Heartburn during pregnancy

Unfortunately there are no clear studies on the safety of heartburn medications on the growing fetus, and researchers are not going to test these drugs on pregnant women to evaluate how safe they are for the developing fetus, so the only option is to test these drugs on pregnant animals. There is no evidence that most of the acid neutralizing or suppressing drugs are harmful to the fetus although nonabsorbable medications are preferred.

Management of heartburn during pregnancy consists of many of the same home remedies and lifestyle changes for a person with heartburn who is not pregnant (see previous section on home remedies and lifestyle changes).

Women who have late pregnancies are more prone to the problem than those who become mothers at an early age.

Heartburn worsens under the following situations:

• If there is more than one baby in your womb.
• If your baby is big in size.
• If your baby is in breech position in the womb.

Is Heartburn An Early Sign Of Pregnancy?

Yes, heartburn could be an early sign of pregnancy. You will start experiencing it before your missed period.

However, heartburn alone doesn’t point to pregnancy as it is caused due to several other reasons such as eating spicy food or having acid reflux. It indicates pregnancy only if you are having other symptoms too.

Heartburn accompanied with acid reflux will begin in the initial few weeks of your pregnancy and will worsen in your third trimester (2).

What Causes Heartburn During Pregnancy?

Acid reflux occurs when the contents of your stomach flow back through the esophageal tube. The junction where the esophagus joins the stomach is called the cardiac sphincter. This cardiac sphincter must function correctly to stop this flow and keep the food in your belly.

1. Improper working of the cardiac sphincter:

If the cardiac sphincter does not work properly or becomes weak owing to your pregnancy, then it can lead to heartburn. This would cause the contents of your stomach to reach the esophagus. Certain enzymes and hormones secreted during your pregnancy cause this flow.

2. Hiatal hernia:

Heartburn can be a result of the condition called hiatal hernia. A hiatal hernia is caused when a part of your stomach pushes into the hiatus (an opening in the diaphragm) as your baby gets bigger (3). This blocks the food pipe, causing heartburn.

3. Infection due to H. pylori:

Helicobacter pylori is a type of bacteria that is capable of causing problems in your intestine (4). The presence of this bacterium in the mucus membrane of your stomach can cause bloating, burping, pain and even stomach ulcers, leading to heartburn.

4. Gastritis:

The chronic inflammation of your protective stomach lining is called gastritis. If you experience gastritis during pregnancy, this can lead to severe heartburn.

6. Other causes of heartburn:

Carrying multiple babies is one more reason for undue pressure on the sphincter, resulting in heartburn. There are a few more lifestyle causes for the condition:

• Overweight or obesity
• Smoking
• Eating oily and spicy food
• Excessive consumption of alcohol or caffeine
• Lying down or sleeping immediately after meals
• Strong medications
• Use of medicines like ibuprofen or aspirin

Most of the causes, other than the lifestyle choices, are majorly due to the pressure put by the expanding uterus on the sphincter. However, the food that you consume can also be the culprit.

Foods That Cause Heartburn During Pregnancy:

From coffee and alcohol to tomatoes and grapefruit, some foods are known to trigger heartburn:

1. Spicy foods:

Sweet or hot peppers, Mexican food, and other spices are inflammatory in nature. They create more acids, resulting in heartburn. Avoid such foods completely or take them in small amounts.

2. Alcohol:

Alcoholic beverages such as wine, beer, and spirits relax the sphincter muscle, which creates an opening. The food in the stomach comes back from the opening. Alcohol also increases the production of acid in the stomach.

3. Fatty foods:

High-fat foods such as cheese, nuts, and red meat can stimulate heartburn as fatty foods slow down the digestion process. The stomach generates more acids to complete the digestion, thus resulting in heartburn.

4. Carbonated drinks:

Gas present in the carbonated drinks or sparkling water gets trapped in your tummy, thereby, creating pressure. This causes the acids to travel back into the esophagus.

5. Citrus fruits:

They contain acids, which make the heartburn worse especially when taken on an empty stomach. Grapefruit, tomatoes, and oranges are some fruits which you need to stop eating to avoid heartburn.

6. Caffeine:

Like alcohol, high amount of caffeine also relaxes the sphincter, creating an opening through which the food can escape and lead to heartburn. Therefore, have coffee, tea and other caffeinated beverages in small portions.

7. Garlic and onion:

Garlic and onion, like the other root vegetables, increase the gastric acids. They also slow down the stomach from emptying its content, causing reflux. Dried or dehydrated forms of these foods are better than the fresh or raw ones.

8. Peppermint:

Peppermint is soothing for the stomach but triggers heartburn. Avoid taking after-meal mint as it can worsen heartburn. It relaxes the sphincter muscle, thus allowing the stomach acids to travel back into the esophagus.

9. Chocolate:

Chocolate has caffeine and, so, causes heartburn. It also contains other heartburn stimulants such as theobromine. Too much chocolate can make the sphincter to relax.

If you think you have consumed a little too much of the above foods, or in general, you suspect heartburn, look for its symptoms.

Symptoms Of Heartburn During Pregnancy:

Do not neglect the symptoms of heartburn during pregnancy as they could be signals sent by your body to indicate that something is not right. You might have one or a few of these symptoms:

1. Throat pain while swallowing
2. Difficulty in swallowing food
3. Panic and breath shortness
4. Bloody stools
5. Sudden pain in the back radiating towards shoulders
6. Feeling of dizziness or light-headedness
7. Pain in the chest
8. Profuse sweating and chest pain

When Is Heartburn A Serious Issue?

Heartburn can sometimes be associated with heart attack. Hence it is important for you to seek immediate medical help if you face these severe symptoms.

