Heartburn or acid indigestion is perhaps one of the most common pregnancy complications, as 40%-80% of all pregnant women will experience this discomfort. Heartburn happens when stomach acids build up into the esophagus. In pregnancy, progesterone hormones relax the muscles in the uterus in preparation for delivery. These hormones may also relax the lower esophageal sphincter (LES), the valve that opens and closes to allow food to pass from the esophagus to the stomach. When the LES is relaxed, it can remain open allowing stomach contents to flow backward into the esophagus and throat. Progesterone also slows the rhythmic contractions of the esophagus and intestines that aid in digestion of food. As a pregnancy progresses, the growing baby may also put pressure on an expectant mother’s stomach and abdominal cavity, causing the stomach contents to be pushed against the LES and into the esophagus and throat, resulting in the characteristic heartburn.
Heartburn symptoms include a burning sensation in the middle of the chest, behind the breastbone, that can radiate up the neck and throat. Often this chest pain is also accompanied by a sour taste in the back of the throat and burping. Less often, heartburn also includes bloating, hiccups and difficulty and pain with swallowing. Heartburn often feels worse after a meal or when bending over or lying down.
Heartburn can be prevented or reduced by a few dietary and lifestyle changes, such as eating small, non-spicy meals, with little liquid, two to three hours before bedtime or periods of rest. Foods like carbonated drinks, alcohol, coffee, chocolate, citrus fruits, tomatoes, mustard, vinegar, processed meats, and those with mint, heavy spice or seasoning, should be avoided as they are likely to cause stomach upset. When exercising, pregnant women should practice bending from their knees and not their waist. In general, pregnant women should wear loose clothing to avoid restricting the abdomen. Sleeping propped up can also assist gravity in pushing foods down out of the esophagus and into the stomach and intestines for proper digestions. In pregnancy, women should strive to gain only the most reasonable amount of weight as excess weight might also crowd an already limited abdominal space.
For the occasional heartburn, relief can be found in over-the-counter antacids that can be ingested as a tablet or liquid. Antacids that contain magnesium or calcium are recommended. Those with aluminum, aspirin or large amounts of sodium should be avoided as they may actually cause constipation [aluminum] or water retention [sodium]. If heartburn persists more than a week or is accompanied by severe pain, consult a doctor immediately.