Pregnant women commonly develop heartburn, a disorder that involves a burning feeling in the chest.

Up to 50 percent of women experience heartburn at some point during pregnancy. Although it can happen at any point during pregnancy, heartburn tends to occur more frequently in the third trimester.

Find out more in this article about heartburn during pregnancy, how to treat and prevent it, and how to tell if it's time to see the doctor.

Contents of this article:

    What is heartburn?
    Why do pregnant women get heartburn?
    Prevention
    Treating heartburn

What is heartburn?

One of the main symptoms is a burning sensation in the middle of the chest. It happens when the valve that connects the esophagus, or food pipe, to the stomach weakens and stomach acid and contents flow back into the food pipe.

The stomach acid is irritating, and this causes the burning feeling in the chest.

Apart from burning in the chest, other symptoms of heartburn include:

    Burping
    Regurgitation
    Bloating
    Nausea

These symptoms tend to occur soon after eating, although not always immediately.

Why do pregnant women get heartburn?

Pregnant women are more likely to get heartburn for a number of reasons.

First, during pregnancy, the hormone progesterone is secreted in higher amounts to support the pregnancy. Progesterone causes the valve that separates the food pipe from the stomach to relax, causing heartburn.

In addition, the growing uterus starts to put pressure on the stomach and other internal organs in later pregnancy. That pressure can also push food and stomach acid back into the food pipe.

Indigestion and heartburn are more likely in women who had heartburn before pregnancy and in those who have been pregnant before.

Prevention

Preventing heartburn is the best way to manage it. Certain foods or beverages tend to trigger the symptoms. Avoiding those foods can help to prevent the discomfort associated with heartburn. Foods that tend to trigger heartburn include:

    Citrus fruits, such as oranges, grapefruits, and pineapple
    Caffeine
    Carbonated drinks, or sodas
    Fatty and greasy foods
    Spicy foods
    Tomatoes
    Chocolate

As well as avoiding these foods, it can be helpful to eat smaller meals more often. Instead of three big meals per day, five or six smaller meals may be better.

Staying upright for at least 20 to 30 minutes after eating can prevent the stomach contents from backing up into the food pipe.

At night, it is better not to eat within 3 hours of going to bed. Propping up the head of the bed or using extra pillows to keep the head elevated can help prevent heartburn that occurs at night.

It is also important to avoid smoking cigarettes and drinking alcohol. Neither is healthy during pregnancy, and they can both contribute to heartburn.

Anyone who finds it difficult to quit should speak with a doctor.

Drinking a glass of milk can help to reduce symptoms. Low-fat or nonfat milk is better because whole milk is rich in fat, and this can worsen heartburn.

Treating heartburn

If these lifestyle changes do not help to prevent the symptoms of heartburn, it may be time to consider medications.

The following is general information about antacids and other over-the-counter remedies for heartburn.

As always, it is best to speak with the doctor before taking any medications, especially during pregnancy.

    Tums: Also known as calcium carbonate. It is considered safe during pregnancy. Calcium carbonate neutralizes the stomach acid so that it is less irritating if it backs up into the food pipe. People should be sure to read the instructions on the bottle for the safe dose in pregnancy.
    H2 receptor antagonists: Also considered safe in pregnancy. They include famotidine, cimetidine, and ranitidine. They are available both over the counter and by a doctor's prescription. These drugs decrease the amount of acid produced by the stomach.
    Proton pump inhibitors: Proton pump inhibitors (PPI) prevent the secretion of stomach acids and work well in the treatment of heartburn. Common PPIs include pantoprazole and lansoprazole. They are also available over the counter and by prescription.

Most proton pump inhibitors are considered to be safe in pregnancy. However, one PPI called omeprazole is not recommended for use. Too few studies have been done to confirm that it is safe.

People should always tell their healthcare provider about all drugs and herbs that they take during pregnancy.

GERD

Heartburn, acid reflux, and gastroesophageal reflux disease (GERD) are often used interchangeably, but they are not quite the same.

Acid reflux is the regurgitation of stomach acid back into the food pipe, causing the symptom of heartburn. GERD is a more serious form of acid reflux and heartburn.

Additional symptoms of GERD can include:

    Chronic cough
    Wheezing
    Chest pain
    Difficulty swallowing
    Regurgitation of food or stomach acid

GERD is estimated to affect 40 percent of Americans on a monthly basis. The treatments for GERD are very similar to the treatments for acid reflux or heartburn.

Avoiding triggers, basic lifestyle changes, and medications can be effective for managing the symptoms. However, in severe cases of GERD, prescription medication or even surgery may be needed to relieve the condition.
When to see a doctor

It is important to see the doctor regularly as part of good prenatal care. Heartburn that is not relieved by lifestyle or diet changes should be mentioned to the doctor at a routine prenatal visit. If medication is recommended, make sure to mention whether or not it is effective in managing the symptoms.

Even though heartburn is common in pregnancy, it is especially important to mention symptoms if they are severe or interfere with daily life.