Heartburn During Pregnancy

Heartburn is a burning sensation in the chest caused by stomach acid backing up into the esophagus. Heartburn (also known as "reflux") is common in pregnancy because a certain hormone (progesterone) changes. The progesterone hormone may relax the valve that separates the esophagus from the stomach. This allows acid to go up into the esophagus, causing heartburn. Heartburn may also happen in pregnancy because the enlarging uterus pushes up on the stomach, which pushes more acid into the esophagus. This is especially true in the later stages of pregnancy. Heartburn problems usually go away after giving birth.

CAUSES

  • The progesterone hormone.

  • Changing hormone levels.

  • The growing uterus that pushes stomach acid upward.

  • Large meals.

  • Certain foods and drinks.

  • Exercise.

  • Increased acid production.

SYMPTOMS

  • Burning pain in the chest or lower throat.

  • Bitter taste in the mouth.

  • Coughing.

DIAGNOSIS

Heartburn is typically diagnosed by your caregiver when taking a careful history of your concern. Your caregiver may order a blood test to check for a certain type of bacteria that is associated with heartburn. Sometimes, heartburn is diagnosed by prescribing a heartburn medicine to see if the symptoms improve. It is rare in pregnancy to have a procedure called an endoscopy. This is when a tube with a light and a camera on the end is used to examine the esophagus and the stomach.

TREATMENT

  • Your caregiver may tell you to use certain over-the-counter medicines (antacids, acid reducers) for mild heartburn.

  • Your caregiver may prescribe medicines to decrease stomach acid or to protect your stomach lining.

  • Your caregiver may recommend certain diet changes.

  • For severe cases, your caregiver may recommend that the head of the bed be elevated on blocks. (Sleeping with more pillows is not an effective treatment as it only changes the position of your head and does not improve the main problem of stomach acid refluxing into the esophagus.)

HOME CARE INSTRUCTIONS

  • Take all medicines as directed by your caregiver.

  • Raise the head of your bed by putting blocks under the legs if instructed to by your caregiver.

  • Do not exercise right after eating.

  • Avoid eating 2 or 3 hours before bed. Do not lie down right after eating.

  • Eat small meals throughout the day instead of 3 large meals.

  • Identify foods and beverages that make your symptoms worse and avoid them. Foods you may want to avoid include:

  • Peppers.

  • Chocolate.

  • High-fat foods, including fried foods.

  • Spicy foods.

  • Garlic and onions.

  • Citrus fruits, including oranges, grapefruit, lemons, and limes.

  • Food containing tomatoes or tomato products.

  • Mint.

  • Carbonated and caffeinated drinks.

  • Vinegar.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have severe chest pain that goes down your arm or into your jaw or neck.

  • You feel sweaty, dizzy, or lightheaded.

  • You become short of breath.

  • You vomit blood.

  • You have difficulty or pain with swallowing.

  • You have bloody or black, tarry stools.

  • You have episodes of heartburn more than 3 times a week, for more than 2 weeks.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.