Heartburn During Pregnancy

Pregnancy is full of nasty surprises. There are a lucky few who sail through pregnancy with no ill effects, but for most of us the physical changes taking place in our bodies bring with them some unwelcome side effects.

Heartburn is the unpleasant burning sensation which seems to travel from the bottom of your ribcage up to the back of your throat and unfortunately, it is one of these nasty surprises. It can creep up on you after you've eaten, and also wake you up at night which can make life difficult when you're trying to preserve your energy.

The good news is that heartburn isn't a serious complication of pregnancy. It may be a nuisance but the symptoms can be relieved and there are medicines out there which can help.

What causes heartburn?

Heartburn is one of the many consequences of the hormonal changes taking place in your body during pregnancy. The hormone progesterone is the culprit this time. The increasing amount of progesterone in your body causes the smooth muscles in your uterus or womb to relax, but it also relaxes the sphincter muscle at your stomach's entrance. It is the relaxation of this sphincter muscle which causes heartburn as the relaxation allows the stomach acids to travel back up into your oesophagus or food pipe. This is what causes the sensation of burning behind your ribcage and in your throat. Sometimes the stomach acids travel all the way up to your mouth where it can leave a bitter taste.

Progesterone can also slow down your stomach contractions as it tries to digest food, which doesn't help the heartburn. Sadly there's no relief in later pregnancy. As your baby grows it makes more room for itself by pushing your stomach and intestines up, putting greater pressure on your digestive system.

Should I be worried?

Heartburn is extremely common during pregnancy and is harmless, if not uncomfortable and annoying. It's thought that around one third of pregnant women will suffer from heartburn during their first trimester of pregnancy. This proportion rises to between two thirds and three quarters of mums-to-be by the final three months. Therefore, you are not alone in your misery!

Heartburn won't harm your baby and nor will it cause you any long term harm. The symptoms should disappear once your baby is born. It's simply an unfortunate side effect of the tumultuous changes taking place in your body to prepare for your baby's birth. It may be difficult to think positively when your chest is burning and keeping you awake at night but at least it's a sign that your bodily changes are going in the right direction.

How can I reduce the symptoms?

Heartburn can be triggered in many ways and your trigger may be different from your other pregnant friends. The most common triggers are eating, bending over and lying down. This is why heartburn most often occurs after meals and at night time. There are no guarantees that you can stop the symptoms by avoiding the triggers but you may be able to lessen the number of attacks and ease the discomfort during an attack.

Many mums-to-be find that eating a meal is often followed by heartburn, so here are some food and drink tips:

• Avoid hard-to-digest foods such as chocolate, spicy or rich, fatty foods and citrus fruits.
• Citrus fruit juices should be avoided too, as should coffee and alcohol as these are all known to trigger heartburn.
• Avoid eating large meals - it's better to eat several smaller meals throughout the day. Take your time eating and try to chew your food thoroughly to help with the digestion.
• Drink plenty of fluids before and after you eat.
• Avoid eating too close to bedtime - try to leave at least three hours between eating a meal and going to bed.
• Some pregnant women find drinking milk helps the heartburn. If you suffer from heartburn at night, try keeping a glass of milk at the side of your bed for when you wake up in the night.

Other guidelines to avoid heartburn include:

• Try not to go to sleep lying down flat. You should suffer less from night time heartburn if you can sleep propped up by a few pillows.
• Try to sit up straight whilst eating and just after a meal. Bending over or slumping is more likely to induce heartburn and avoid lying down for an hour after you've eaten. Wearing loose clothing may also help to relieve the symptoms.
• If you are still smoking make a huge effort to stop. Apart from the damage you may be doing to your baby the smoking is likely to be making your heartburn worse by encouraging the stomach sphincter muscle to relax even more.
• If you are taking medication for an unrelated condition it could be making your heartburn worse. If you are taking non-steroidal anti-inflammatory drugs or antidepressants, for example, it's probably worth talking to your midwife as these drugs are known to trigger heartburn symptoms.

Should I speak to my midwife or doctor?

If you're finding your heartburn symptoms difficult to deal with you could talk to your midwife or doctor as they may be able to suggest some over-the-counter treatments which are safe to use during pregnancy.

The most common treatments for heartburn are antacid or alginate remedies. Alginates are the best treatment for reflux and work by creating a coating to protect your stomach and oesophagus walls. Antacids neutralise the stomach acids and are best taken when you know heartburn is likely to strike, such as at mealtimes and in the night. However bad your heartburn is, don't be tempted to take more than the dose recommended by the manufacturers.

It's worth taking the advice of your midwife before buying any of these remedies as some can cause tummy upset. Some should also be avoided if you're at risk of suffering from high blood pressure or the pregnancy complication of pre-eclampsia. Be aware that if you're taking iron tablets, then antacids can affect the way the iron is absorbed into your body. Therefore, it's best to allow at least two hours between taking your iron tablet and the antacid remedy.

Could my painful symptoms be something more serious?

Provided your pain or burning sensation is limited to travelling behind your breastbone and up to your throat, it's likely that your symptoms are nothing more serious than heartburn. However, a pain just below your ribs could be a symptom of pre-eclampsia and a pain in the top right-hand side or your stomach could be a sign of a pregnancy-related liver problem, particularly if it is accompanied with being sick. Other pains in the stomach area could be related to a condition such as peptic ulcer.

If you're worried that your pain may not be related to heartburn then you should see your midwife or doctor so that it can be investigated and treated appropriately.

The saying goes 'no pain, no gain' and this is certainly true of pregnancy. Heartburn is one of those pains which you need to go through to reach the end result of holding your baby. Yes, it's uncomfortable and miserable but you need to remember that it won't last forever and it's all for a good cause.