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  What to do For Heartburn in a Pregnancy?

Heartburn is a common accompaniment of pregnancy. The first trimester of pregnancy is often the most troublesome for women because of the various gastric disturbances like nausea, acidity, loss of appetite, indigestion, bloating of abdomen and vomiting that is so prevalent in this period.  

What can be done about heartburn during a pregnancy?
Heartburn during pregnancy could be due to myriad reasons. Pregnancy hormone- progesterone could have a relaxant effect on the sphincters that guard the opening between your esophagus and stomach, allowing the contents of the stomach to reflux back. Acid is the natural component of the stomach contents, which is the reason behind your distress. 

Another reason could be pregnancy cravings, called as pica. Many women develop cravings for unpalatable items like chalk, mud, raw rice etc. These items when consumed can cause secretion of excessive amounts of acid, part of which can be refluxed back to cause a burning sensation in the throat. So check what you put in to your mouth during pregnancy; if it is something weird like those described above, try to avoid them. 

Another bothersome symptom is the hunger pangs that come on at odd times, like after bedtime or sometimes in the middle of the night. You might have noticed that such hunger pangs are usually combined with the cravings for some high calorie or high sugar foods like cakes, pastries, sweets or chocolates. Gorging to your heart’s content on such high calorie foods at odd hours can leave you feeling bloated and the high acidity caused by such foods can bring about a fresh bout of heartburn. 

Pregnancy with twins, triplets or more can spell trouble for the mom, and symptoms can be more severe and may start earlier compared to single pregnancies. This is mainly due to the growing uterus, which starts applying pressure to the stomach, especially when the stomach is distended after a full meal. This pressure can force the contents of the stomach backwards in to the esophagus and cause a burning sensation. So if you are going through a multiple pregnancy, try to eat smaller meals frequently. 

The American College of Gastroenterology (ACG) has updated its manual titled “Pregnancy in Gastrointestinal disorders” and has suggested several self help techniques for relieving heart burn during pregnancy. Here is the detailed list for your convenience: 

  1. Avoid late night snacks or eating at odd times.
  2. Avoid high risk foods like citrus fruits, greasy / spicy foods, sauces, sweets, pizzas, junk food, chocolate etc which are sure to trigger a spell of hyperacidity.
  3. Try to wear comfortable and loose fitting clothes, especially around your abdomen and chest. Undue pressure due to tight fitting clothes can force your stomach contents backwards and cause trouble.
  4. Make a habit of spacing out your meals so that the food that you do not overload your stomach and distend it beyond capacity.
  5. Try to maintain a gap of at least 3 hours between your dinner and bedtime. Lying down soon after a full dinner is inviting trouble, because there are more chances of the distended stomach refluxing its contents backwards when you sleep.
  6. Adjust the head of your bed in such a way that it is elevated to about 3-4 inches higher than the foot end. An adjustable bed will be easier to handle or you can also place wooden kegs below the head end to achieve this. This helps in preventing the gastric contents from entering into the esophagus while you lie down.

In addition to following the instructions from ACG, some additional precautions can help you achieve freedom from hyperacidity and related acid reflux during pregnancy. Alcohol, coffee, tobacco are all triggers for the stomach to secrete high amounts of acid. In case pregnancy was not an adequate motivation for you to quit using these harmful substances, the distress caused by reflux of acid is a much better reason to do so.  

In case your acidity as well as acid reflux symptoms do not subside despite using the abovementioned precautions, you can use antacids to get relief. While most of the antacids are available over the counter and mostly safe to be consumed during pregnancy, it is always better to consult your physician before using any drugs.  

Antacids that contain magnesium may interfere with the uterine contractions during labor, so using such antacids may not be a good idea during the last phase of pregnancy. Also antacids that have sodium bicarbonate as their content can also prove to harmful to both mother and fetus as it leads to a fluid imbalance and metabolic alkalosis in the body.