Heartburn during pregnancy is a common discomfort. According to statistics, between 30% to 80% of pregnant women experience symptoms of heartburn, indigestion, or acid reflux. This condition can start at any stage of pregnancy but is more common in the second and third trimesters when the baby grows.
Heartburn happens when food and stomach acid flow back into the esophagus. The stomach lining can withstand acid and digestive enzymes, unlike the esophagus, which is more sensitive. That is why when stomach acid moves up, it causes a burning sensation known as heartburn.
It is important to know that heartburn during pregnancy is harmless to the mother or baby. However, it can be quite uncomfortable and may affect sleep quality. In some cases, the pain can be intense and resemble a serious pregnancy complication called preeclampsia. In the following sections, we will discuss the causes of heartburn during pregnancy and how to relieve it.
What Is Heartburn during Pregnancy?
Despite its name, heartburn during pregnancy has nothing to do with the heart. But, some of its symptoms can resemble those of a heart attack or heart disease. In reality, heartburn is the irritation of the esophagus caused by stomach acid. It is one of the most common pregnancy complaints, especially in the third trimester when the growing uterus puts pressure on the stomach.
Heartburn during Pregnancy
A muscular valve called the lower esophageal sphincter (LES) helps keep stomach acid in place with the aid of gravity. The LES is located where the esophagus meets the stomach, just below the chest and slightly to the left of the center. Normally, this valve opens to allow food into the stomach or to let out a burp, then closes again. However, if the LES opens too soon or does not close tightly enough, stomach acid can flow back into the esophagus, causing a burning sensation.
Occasional heartburn is not dangerous, but chronic heartburn may be a sign of more serious conditions, such as gastritis or gastroesophageal reflux disease (GERD). Heartburn affects about 10% of the general population daily and occurs in 50% of pregnant women. For 30% of people, it is an occasional but bothersome issue.
Heartburn during Pregnancy Causes
Doctors are not entirely sure what causes heartburn during pregnancy, but they believe it results from a combination of three main factors:
Hormonal Changes
The primary culprit behind pregnancy-related heartburn is progesterone, often called the “pregnancy hormone.” This hormone helps relax muscles throughout the body, including the lower esophageal sphincter (LES)—the valve that separates the stomach from the esophagus.
Normally, the LES stays closed to prevent stomach acid from flowing back up. However, during pregnancy, increased progesterone levels relax this valve, allowing acid to escape into the esophagus and even reach the throat, causing heartburn.
Growing Baby
As the uterus expands to accommodate the developing baby, it pushes against other organs, including the stomach. This pressure on the stomach and LES makes acid reflux more likely, especially when the stomach is full. This is why heartburn tends to worsen as pregnancy progresses.
Slower Digestion
Higher progesterone levels also slow down digestion, causing food to remain in the stomach longer than usual. This increases the risk of acid buildup and reflux, leading to heartburn.
Heartburn during Pregnancy Causes
Other Factors That Can Cause or Worsen Heartburn During Pregnancy
- Certain Medications: Some anti-nausea drugs used during pregnancy can trigger or worsen heartburn.
- Preexisting Acid Reflux: Women who had acid reflux before pregnancy or in a previous pregnancy are more likely to experience heartburn.
- HELLP Syndrome: A severe pregnancy complication known as HELLP syndrome can cause symptoms like heartburn, stomach pain, a burning sensation in the chest, and pressure in the upper abdomen.
- Overeating: Eating large meals can overfill the stomach, increasing pressure and acid reflux.
- Spicy, Fatty, or Processed Foods: Eating foods high in fat, spice, or processed meats can worsen symptoms.
- Citrus, Tomatoes, and Caffeine: Consuming acidic foods like citrus fruits, tomatoes, chocolate, caffeine, and carbonated drinks can trigger heartburn.
- Smoking: Smoking weakens the LES and increases stomach acid production, making heartburn worse.
- Obesity: Excess weight puts extra pressure on the stomach, increasing acid reflux.
- Alcohol Consumption: Drinking alcohol during pregnancy can irritate the stomach lining and worsen heartburn.
Heartburn during Pregnancy Symptoms
Heartburn symptoms can vary from person to person. However, common signs of heartburn in pregnant women include:
- Burning sensation in the chest: A feeling of burning discomfort behind the breastbone, usually occurring after eating and lasting from a few minutes to several hours.
- Chest pain: Especially noticeable after bending over, lying down, or eating.
- Burning in the throat: A sensation of warmth, sourness, or saltiness at the back of the throat.
- Burping (belching): Frequent burping, often accompanied by a bitter or acidic taste.
- Chronic cough: A persistent cough that may worsen after meals.
- Hoarseness: Changes in the voice, making it sound rough or strained.
- Wheezing or asthma-like symptoms: Some pregnant women experience shortness of breath or wheezing, similar to asthma.
Heartburn during Pregnancy Symptoms
Heartburn during Pregnancy Treatment
Nowadays, many medications can help relieve heartburn during pregnancy. Antacids, which neutralize stomach acid, are among the most common options. Calcium-carbonate-based antacids are widely used for heartburn relief.
If the heartburn is severe, a doctor may prescribe acid-reducing medications such as sucralfate, H2 receptor antagonists, or proton pump inhibitors like ranitidine and omeprazole. A 2015 study also highlighted the benefits of combining sucralfate with lifestyle changes in managing acid reflux during pregnancy.
Medications to Avoid During Pregnancy
During pregnancy, it is crucial to consider the safety of everything you consume. Some antacid medications are not suitable for pregnant women, including:
- Sodium bicarbonate-based antacids: These can increase swelling of the valve between the stomach and esophagus, worsening reflux.
- Aspirin-containing antacids: These can be harmful to the baby, as aspirin use during pregnancy is linked to miscarriage, heart defects, and brain bleeding in premature infants.
- Magnesium trisilicate-based antacids: Their safety in pregnancy has not been fully established.
If you are taking medication for other conditions, such as antidepressants, consult your doctor, as some drugs can worsen acid reflux. Only stop taking prescribed medication if your doctor advises you to do so. Additionally, antacids can interfere with iron absorption, so avoid taking iron supplements and antacid tablets at the same time to ensure proper nutrient absorption.
When to See a Doctor?
A pregnant woman should regularly visit her doctor or midwife and report any symptoms, no matter how minor. Some serious conditions can present symptoms similar to heartburn and may require urgent medical attention.
- Home remedies and over-the-counter medications are not providing relief.
- Heartburn is so severe that it disrupts your sleep.
- Your symptoms worsen after taking medication or are accompanied by high blood pressure, unexplained pain, or changes in fetal movement.
- You experience side effects from medications, such as skin rashes or diarrhea.
- Heartburn persists for several days after giving birth.
Heartburn during Pregnancy Treatments
Final Word
As mentioned earlier, indigestion, also known as heartburn or acid reflux, is common during pregnancy. This can be due to hormonal changes and the growing baby putting pressure on the stomach. During pregnancy, the hormone progesterone increases, causing muscles to relax, including the valve between the esophagus and stomach.
This valve normally prevents stomach acid from flowing back up, but when it relaxes, acid can easily move into the esophagus, especially after eating or when lying down. As a result, heartburn occurs. For some mothers, this condition can be frustrating and uncomfortable. However, you can reduce heartburn and indigestion by making changes to your diet and lifestyle. Some medications are safe to use during pregnancy. If you experience persistent heartburn, be sure to consult a doctor. With the right guidance, you can have a more comfortable pregnancy.
