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Heartburn and indigestion in pregnancy

Heartburn in pregnancy

Hormonal changes during pregnancy unfortunately make heartburn and indigestion all too common. The symptoms can be very uncomfortable but they won’t harm your baby – and there are plenty of treatments you can try for a bit of relief

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. The symptoms usually occur soon after eating.

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. Symptoms usually come on soon after eating, but there can be a delay. The most common symptoms of indigestion include:

  • Feeling uncomfortably full during or after eating
  • Stomach pain
  • Frequent burping
  • Feeling sick or vomiting
  • Regurgitation (food coming back up from the stomach)
  • Having heartburn
  • Feeling bloated

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 your stomach that normally prevents acid from travelling up the oesophagus to your mouth. As a result, that acid can easily sneak 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 – which leads to indigestion.

Gaviscon is no longer working for me – the only thing I have found that helps is drinking hot soya milk.

The symptoms of indigestion and heartburn are due to stomach acid coming into contact with – and breaking down – your digestive system’s protective lining (mucosa). This causes your insides’ irritation – and your uncomfortable symptoms.

Heartburn and indigestion can happen at any point during pregnancy, but symptoms are likely to be worse, and more frequent, later on – particularly after Week 30. By then, your baby and womb (uterus) are bigger, and push the stomach further up into the chest, putting pressure on the digestive tract. You're also more likely to be affected if you’ve had heartburn and indigestion before, or if you’ve been pregnant before.

What's the difference between heartburn and indigestion?

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

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 – you're certainly not alone if you’re feeling gassy and bloated: 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.

Will heartburn affect my baby?

No, heartburn can be searingly uncomfortable but it doesn't affect your baby in any way.

How can I avoid heartburn and indigestion?

Don't bend over too far. If you need to pick something up from the floor then squat to reach it instead. It sounds trivial but I found it really helped reduce heartburn during pregnancy.

Things which can make matters worse:

  • Smoking – get support with quitting on the Mumsnet Talk boards
  • 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

How can I treat heartburn and indigestion in pregnancy?

Relief for heartburn and indigestion

Everyday things you can do to ease the suffering:

  • Avoid the triggers listed above, such as spicy food and smoking
  • Try to keep meals small, or eat little and often
  • Avoid drinking excessive amounts with meals as fluids will expand the stomach more and irritate it
  • Eat slowly and chew well
  • Try drinking milk – many women say that it helps relieve the discomfort, but for some dairy products make it worse, so don’t be disheartened if it’s not for you
  • Chew sugarless gum after meals to increase saliva production and neutralise 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
  • Keep a food diary to help identify triggers
  • Acupuncture may help with some symptoms or with sleeping problems caused by heartburn
Anything minty works for me. Tic Tacs, polos, chewing gum – and if I’m really desperate and have none of those at hand, a bit of toothpaste. It might sound gross, but trust me anyone who suffers with it bad enough will try anything!

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.

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

However, some tablets might give you an upset stomach, and if your doctor has said you’re at a risk of hypertension or preeclampsia, make sure you talk to them before taking anything.

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.

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 this 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 first. These may include:

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

And – if nothing seems to help – when will the heartburn end?

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

Could something else be causing it?

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.

You are more likely to experience heartburn if you are expecting multiples, carrying a big baby (macrosomia) or if your baby is in breech position in late pregnancy, as his head might be pressing up under your diaphragm.

However, if you do not get relief from over-the-counter medicines after trying for two weeks, or if symptoms are very frequent, discuss this with your doctor in case there is another cause. Indigestion can also be caused by feeling stressed or anxious (which you might well be if you’re heavily pregnant) and conditions like ulcers, pancreatitis, gastritis, or gallstones.

Additionally, think about where the pain is coming from – heartburn pain usually travels up from your stomach to your throat, so if you find you have a sharp pain in the top of your belly below your ribs, it could be a sign of pre-eclampsia. If the pain is in the upper right side of your stomach and you’re vomiting, it could be a liver problem, so speak to your doctor to get checked over.

Symptoms can become more frequent in later stages of pregnancy as you get bigger. However, if you’re struggling to eat, your 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.

Does heartburn and/or indigestion in pregnancy mean my baby is going to be born with a full head of hair?

Er, well – no one really knows for certain, but scientists do believe there’s a link between high levels of oestregen (which can cause heartburn) and foetal hair growth. It’s not a sure thing though, so don’t assume that your dicky tummy means you’ll have Cousin It whizzing out of your fanjo.