PregnancyHeartburn and heartburn in pregnancy: when does it appear and how to...

Heartburn and heartburn in pregnancy: when does it appear and how to prevent it

It is estimated that 50% of pregnant women suffer from heartburn and burning. Fortunately, there are some guidelines that help prevent it.

In our stomach, a series of really strong acids are secreted normally. They are known as gastric acids, and their main purpose is to break down food to later allow digestion. These acids tend to be very corrosive, and do not usually cause problems, until they reflux into the esophagus, causing burning, heartburn, and unpleasant pain. Both heartburn and heartburn are extremely common during pregnancy, but do you know why? What are its causes, and why are they more common in the second and third trimesters? Is there anything that can be done to alleviate them?

Why do heartburn appear in pregnancy?

The truth is that, during pregnancy, the future mother is very prone to stomach pain, burning and heartburn, especially in the second half of pregnancy, and even more so, throughout the third trimester. Although it usually starts from the third month of pregnancy. This is due to progesterone and other pregnancy hormones, which cause the lower esophageal sphincter muscle to relax, and therefore, to close poorly.

This causes gastric emptying to slow down, increasing the risk that stomach contents will flow back. Due to this, it is very common that during pregnancy the contents of the stomach can flow upwards, towards the esophagus, causing in turn the different symptoms and discomfort so associated with this disorder. And what is the esophagus? It basically consists of the muscular conduit that communicates the pharynx with our stomach, and is designed to carry both food and ingested liquids precisely from the mouth to the stomach.

On the other hand, the main reason why heartburn tends to be more common in the second half of pregnancy and in the third trimester is because the hormonal effect on the digestive sphincters is even greater, which adds to the effect caused by lack of space due to the large size of the uterus.

Finally, as the stomach contents return and reflux occurs, the acids irritate the area, causing pain, burning and inflammation.

At what time of day is it most common for it to appear?

While the typical morning sickness is usually more common in the morning, before getting out of bed, with heartburn and heartburn the opposite occurs: it is more common to appear especially at night when you go to bed, hence It is very important (as we will see in the section dedicated to it) to have dinner early and especially light food, since it will be of great help in preventing its uncomfortable appearance.

It’s a myth: If you have heartburn during pregnancy, it doesn’t mean that the baby will be born with a lot of hair. There is no scientific evidence to support such a claim. The real cause? The action of progesterone and other hormones on smooth muscle, promoting reflux by relaxing it.

What to do to prevent it?

Although there are times that it cannot be prevented, the truth is that following some basic guidelines such as the ones we propose below can be very useful, being in fact very helpful:

  • Dinner early and little. It is essential to try to eat dinner earlier and also eat a small meal, opting for lighter foods. This means that you should avoid overeating and filling up to exhaustion, while at the same time having to bring your dinner time forward.
  • Don’t go to bed immediately after you’ve eaten. Either at night, or after lunch, it is advisable to wait at least 2 hours until bedtime. The reason is obvious: lying down or lying down favors the appearance of reflux.
  • Avoid foods that increase acidity or delay gastric emptying. If you suffer from heartburn and heartburn, you should avoid certain foods that can worsen symptoms, or increase the risk of suffering from it. This is the case of chocolate (yes, chocolate), citrus fruits (such as oranges, tangerines, lemons and grapefruits), tomato sauce, caffeine, theine, carbonated drinks and certain condiments (such as pepper, any herb spicy and vinegar). In addition, fatty foods (such as fried foods or stews with excess fat) should also be reduced.
  • Increase your fluid intake. It is advisable to drink plenty of water throughout the day, outside of meals. In addition, in order not to increase the volume of the stomach, it is advisable not to drink any liquid while eating.

Can you take antacids during pregnancy?

If you suffer from heartburn in pregnancy and you have not been able to reduce or prevent its symptoms, many experts advice asking your doctor about the risks of taking antacids during pregnancy, which help neutralize the acid present in the stomach.

The truth is that, under proper medical supervision, antacids can be safe during pregnancy, but with nuances: antacids containing aluminum hydroxide or aluminum carbonate should be avoided, as well as Alka-Seltzer- type drugs that contain aspirin (acetylsalicylic acid or salicylate) or sodium bicarbonate, due to its excess sodium.

Basically, those that contain magnesium oxide, magnesium hydroxide or calcium carbonate are more advisable, as they are the fastest, most effective and safest.

Bibliographic references:

  • Dağlı Ü, Kalkan İH. Treatment of reflux disease during pregnancy and lactation. Turk J Gastroenterol. 2017 Dec; 28(Suppl 1):S53-S56. Doi: 10.5152/tjg.2017.14.
  • Body C, Christie JA. Gastrointestinal Diseases in Pregnancy: Nausea, Vomiting, Hyperemesis Gravidarum, Gastroesophageal Reflux Disease, Constipation, and Diarrhea. Gastroenterol Clin North Am. 2016 Jun; 45(2):267-83. Doi: 10.1016/j.gtc.2016.02.005.
  • Frawley J, Hall H, Adams J, Sibbritt D. Health care utilisation of women who experience pregnancy-related reflux, nausea and/or vomiting. J Matern Fetal Neonatal Med. 2017 Aug; 30(16):1938-1943. Doi: 10.1080/14767058.2016.1232711.


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