Heartburn and Indigestion in Pregnancy

If you're pregnant and you're suffering from heartburn or indigestion, you are not alone. Up to 75% of pregnant women can suffer from heartburn by the third trimester of their pregnancy.¹

But please be reassured that neither of these two conditions should have any health impact on your baby. Apart from the pain and discomfort that they may cause you, they shouldn't cause any other ill effects.

In this article we're going to have a look at what causes heartburn and indigestion in pregnancy, suggest some ways you can try to avoid these conditions and to help you identify treatments that can reduce the symptoms.

Why are heartburn and indigestion common in pregnancy?

There are two main reasons why heartburn and, to a lesser extent, indigestion may occur frequently when you're pregnant:

Hormone-associated changes

The hormone progesterone can cause muscles in your body to relax. When you're pregnant, there is a surge in the levels of this hormone. One of the muscles that can be affected is the one at the entrance to your stomach. This muscle is also called the lower oesophageal sphincter. Its function is to open in order to allow food into your stomach and then to close to keep your stomach contents in place.

But if the effect of progesterone causes this muscle to relax, your stomach contents, including stomach acid, can pass up/ reflux, into your food pipe, which is also called oesophagus.

The lining of the oesophagus can't withstand the effect of too much stomach acid for too long, since it does not have the same lining as your stomach. Consequently, pain can result.

Your growing baby

As your baby grows, it gradually puts extra pressure on your digestive tract, including your stomach and intestines. The pressure on your stomach can cause acid to be pushed upwards into the oesophagus and again this can result in causing you pain.

You could be more likely to suffer indigestion when you are pregnant:²

• if you suffered from indigestion before you became pregnant
• if you have been pregnant previously

Heartburn and indigestion can also occur for other reasons. For example, food and drink can also stimulate your stomach to produce excess acid, which can begin to break down the protective stomach lining. This is the innermost layer of the stomach that's directly in contact with its contents - including stomach acid.  If this occurs, it can be a cause of indigestion.

Symptoms of heartburn and indigestion in pregnancy

Broadly, Reflux or Reflux symptoms can be described as:

• An acidic taste  that may sometimes be accompanied by the feeling of sickness
• A hoarse feeling at the back of your throat, accompanied by a bitter taste. (This is often described as silent reflux, or reflux cough, but it isn't usually associated with a burning pain.).

More specifically for Heartburn, symptoms are often described as:

• A hot pain or burning sensation in the chest area, usually behind the breast bone
• A tight feeling in your chest

If heartburn occurs, the feeling may last for anything between a few minutes to several hours, if you're having a severe bout.

Indigestion is usually described as:

• A pain in the lower part of your chest, abdomen or in your stomach. Usually coming on after a meal, although not necessarily straight away
• A "bloated" feeling. Such as when your stomach feels full, bursting or pushing outwards
• A need to burp or pass wind, due to a buildup of gas
• A feeling of nausea

Treating heartburn and indigestion in pregnancy

1. Self help

As we've already said, most pregnant women can experience heartburn and indigestion, but here are some helpful hints that might help you minimise their frequency:

Eating Habits

• Even though you're pregnant, it isn't essential to eat twice as much. Excess weight gain may cause problems later in your pregnancy. For women with a normal pre-pregnancy weight, a 10-14 kg weight gain during pregnancy is associated with the lowest risk of pregnancy complications, according to the World Health Organisation (WHO).³

Relax

• Pregnancy should be a happy exciting time for Mum's and families, but you may find there are times when you can feel a little stressed. Since stress can also be linked to heartburn and indigestion, try to give yourself regular "me time" to help you unwind and help keep stress down to a minimum.

Try these physical measures

• When you've finished eating, try sitting or standing for a little while, rather than lying down. And aim not to do anything too active once you've eaten, especially if it would involve bending forwards.
• Try not to put any unnecessary pressure on your waist and abdomen. So watch out for tight waist bands, for example. And be careful if you allow children or pets onto your lap.
• Adjusting your sleeping position may also help if the problems are happening at night. Laying or sleeping on your back may increase the chance of acid moving into your oesophagus.  Some people find that propping up the head end of the bed can help. But always take great care with physical measures like this - whether you're pregnant or not!

2. Medication

If you're pregnant you may worry about taking medications. Understandably, you don’t want to risk injury to your baby. However, the following types of medications can be taken during pregnancy - although you should always speak to your healthcare professional before use and always read the label:

Antacids

• These treatments usually contain ingredients like calcium carbonate, magnesium carbonate or aluminium hydroxide, which have an acid neutralising effect. Often used for mild bouts of indigestion or heartburn, they are available in various formulations, including liquid and chewable tablets.

Alginates (rafting agents)

• Alginates are components extracted from brown seaweed. They work by forming a foam barrier that floats on the surface of your stomach contents. This keeps stomach acid in your stomach and away from your oesophagus.²
• Gaviscon Extra is a product that has a combined alginate-antacid formulation. The sodium alginate in Gaviscon works by producing a protective layer, or raft, on top of the stomach contents. This forms a strong protective barrier to help prevent stomach acid getting up into the oesophagus.
• Additionally, the Gaviscon contains calcium carbonate and sodium bicarbonate, which work quickly to neutralise stomach acid. Gaviscon offers a long-lasting effect that's up to twice as long as an antacid.

Gaviscon Extra is suitable for use during pregnancy

If you take antacids or an alginate-based product, like Gaviscon Extra, remember not to take any more than advised. Carefully follow the instructions in the leaflet that comes with the medication. Take the product in the correct way and at no more than the recommended dose advised in the leaflet.

Other potential treatments

The following medications are not routinely given during pregnancy. They should only be taken during pregnancy if absolutely necessary and on the advice of, or if prescribed by, a doctor or other qualified healthcare professional:

• Histamine H2-receptor antagonists (H2- antagonists or H2-blockers)
• H2-antagonists work by turning off chemical receptors in the cells in your stomach lining that make the acid. As a result, the acid production is reduced or stopped. They can be bought over-the-counter from a pharmacy, or be prescribed by a doctor. But you should let them know you are pregnant before buying or taking them.

Proton pump inhibitors (PPIs)

• PPIs stop stomach acid production in a different way to H2-antagonists. They block the acid pumps, which are the source of acid in the stomach. Some PPIs can be bought over-the-counter, while others are only available on prescription. But once again, you should let pharmacists or doctors know that you're pregnant before buying or taking them.

Asking for help

If you are in any doubt about your symptoms, your doctor or pharmacist will be only too glad to help and advise you. And if you're unsure about which medication to choose, always let them know you are pregnant. 

 

All information presented is not meant to diagnose or prescribe. Gaviscon Extra Oral Suspension, and Gaviscon Extra Chewable Tablets contain Sodium alginate, Sodium hydrogen carbonate, Calcium carbonate for Heartburn & Indigestion. Always read the label. If symptoms are severe or prolonged you should consult a doctor or pharmacist.

 

 

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