Heartburn in pregnancy

Pregnant woman at work with laptop looking stressed

Dr Richa Sharma, Dr Amit Basnotra
Pregnancy is a new and unique feeling which a female has when her body undergoes various physiological changes for some of which she is prepared and for some she is not prepared.
So best is to make pregnant mom aware and take due precautions for a wonderful experience of life in her journey of motherhood to make it memorable.
Through this article we are trying to explain the various aspects of heartburn which happens more so in the early months of pregnancy.We will try to explain in the form of various questions which we come across in our clinical practice
What is Heartburn ?
Heartburn is a burning sensation that extends from the bottom of your breastbone up to your lower throat. It happens when acid from your stomach is brought up into your food pipe. If it shows reflux into your mouth then it will leave a sour and bitter taste.Its very unpleasant and unavoidable situation which happens in 8 out of 10 pregnant patients more so in the second and last half of pregnancy.Its generally temporary harmless but exceptionally it can be painful as in situations with pre existing acid peptic disease or gastritis.This we all must have experienced as such also sometime in life irrespective of pregnancy but definitely pregnancy is a precipitating factor.
What causes heartburn?
There are many causes of heartburn some are physiological and many are non physiological.
Normally in pregnancy various hormonal changes happen especially progesterone has a role due to which the smooth muscles gets relaxed along with womb so causing reflux of the acid.Besides as the pregnancy advances, growing baby pushes the gut up causing delay in digestion and reflux of acid so resulting in heartburn.
Heartburn is very common when you’re pregnant, particularly in mid-pregnancy to late pregnancy. Many mums-to-be start getting heartburn and indigestion in the second half of pregnancy, although it’s not unheard of to get it before then.
About a third of pregnant women experience heartburn as early as the first trimester, rising to two-thirds by the third trimester.
Try not to worry about coping with heartburn after your baby’s born. The symptoms will disappear once you give birth.
How can I prevent it ?
You need to make minor changes in the routine besides comes the role of certain medicines.
Avoid excess of oily and spicy food
Avoid cola and chocolate products
Take frequent small meals instead of eating in one go
Don’t lie down immediately after having meals
Keep yourhead end elevated with pillows to avoid reflux
Say no to alcohol and smoking as that’s going to make the situation worse
Avoid eating anything at least three hours prior to sleeping at night
Check with your doctor if you are on certain medicines for medical illness as they may be precipitating factor like antidepressants, painkillers , antihypertensives etc
Role of antacids there but consult your doctor first.
Conditions Mimicing Heart Burn(Differential Diagnosis)-
* Acid Peptic Disease/Peptic Ulcer
* Pregnancy Induced High Blood pressure(Pre eclampsia)
* Liver Disorder
* Gastrointestinal Problem
(The authors are senior IVF Consultant Delhi and Senior Gastroentrologist).