• Breathing difficulty
• Arm or jaw pain
• Extreme pain in the chest

Self-Help Measures To Manage Heartburn During Pregnancy:

When the heartburn is severe, you need to see the doctor immediately. However, if it is mild, follow these self-help tips for relief:

The major triggers for heartburn are eating, bending over and lying down. Minimize these to mitigate heartburn.

1. Choose easy-to-digest foods and drinks. Stay away from highly fatty or spicy foods, citrus fruits, chocolates, alcohol, coffee and the other foods mentioned above.

2. Eat often in small portions as it restricts the stomach from generating excessive acids (5).

3. Stop smoking as it relaxes the valve between the stomach and esophagus, causing acid reflux. It can also be harmful to the fetus.

4. Slumping posture can be harmful. Bending or leaning can make the symptoms worse. Sit straight and remain upright for at least one-hour after eating.

5. Avoid eating or drinking just before bedtime. Heartburn can be worse in the night. Have a gap of three hours between your supper and sleep.

6. Sleep propped up. Keep some cushions to raise your head or some sturdy objects under the head-end of the bed. Gravity works here by keeping the stomach acids in place and aids better digestion (6).

7. Medications can also be risky. Some medications such as non-steroidal drugs and antidepressants can make the heartburn worse. You should check with your doctor if you have heartburn due to these medications.

8. Chew gum after meals. It helps to stimulate the salivary glands as saliva neutralizes stomach acids (7).

9. Wear comfortable and loose clothing. See to it that there is no tightening around your tummy and waist as it can increase the pressure and trigger heartburn.

Though you may not completely avoid heartburn through the above measures, they can provide your some relief.

Club them with some home remedies for more relief.

Home Remedies For Relief From Heartburn:

Try these natural cures for heartburn instead of opting medications. However, for severe conditions, you need to follow your doctor’s prescriptions.

1. Almonds:

Raw Almonds are considered one of the best remedies for curing heartburn. The rich oil content in almonds helps in reducing heartburn by controlling gastric acid production. Remember the crunchier they are, the better it is for you.

2. Aloe vera juice:

Aloe vera plant is good for several pregnancy-related problems. You can juice the pulpy center of this plant and consume it for a soothing feel. This will help in reducing heartburn and bring a glow to your skin.

3. Coconut water:

You will be amazed to know that this useful acid neutralizer can put an end to your heartburn. Drink for quick relief from heartburn.

4. Fennel seeds:

Fennel seeds not only enhance the flavor of your dishes but also cure heartburn. Take two teaspoons of fennel seeds in half a cup of boiling water, and leave it for 10 minutes to steep. Strain it consume. This concoction can give immediate relief to your heartburn.

5. Apple cider vinegar:

Raw vinegar usually has a nasty tangy taste. Apple cider vinegar, though vile in taste, can make your stomach produce fewer acids. This helps to stop your heartburn immediately.

6. Ginger:

Ginger is anti-inflammatory. It absorbs the excess acids generated in the stomach and regulates the flow of the juices to ensure timely digestion of food. A cup of ginger tea in the morning can be a wonderful remedy for your gastric troubles.

7. Heartburn tea:

This is a special tea, which can be purchased from reputed herbal stores. Herbal seeds and leaves make it highly nutritious and cure your heartburn effectively. However, read the label of the tea pack to make sure there are no allergic ingredients.

8. Papaya:

After a meal, chew some pieces of papaya to let its enzymes flow into your digestive system. This will lower the production of acids in your stomach and put an end to your heartburn.

9. Fresh liquids:

Nothing cures heartburn better than healthy living. Drink lots of water and fresh fruit juices to help cure heartburn effectively. Drink sufficient water throughout the day and enjoy a glass of fresh fruit juices every morning.

The best thing about all the above home remedies is that they are affordable and do not have side effects. However, consult your doctor before taking having these home remedies, and also do not overdo them.

Treatments For Heartburn:

If your heartburn does not subside in spite of all your efforts, your doctor will suggest a few medications:

1. Antacids such as Tums (8) are prescribed if the heartburn is strong. They neutralize your stomach acids.

2. Alginates also provide relief from heartburn. They form a protective layer over the walls of your stomach and esophagus and provide relief against reflux.

Beware:

• Antacids will interfere with iron absorption if you take them without enough time gap. Schedule different timings for the two medications.

• Certain antacids contain higher amounts of sodium, which stimulate fluid buildup in the body tissues. If it is severe, you should see your doctor immediately.

Heartburn is a minor problem during pregnancy, but it ruins your day. Also, it is not an ailment in itself but severe and frequent heartburn could indicate a serious health issue. Therefore, never neglect it. Use some home remedies for minor irritation and for a recurring problem, see a specialist doctor.

Did you experience heartburn during your pregnancy? What did you do to ward it off? Share your tips and thoughts with other expecting mothers in the comment section below.

How is heartburn diagnosed?

Often all that a health-care professional requires is a thorough history and physical to make the preliminary diagnosis of heartburn. To evaluate if there is any damage and how severe your heartburn is, the doctor my suggest some of the following tests:

• Endoscopy: A flexible scope is passed down the esophagus to examine the esophagus as well as the stomach. Biopsies can be taken if indicated. This lets the doctor see if there is any obvious damage, and also eliminate other reasons for the patient’s symptoms (foreign body, malignancy).
• Upper GI series (upper GI series): After drinking a liquid that coats the inside of the digestive tract, X-rays are taken. These X-rays will show the outline of the digestive system.

• Ambulatory pH testing: This test measures the acidity in the esophagus via a small tube that goes through the nose into the stomach.