pregnant before - but in truth, anyone can draw the short straw.

How can you avoid heartburn and indigestion?

Things which can make matters worse:

  • Smoking 
  • Trigger foods - known culprits are spicy foods, caffeine, alcohol, fatty foods, citrus fruits and juices, and chocolate (sorry!)
  • Weight gain - try to stick within the recommended range of weight gain for pregnancy
  • Having a hiatal hernia
  • Gastro-oesophageal reflux disease (GORD)
  • Some medication, such as non-steroidal anti-inflammatories (NSAIDs) like ibuprofen and antidepressants - but do not stop taking these without speaking to a doctor first 

In addition, indigestion may also be caused by:

  • Feeling stressed or anxious
  • Conditions like ulcers, pancreatitis, gastritis, or gallstones

Ruling out other causes of heartburn or indigestion during pregnancy

If your heartburn or indigestion is pregnancy-induced (ie, you were fine before you got pregnant) then the symptoms are generally nothing to worry about and will disappear as soon as your baby arrives.

However, if you do not get relief from over the counter medicines after trying for two weeks, or if symptoms are frequent, ie 2-3 times a week, discuss this with your doctor in case there is another cause.

Symptoms can become more frequent in later stages of pregnancy as you get bigger. However, if symptoms are changing and do not seem typical, or if they are worsening over a short period of time, speak to your doctor, just in case there's another cause.

pregnant woman eating lying down

How can you treat heartburn and indigestion in pregnancy?

Everyday things you can do to ease the suffering:

  • Avoid the triggers listed above - spicy food, smoking etc
  • Try to keep meals small
  • Avoid drinking excessive amounts with meals as fluids will expand the stomach more and irritate it
  • Eat slowly and chew well
  • Chew sugarless gum after meals to increase saliva production and neutralize acid in the oesophagus
  • Stay upright while eating and for a couple of hours afterwards
  • Try to leave a good few hours between your last meal and bedtime
  • Sleep propped up against pillows, rather than lying flat
  • Avoid tight clothing around your stomach and chest
  • Bend with your knees and waist rather than bending the whole upper body over, to avoid squashing your tummy
  • Acupuncture may help with some symptoms or with sleeping problems caused by heartburn

Indigestion and heartburn remedies which are safe to use during pregnancy

Over the counter treatments for heartburn and indigestion can often be used during pregnancy - but always check with your antenatal team before taking anything, and be sure to stick to their recommended dosage.

Commonly known as antacids, treatments come in both tablet and liquid form - eg Gaviscon, Rennies and own-brand variations - and are widely available from chemists and supermarkets. They work by neutralising the acid so it no longer irritates the stomach.

Sometimes antacids are combined with alginates; these work by forming a foam barrier on top of the surface of the stomach contents, keeping the acid away from the oesophagus.

You may need to take the medication before food and before bed, ie up to four times a day. If you are taking iron supplements, the antacids may prevent them being absorbed, so try to space them two hours apart from one another.

If this treatment is still not helping, there are other medicines that you can buy to help, but speak to your GP or midwife about it first. These may include:

  • Ranitidine - usually taken twice a day 
  • Omeprazole - usually taken once a day 

And the best cure of all is to give birth (that will happen eventually, we promise!) at which point your heartburn will instantly disappear.

What Mumsnetters say

"Love Hearts, Refreshers, and Giant Fizzers worked for me. Packets of them. Rot your teeth but leave your tummy calm."

"I am waking up five times a night on average in need of a swig of Gaviscon. I have grown to love the stuff and am developing a serious addiction."

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Foods to avoid during pregnancy How to cope with morning sickness Things people don't tell you about pregnancy

Last updated: 23 days ago