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Despite its name, heartburn has nothing to do with the heart. (Some of the symptoms, however, are similar to those of a heart attack or heart disease.) Heartburn is an irritation of the esophagus that is caused by stomach acid and is a common pregnancy complaint, especially in the third trimester when the growing uterus places pressure on the stomach. With gravity's help, a muscular valve called the lower esophageal sphincter, or LES, keeps stomach acid in the stomach. The LES is located where the esophagus meets the stomach -- below the rib cage and slightly left of center. Normally it opens to allow food into the stomach or to permit belching; then it closes again. But if the LES opens too often or does not close tight enough, stomach acid can reflux, or seep, back into the esophagus and cause a burning sensation. Occasional heartburn isn't dangerous, but chronic heartburn can indicate serious problems, such as gastritis or gastroesophageal reflux disease, also called GERD. Heartburn is a daily occurrence for 10% of Americans and 50% of pregnant women. It's an occasional nuisance for another 30% of the population. If you didn't have heartburn before you were pregnant, it will probably go away when your baby is born. Common heartburn symptoms reported by pregnant women include:
To ease heartburn during pregnancy without medications, you should try the following:
If your heartburn persists, see your doctor. They may recommend over-the-counter antacids or prescribe drugs that are safe to take during pregnancy. Pregnancy-related heartburn usually disappears after childbirth. Reach out to your doctor if you:
Medically Reviewed by Neha Pathak, MD on August 25, 2020 More than half of pregnant women get serious heartburn, particularly during their second and third trimesters. Heartburn, also called acid indigestion, is an irritation or burning sensation of the esophagus (the tube that carries food and liquid to your stomach when you swallow). It’s caused by stomach contents that reflux (come back up). If you have heartburn while you’re pregnant, you may:
Heartburn in pregnancy may happen because of changing hormone levels, which can affect the muscles of the digestive tract and how your body handles different foods. Pregnancy hormones can cause your lower esophageal sphincter (the muscular valve between the stomach and esophagus) to relax, allowing stomach acids to flow back up into your esophagus. Also, as your baby grows, your enlarged uterus can crowd the abdomen, pushing stomach acids upward. Although it's rare, gallstones can also cause heartburn during pregnancy. Some tips that may help you cut down on heartburn during your pregnancy include:
If your heartburn won’t go away, see your doctor. They may prescribe or recommend OTC medications that are safe to take during pregnancy. Heartburn usually disappears following childbirth. Medications may include: Over-the-counter antacids such as calcium carbonate or magnesium hydroxide. These are generally safe to use during pregnancy. You may find that liquid heartburn relievers are more effective in treating heartburn, because they coat the esophagus. H2 blockers. These medications block chemical signals that produce stomach acid. They include cimetidine (Tagamet) and famotidine (Pepcid, Zantac 360), and they’re available in over the counter and prescription strengths. Proton pump inhibitors (PPIs). Like H2 blockers, these drugs help cut down on stomach acid. PPIs, which include lansoprazole (Prevacid) and omeprazole (Prilosec), are available over the counter and by prescription. If you take iron supplements, talk to your doctor before you take a PPI or H2 blocker. These medications can make the supplements less effective. Talk to your doctor before taking any antacids. Some contain ingredients that may harm you or your baby. Be sure to not to take these medications: Ranitidine. In 2020, the FDA stopped sales of an H2 blocker called ranitidine (the ingredient in older Zantac products) because it was contaminated with a cancer-causing agent. If you take OTC ranitidine, stop your use. If you have a prescription for ranitidine, talk to your doctor about other options before you stop your medication. Medically reviewed by Valinda Riggins Nwadike, MD, MPH — Written by Donna Christiano on August 13, 2019
WITHDRAWAL OF RANITIDINE You expected the swollen ankles, the morning sickness, and the burgeoning breasts. But this burning indigestion? Where’d that come from? As the name implies, heartburn (also called gastroesophageal reflux and acid indigestion) feels like a fiery churning that starts behind your breastbone and travels up your esophagus, a tube connecting your throat to your stomach. These acids can even make it all the way up your throat. In addition to feeling a burning sensation — which can last several minutes to several hours — you may also:
While the burrito you ate for dinner probably didn’t help matters (spicy foods can make heartburn worse), the burning feeling you have has more to do with hormones than jalapenos. If you feel like you have a three-alarm fire dancing in your chest, you’re not alone. According to one study, up to 45 percent of moms-to-be experience heartburn. And if you had heartburn before pregnancy, you’re even more likely to have it during. Heartburn can fire up, so to speak, at any point in pregnancy, but it’s most common during the second and third trimesters. Experts aren’t exactly sure what causes the smoldering, but they suspect it’s a three-pronged problem. HormonesProgesterone, also called the “pregnancy hormone” because it nurtures your womb and the baby inside it, is the leading culprit behind pregnancy-related heartburn. Progesterone acts as a muscle relaxer. In the case of heartburn, the hormone can loosen the tight muscle (called the lower esophageal valve) that closes your stomach off from your esophagus. When you eat or drink, the muscle normally opens to let contents into the stomach before shutting tightly. But the surging progesterone levels that occur during pregnancy can make that muscle slack, allowing stomach acid to backflow up your esophagus and even into your throat. Growing babyAs your uterus expands with your growing baby, it competes for space with some of your other organs. Like a tube of toothpaste being squeezed, your growing uterus places pressure on your stomach, making it more likely stomach acids will spill out ― especially if your stomach is full. The more your uterus grows, the more likely your stomach will get squeezed. This may help explain why heartburn is more common as you progress through pregnancy. Slowed digestionThanks to progesterone, stomach contents stick around longer than normal. As digestion slows and the stomach remains fuller longer, the chances of heartburn increase. Heartburn can be uncomfortable, but here’s how to fire back: 1. Watch what you eatNot surprisingly, acidic and spicy foods create more stomach acid than bland ones (till we meet again, Taco Tuesday!). Avoid citrus, tomatoes, onions, garlic, caffeine, chocolate, sodas, and other acidic foods. Also steer clear of fried or fatty foods, which slow digestion. 2. Eat frequent small meals instead of three a dayThis helps to avoid overwhelming the stomach and allows it to empty quicker. 3. Sit up straight when you eatYour mom was actually right about this — and well, a lot of other things, too. Gravity will help your food stay put. 4. Don’t eat within three hours of going to bedGiving digestion a head start before you lie down — which slows the emptying of your stomach — for the night will help control your heartburn. 5. Don’t smokeThere are a lot of reasons why you shouldn’t smoke during pregnancy, and heartburn is just one of them. Chemicals in cigarettes cause the valve that keeps stomach contents down to relax. This allows acids and undigested foods to splash upward and take their fiery aim. 6. Elevate your head 6 to 9 inches when you sleepThe easiest way to achieve this is by placing pillows under your shoulders, raising the head of your bed with blocks placed underneath the bed’s legs, or buying a special wedge pillow to place between the mattress and box spring. Sleeping propped up is another way to have gravity work for you. 7. Wear loose-fitting clothingStep away from the Spanx and any other garment that creates pressure around your midsection. Rock your bump, and the stretchy, comfy pants, too! 8. Drink after meals, not with themDrink liquids along with your food and you could be creating an overfull, sloshy stomach environment primed for heartburn. 9. Give acupuncture a tryIn a 2015 study, pregnant women who received acupuncture versus those who didn’t showed no difference in their symptoms — but the women who had acupuncture did report improvement in their ability to sleep and eat. 10. Don’t drink alcoholBesides the fact that exposure to alcohol can cause all kinds of problems for your developing baby ― everything from low birth weight to learning disabilities ― alcohol can also relax the valve that keeps stomach contents in the stomach. 11. Talk to your doctor about heartburn medicationsThis includes over-the-counter (OTC) ones — some are safe to take during pregnancy. Antacids help neutralize the acid in your stomach and quell that burning sensation. The University of Wisconsin School of Medicine and Public Health says OTC antacids containing calcium carbonate (like Tums) are safe to use. If you haven’t been able to quiet your heartburn with lifestyle changes, your doctor may suggest heartburn drugs like Tagamet and Prilosec, which are generally considered safe during pregnancy. While these drugs are available OTC, you might receive a prescription for a stronger dose if your doctor thinks it’s warranted. When you’re pregnant, you have to think about the safety of everything you put into and on your body. Some heartburn medications that might be OK for your nonpregnant sister ― but not for you ― include:
While pregnancy heartburn is common and uncomfortable, the sizzle should subside once you give birth and hormone levels return to normal. You may not be able to prevent heartburn, especially if you’re prone to it even when you’re not pregnant, but you can help put out the flames with some simple lifestyle changes, such as eating small meals, avoiding spicy or fatty foods, and sleeping with your head and shoulders elevated. If these measures don’t bring enough relief, talk to your doctor about medications that are safe to use during pregnancy. Last medically reviewed on August 13, 2019 |