Heartburn symptoms are one of the most commonly reported complaints among pregnant women. Heartburn usually starts during the first trimester and tends to worsen during the second and third trimesters.
Studies have shown elevated levels of the hormone progesterone accompanied by increased intra-abdominal pressures from the enlarging uterus, may lower esophageal sphincter (LES) pressure in pregnant women contributing to heartburn symptoms, according to research highlighted in the newly updated “Pregnancy in Gastrointestinal Disorders” monograph by the American College of Gastroenterology (ACG).
From the monograph, physician experts from ACG have compiled important health tips on managing heartburn symptoms, and importantly, identifying which heartburn medications are safe for use in pregnant women and those, which should be avoided.
Strategies to Ease Heartburn Symptoms during Pregnancy
According to the ACG, pregnant women can treat and relieve their heartburn symptoms through lifestyle and dietary changes. The following tips can help reduce heartburn discomfort:
Avoid eating late at night or before retiring to bed. Common heartburn triggers include greasy or spicy food, chocolate, peppermint, tomato sauces, caffeine, carbonated drinks, and citrus fruits.
Wear loose-fitting clothes. Clothes that fit tightly around your waist put pressure on your abdomen and the lower esophageal sphincter.
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Eat smaller meals. Overfilling the stomach can result in acid reflux and heartburn
Don’t lie down after eating. Wait at least 3 hours after eating before going to bed. When you lie down, it’s easier for stomach contents (including acid) to back up into the esophagus, particularly when you go to bed with a full stomach.
Raise the head of the bed 4 to 6 inches. This can help reduce acid reflux by decreasing the amount of gastric contents that reach the lower esophagus.
Avoid tobacco and alcohol. Abstinence from alcohol and smoking can help reduce reflux symptoms and avoid fetal exposure to potentially harmful substances . The Do’s and Don’ts of Using Heartburn Drugs during Pregnancy
Pregnant women with mild reflux usually do well with simple lifestyle changes. If lifestyle and dietary changes are not enough, you should consult your doctor before taking any medication to relieve heartburn symptoms. According to ACG President Amy E. Foxx-Orenstein, DO, FACG, “Heartburn medications to treat acid reflux during pregnancy should be balanced to alleviate the mother’s symptoms of heartburn, while protecting the developing fetus.”
Based on a review of published scientific clinical studies (in animals and humans) on the safety of heartburn medications during pregnancy, researchers conclude there are certain drugs that are considered safe for use in pregnancy and those which should be avoided. Antacids are one of the most common over-the-counter medications to treat heartburn. As with any drug, antacids should be used cautiously during pregnancy.
Antacids containing aluminum, calcium, or magnesium are considered safe and effective in treating the heartburn of pregnancy.
Magnesium-containing antacids should be avoided during the last trimester of pregnancy because it could interfere with uterine contractions during labor. Avoid antacids containing sodium bicarbonate. Sodium bicarbonate could cause metabolic alkalosis and increase the potential of fluid overload in both the fetus and mother.