Acid reflux occurs when stomach acid leaks out of the stomach and up into the esophagus. The primary symptom is heartburn, which is an uncomfortable, burning sensation in the chest. Pregnant women are particularly prone to acid reflux and heartburn.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), severe acid reflux affects about 20% of people in the United States each year.
In this article, we outline the symptoms of acid reflux and explain what causes it during pregnancy. We also list some medical treatments and home remedies for treating heartburn during pregnancy.
The primary symptom of acid reflux is heartburn, which is a burning sensation in the middle of the chest. It may accompany a feeling of heaviness or fullness in the chest or stomach.
A person may be more likely to experience heartburn:
- after eating a meal or drinking
- when lying down
- when bending over
Heartburn can affect anyone at any time, but it is particularly common during pregnancy.
Other potential symptoms of acid reflux include:
According to an older study from 2010, severe acid reflux or gastroesophageal reflux disease (GERD) affects about 80% of pregnancies. Heartburn can develop at any stage of the pregnancy, but it is most common during the second and third trimesters.
Researchers do not fully understand why acid reflux begins or worsens later in pregnancy. However, below are some factors that they believe to play a role.
During pregnancy, a woman produces increased amounts of the hormone progesterone. This hormone is responsible for relaxing smooth muscle tissue throughout the body. It plays an important role in relaxing the uterus so that it can stretch and grow as the fetus develops.
However, progesterone can also relax the sphincter muscle that connects the esophagus to the stomach. The sphincter allows food to enter the stomach while preventing food and stomach acid from leaking up into the esophagus. Progesterone loosens the sphincter, allowing acid to travel back up the esophagus.
Increased pressure on the stomach
In the later stages of pregnancy, the growing uterus and fetus put increasing pressure on the stomach. This pressure can cause acid to leak out of the stomach and up the esophagus. This leakage is more likely to occur after a meal when the stomach is full.
Women should talk to their doctor before taking a particular heartburn medication during pregnancy. A doctor can offer advice on which medications are safe for the woman and the developing fetus.
According to UT Southwestern Medical Center, there are three main types of heartburn medication that are safe for a woman to take during pregnancy. These medications are:
Oral antacids (OAs) neutralize stomach acid, making it less acidic. Examples of OAs include aluminum and magnesium hydroxide (e.g., Maalox and Mylanta) and calcium carbonate (e.g., TUMS).
Oral antacids are available over the counter and via prescription.
H2-receptor antagonists are medications that stop the cells in the stomach from producing too much acid. They work by reducing levels of the chemical H2 histamine, which stimulates cells in the stomach to produce stomach acid.
Examples of H2-receptor antagonists include cimetidine (Tagamet HB) and famotidine (Pepcid).
The above brands are available over the counter.
Proton pump inhibitors
Proton pump inhibitors (PPIs) are medications that stop the stomach from producing too much acid. They work by blocking an enzyme necessary for producing stomach acid.
Examples of PPIs include lansoprazole (Prevacid) and omeprazole (Prilosec).
People should be aware that PPIs can take several days to work effectively. As such, people may wish to consider trying an antacid or H2-receptor antagonist first.
PPIs are available over the counter and via prescription.
In addition to medication, a person can help treat their acid reflux using home remedies. The NIDDK provide the following tips for reducing stomach acid naturally:
- raising the head of the bed off the floor by 6–8 inches to sleep at a slight angle
- sitting in an upright position for 3 hours following a meal
- wearing loose fitting clothing around the abdomen
- avoiding eating food within 2–3 hours of going to bed
- eating smaller meals
- avoiding spicy or greasy foods that can trigger heartburn
Pregnant women should talk to their healthcare provider before consuming any natural remedies for heartburn. A healthcare provider can help determine whether the remedy may be effective and whether it will be safe for the woman and fetus.
It may not always be possible to prevent acid reflux and heartburn during pregnancy. However, practicing the techniques above can help women manage symptoms when they occur.
Pregnant women should see their doctor if they experience severe or persistent heartburn that does not respond to over-the-counter or at-home treatments. Heartburn-type pains below the ribs can sometimes be a sign of preeclampsia. Without regular monitoring and any necessary treatment, this serious condition can threaten the life of the woman and fetus.
Other signs and symptoms of preeclampsia include:
It is important to attend all scheduled routine antenatal appointments. Doing this will help ensure that healthcare providers pick up on any health issues that arise during the pregnancy.
Acid reflux during pregnancy is a common occurrence. In most cases, acid reflux and its associated symptoms should go away once a woman gives birth.
Several medications are suitable for treating acid reflux and heartburn during pregnancy. Women can also try home remedies, such as wearing loose fitting clothes, eating smaller meals, and avoiding foods that can trigger heartburn.
Women should see a doctor if they experience heartburn that is severe or persistent during pregnancy. Heartburn-type symptoms can sometimes mimic those of other conditions, such as preeclampsia. Attending all routine antenatal appointments reduces the risk of complications developing during the pregnancy.