What’s different about pregnancy heartburn?
Most women suffer from heartburn during pregnancy due to hormonal and physical changes, particularly during their second and third trimester. The hormone progesterone is produced at greater levels during pregnancy. It relaxes muscles including the digestive tract and lower esophageal sphincter (LES). The relaxed muscles in the digestive tract slow digestion causing food to remain in the stomach longer and triggering increased acid production. The LES is the valve that closes off the stomach to keep stomach acid for refluxing back into the esophagus. When stomach acid leaks into the esophagus, it causes irritation. This irritation is what we know as heartburn. The physical changes during pregnancy also contribute to heartburn. As the baby grows larger, it takes up more room pushing the stomach upward. The pressure of the baby on the stomach and the modified stomach position lead to added pressure of stomach contents on the LES. Both, progesterone and physical changes, lead to acid reflux and heartburn.
Preventing acid reflux instead of treating once it’s occurred is the best option.
Ways to Prevent Heartburn During Pregnancy
- Clothes: Wear lose clothes. Tight clothes will cause more pressure on the stomach and thusly the LES.
- Eat healthy foods and high fiber foods. Constipation is a concern during pregnancy due to hormones slowing the digestive tract. A high fiber diet can keep the digestive tract moving at a good pace preventing stomach contents lingering longer than needed and triggering an increase in stomach acid production. Fiber supplements are available if supplementation is needed.
- The following foods can be heartburn triggers for many people: Processed food, fatty food, fried food, dairy products high in fat, spicy food, tomatoes, citrus, coffee, carbonated drinks, mint, chocolate, candy containing citrus and mint, and the allium family of produce (garlic, onions, shallots, leeks, and chives).
- Avoid drinking a large amount of liquid during a meal. This will dilute stomach acids. The stomach acid is needed to help trigger the LES to stay closed and for efficient digestion. It’s better to sip liquids throughout the day to keep up with your water intake.
- Liquids should also be avoided 2-3 hours before bedtime or any laying down to prevent stomach acid from leaking through the LES.
- Alcohol should be avoided during pregnancy. But if you do imbibe know that it increases acid production, slows the digestive process, and relaxes the LES. All of these side effects can lead to heartburn.
- Eat slowly, chew throughly, stop before getting full, and eat smaller meals more often. Five or six meals are better than three.
- Stop eating 2-3 hours before bedtime to prevent added pressure on the LES.
- Sitting up straight and not reclining or laying down during waking hours is important to prevent pressure on the LES.
- Avoid bending over at the waist when picking up items, doing chores, or exercising to prevent pressure on the LES as well.
- Due to the shape and position of the stomach and digestive tract, lying on your left side causes your stomach to hang lower preventing your stomach contents from placing as much pressure on the LES.
- Gravity can be a help in keeping stomach contents in there place when you raise the head of your bed 6 inches by using blocks. Less effective methods of creating an incline are sleeping on a wedge pillow or creating the angle by propping up pillows.
- Weight: Maintaining a healthy weight during pregnancy is important. Ask your doctor how much weight you should be gaining. Too much weight gain will increase the pressure you already have on the stomach.
- Stress: Since avoiding stress is virtually impossible manage the stresses you encounter. Stress may cause increased stomach acid production and causes greater sensitivity to acid irritation in the esophagus. Some ways to reduce stress are:
- Participate in enjoyable activities
- Listen to soothing music
- Soak in the tub
- Sex with a partner
- Medications: Medications including over the counter medications (OTC) and supplements can contribute to heartburn. If you have to take medications that contribute to heartburn, check to see if they should be taken with or without a meal. If medications taken in the evening are giving you nighttime heartburn, see if they can be taken in the morning instead.
- Tobacco: As you know, the intake of nicotine should be eliminated during pregnancy for the baby’s health. It can also relax the LES and irritate the esophagus, even the second had smoke can also irritate the esophagus.
All people are different and some things trigger heartburn in some people where they wont in others. You will have to spend time learning what actions and foods trigger your heartburn. Keeping a heartburn trigger journal can help make that process easier.
If you are suffering from heartburn during pregnancy, there are relief options, but remember it’s easier to prevent than to treat once it’s occurred.
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