Chances are good that you’re one of many pregnant women who experience the churning and burning of heartburn or acid indigestion. It typically hits somewhere in the second or third trimester, and it can be miserable. Heartburn doesn’t really mean your heart is burning, but it’s a good description of the discomfort that begins
behind the breastbone. It then moves upward to the neck and throat. Officially, heartburn is known as gastroesophageal reflux, when acidic stomach juices or food and fluids back up into the esophagus. This is a hollow muscular tube between your mouth and your stomach. Many women who have heartburn during pregnancy have never had problems before. Unfortunately, if you had heartburn before becoming pregnant, you’re more likely to have symptoms
while you are pregnant. Although the exact reasons aren’t clear, most experts believe that pregnancy hormones, particularly progesterone, play a role. Hormones cause relaxation of the esophageal sphincter. This is a tight circular band of muscle at the top of the stomach. This allows partially digested food and stomach acids to backflow, or reflux, into the esophagus. In addition, progesterone also slows the digestive process. This keeps food in the stomach longer. The pregnancy itself—the
upward pressure of the growing uterus—also may play a role. Most spicy, greasy, fatty foods known for causing heartburn are also likely to cause problems for pregnant women. Food doesn’t digest as well or move as quickly during pregnancy. So, eating large meals or overeating in general can also increase the risk for heartburn. Eating right before bedtime can cause problems, too. Smoking makes heartburn worse and is another reason to quit, especially while
pregnant. For most women, things that help reduce acid production or prevent reflux are helpful in avoiding the discomfort of heartburn. Here are tips that may help: Avoid classic spicy foods, as well as those with lots of fat or grease. Many people recommend avoiding citrus and chocolate, as well. Eat multiple, small meals spread throughout the day, much like “grazing,” instead of three big meals.Why does it happen in pregnancy?
What makes it worse?
What makes it better?
Try elevating the head of your bed by several inches, and wait a while after eating before going to bed or lying down.
Some women find that it’s better to drink fluids between meals, rather than with a meal. This can increase the amount of contents in the stomach.
If your symptoms do not improve after the above recommended diet and lifestyle changes are in place, talk with your healthcare provider about over-the-counter medicines. Antacids are available as chewable tablets and liquids. They work by coating the lining of the esophagus and stomach and neutralizing stomach acid. Heartburn medicines called H2-blockers work by reducing the amount of acid made by your stomach. Although most of these are considered safe in pregnancy, as with all medicines, these should be avoided in the first trimester.
When will it end?
Heartburn symptoms are usually mild and manageable. Tell your healthcare provider if your heartburn is severe, if you spit up blood, or have dark-colored bowel movements. This is a sign of blood in your digestive tract. Fortunately, heartburn usually ends with the birth of your baby and your body goes back to its nonpregnant state.
Heartburn is one of the most common side effects of pregnancy. But how can you treat the condition safely when you're expecting? And if you already suffer from gastroesophageal reflux disease (GERD) before getting pregnant, you may be wondering if Prilosec and other medications are safe.
What is Prilosec?
Prilosec (omeprazole) is an acid pump inhibitor used mainly to treat severe heartburn by decreasing the amount of acid produced in the stomach. Prilosec is used to treat GERD and other conditions caused by excess stomach acid. However, it's not usually prescribed for the immediate relief of heartburn symptoms.
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Is Prilosec Safe During Pregnancy?
Prilosec is in a family of medications called proton pump inhibitors and it should be taken with caution during pregnancy. It has a category C rating. According to the U.S. Food and Drug Administration (FDA), this rating means that it is not known whether a particular medication will cause harm to an unborn baby if the medication is taken during pregnancy. This also means that, if possible, other alternative therapies should be tried.
A board-certified obstetrician and assistant professor at the New York University School of Medicine, Daniel Roshan, M.D., who specializes in high-risk fetal medicine, explains that while there are no known risks to the fetus, there are other medications that are safer for pregnant women. If you are taking Prilosec and find out that you are pregnant, you should consult your doctor immediately.
Dr. Roshan advises his pregnant patients against taking Prilosec in the first trimester since it is classed as a category C, but Dr. Roshan says women can take it in the second and third trimesters, if necessary.
Nursing mothers should avoid breastfeeding while taking Prilosec since omeprazole can pass into the breast milk and may harm your infant.
Heartburn and Pregnancy
Even if you do not normally experience heartburn, you may find that during your pregnancy you have it as early as the first trimester. This occurs for a variety of reasons.
"Heartburn is certainly not a stranger to the pregnant woman," says Michele Hakakha, , M.D., a Los Angeles-based board-certified obstetrician and gynecologist. "It is triggered by the high levels of progesterone causing relaxation of the muscular sphincter between the stomach and the esophagus."
Changes in digestion can also lead to increased instances of heartburn during pregnancy. "Food sits in the stomach for longer periods of time and as the uterus enlarges, it puts mechanical pressure on the stomach," Dr. Hakakha says. "All of these things lead to stomach acid creeping its way up the esophagus to cause heartburn."
There are many remedies to help ease the symptoms of pregnancy heartburn, from changing your diet to trying out a new sleeping position. Dr. Hakakha recommends eating small, frequent meals instead of three large meals each day, as well as cutting certain foods from your diet, such as citrus fruits, spicy foods, tomatoes and tomato sauces, caffeine, and chocolate, all of which can make heartburn worse. Dr. Roshan also suggests elevating the head of the bed, drinking a lot of water, and avoiding tight clothing.
Alternatives to Prilosec During Pregnancy
Because Prilosec has a category C rating, doctors typically recommend alternative medications for pregnant women. Safe alternatives for treating pregnancy heartburn include over-the-counter Tums or Mylanta, and prescription medications including H2 blockers (Tagamet, Zantac, and Pepcid) and other proton pump inhibitors (like Prevacid, Aciphex, and Nexium), which have a category B rating, which indicates that they're routinely and safely used during pregnancy.