Heartburn in pregnancy—Easing the pain!

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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.

 

References:

http://www.tums.com/heartburn-information/pregnancy.html?google=b_&rotation=6860&banner=43430&kw=321043

http://www.stopheartburn.com/heartburn-prevention/ten-tips-for-eating-well-while-avoiding-heartburn

http://www.babycenter.com/0_heartburn-during-pregnancy_242.bc

http://www.babycenter.com/404_which-heartburn-medicines-are-safe-during-pregnancy_1440876.bc

Dr. Gareth Forde

About Dr. Gareth Forde

An obstetrician-gynecologist, a clinical professor, a researcher, and a father of five—and he delivered them all! He speaks and publishes extensively on maternal and child health issues, where he emphasizes the role of a healthy maternal lifestyle, good nutrition, and breastfeeding on infant development. He chose the field of obstetrics because it is a celebration of life, a happy and exciting profession. “Children are a blessing and they bring joy and laughter to the world,” he says. “I cherish my work, as a doctor and a dad.” The study of genetic imprinting is a major focus of both Dr. Forde’s research and medical practice. This looks at what happens in the womb, how the genes a baby inherits are expressed (turned on and off), and how this influences the child’s health after birth. “This field holds great promise, shedding light on many unsolved mysteries in health and disease from infancy to adulthood,” he adds. Dr. Forde grew up in London, England and Orlando, Florida. He received his medical degree from the University of Minnesota Medical School and is currently pursuing a fellowship in gynecologic oncology at the University of California, Irvine. Prior to this, he practiced with Grand Rapids Medical Education Partners, a consortium of Saint Mary’s Health Care, Spectrum Health, Grand Valley State University, and Michigan State University College of Human Medicine—where he was a clinical professor of obstetrics, gynecology, and reproductive biology. He also has a master’s in molecular and cellular biology from Florida Agricultural & Mechanical University; a Ph.D. in environmental science (computational chemistry) from Jackson State University; and a post-doctoral fellowship in biophysics from Mount Sinai School of Medicine, in New York.”