Heartburn and indigestion in pregnancy: causes, symptoms and remedies
Emily Cater
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Heartburn and acid reflux – both signs of indigestion – are unpleasant and uncomfortable pregnancy symptoms. We look into what causes them and why they're so common in pregnancy. Plus, from home remedies to over-the-counter or prescribed medicines, we look at how to get rid of heartburn safely and effectively.
What is heartburn?
Heartburn – or acid reflux – describes the burning, uncomfortable feeling in your chest that can begin after eating.
These effects are caused by stomach acid that escapes into the tube that links your tummy with your throat and mouth (oesophagus).
Although heartburn and acid reflux mean the same thing, they're not quite the same as indigestion.
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In fact, technically, heartburn and reflux are actually a symptom of indigestion (alongside others such as fullness, bloating, nausea, gassiness etc).
However, most of us use the terms indigestion, acid reflux and heartburn equally to describe the general discomfort such as pain, burning and acid after eating.
What causes heartburn in pregnancy?
According to the NHS, heartburn in pregnancy is caused by three main things. These are:
- pregnancy hormones and hormonal changes
- the baby growing inside you and pressing on your stomach
- muscles relaxing and allowing stomach acid to come back up rather than stay in your stomach - again, largely due to those pregnancy hormones
It also states that you're more likely to get heartburn or indigestion in pregnancy if:
- you suffered from indigestion before you were pregnant
- you've been pregnant before
- you're in the later stages of pregnancy
Can you get heartburn in early pregnancy?
Although some people find that heartburn is an early sign of pregnancy, it actually tends to start later on.
The NHS says it's most common towards the start of your third trimester, from around the 27-week mark.
However, it can start at any time.
Research from Rennie found that heartburn affects:
- 22% of women in the first trimester
- 39% in the second trimester
- 72% in the last trimester.
The good news is that it should stop after the birth of your baby.
What are the symptoms of heartburn?
Signs and symptoms of heartburn could be all or some of the following:
- a burning feeling in your chest or back of your throat
- pain in your chest
- being gassy ie burping or feeling the need to burp a lot
- feeling sick or being sick
- a bitter, salty or sour taste in the back of your throat
The symptoms often come on soon after eating and drinking, but sometimes there's a bit of a delay. Heartburn can be particularly bothersome at night. This is because, when you lie down, it's easier for the stomach acid to make its way up into your oesophagus.
The best ways to treat heartburn in pregnancy
Although there are medicines and remedies that are safe during pregnancy (see below), there are lots of non-medicinal things you can try doing to relieve symptoms of indigestion in pregnancy.
These include making dietary and lifestyle changes such as:
- eating little and often – overeating can cause or worsen heartburn.
- avoiding eating for three hours before bed – a big, heavy late dinner won't help.
- avoiding caffeine, and spicy, fatty and rich foods - review your diet and make sure you're getting plenty of veggies.
- eating sitting up – a good posture can help
- propping yourself up in bed – use pillows to help stop stomach acid coming up when you're asleep
- cutting out alcohol – drinking alcohol causes indigestion so stick to latest medical advice, which says to avoid alcohol during pregnancy.
- not smoking – again this is warned against in pregnancy anyway but will make indigestion and acid reflux worse if you carry on
Of course, if these don't work or your heartburn is severe, your GP will be able to prescribe something to help (see below).
What's the best thing to take for heartburn and indigestion in pregnancy?
There are plenty of heartburn treatments available over-the-counter so you can always visit your nearest pharmacy for advice. Always check with a pharmacist before taking any OTC medicines in pregnancy, as some may not be safe for your developing baby.
However, if you're pregnant it's a good idea to see your GP before you start taking something.
Your GP will be able to recommend the best medicine that takes into account your health and pregnancy. For instance, you may not be able to take heartburn remedies if you're at risk of or have:
- pre-eclampsia
- kidney stones
- high blood pressure
- anaemia (low iron)
Antacids – medicines that neutralise the acids in your stomach – can stop iron being absorbed by your body and may make iron supplements ineffective if you take them at the same time.
If you're taking iron for anaemia, your GP will make sure you know how and when to take both.
Another advantage of seeing your GP is that prescriptions are free during pregnancy so any treatment or medication won't cost you a penny.
Different ways to treat heartburn include:
- antacids – as mentioned above, taking an antacid will reduce excess stomach acids to relieve symptoms. Pregnancy-friendly antacids include Rennie.
- alginates – these form a layer on top of the stomach contents and help to reduce reflux. Gaviscon is a commonly used alginate during pregnancy.
If antacids don't help, your GP may prescribe something stronger, such as:
- ranitidine
- omeprazole
These are safe during pregnancy and work by reducing the amount of acid your stomach makes.
Taking Gaviscon during pregnancy
Many mums swear by Gaviscon during pregnancy to soothe and relieve the burning and acid caused by heartburn and indigestion.
The NHS says that Gaviscon is usually safe to use in pregnancy. This is because it doesn't need to be absorbed into the bloodstream to work.
According to Gaviscon:
'It works with the body by forming a protective barrier on top of the stomach contents. The physical barrier helps prevent the acid rising into the oesophagus (food pipe) meaning that Gaviscon does not need to be absorbed into the bloodstream to provide effective relief.'
Although it can be tempting to swig it from the bottle when your heartburn is bad, make sure you stick to the amounts your doctor prescribes.
Gaviscon can be bought as a liquid – see more details here at Amazon – or in easy-to-swallow tablets – see more details here at Boots.
Milk for heartburn
Some people swear by drinking milk for heartburn and indigestion, and it is often touted as an easy solution which *may* help relieve symptoms.
However, many studies and health authorities including patient.info claim that the fats in milk, particularly full-fat milk, can actually stimulate stomach acid, making your heartburn worse.
So is it a placebo, then? Well, everyone is different, and if it works for you, then there's certainly no real harm in drinking it.
Experts recommend though, that if you want to try milk for pregnancy indigestion and heartburn, you drink skimmed or semi-skimmed milk, or low-fat yoghurt.
When to see your GP for heartburn
During pregnancy there's no harm in seeing your GP for help with your heartburn, acid reflux or indigestion – especially if it's stopping you eating, sleeping or is severe and unmanageable.
The NHS also recommends seeing a doctor if you:
- keep getting indigestion
- are in bad pain
- have lost a lot of weight without meaning to
- have difficulty swallowing (dysphagia)
- keep vomiting
- have iron deficiency anaemia
- feel like you have a lump in your stomach
- have bloody vomit or poo
These symptoms can be a sign of something more serious, so it's always worth getting checked out and asking for more information.
Does having heartburn in pregnancy mean my baby will be hairy?
Many people think that severe heartburn in pregnancy means that a baby will be born with lots of hair.
There isn't much evidence to support this, but one small 2006 study did find a link; among 64 pregnant women, those who had the worst heartburn also tended to have the hairiest babies!
We still need more research to be sure there's a link. But if it exists, experts think that it's probably not because the baby's hair causes heartburn. Instead, it's more likely that the hormones which make heartburn particularly bad are the same hormones that encourage hair growth in babies.
Who knew?!
Are you pregnant and suffering from symptoms of indigestion? Share your tips and tricks for managing it with other pregnant mums over on our forum:
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