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Indigestion and Heartburn During Pregnancy

We’re all well aware that most women experience nausea and morning sickness early in pregnancy (this condition is sometimes very serious). One unfortunate fact about pregnancy is that it wreaks havoc on your entire digestive system, from one end to the other, and morning sickness is only one of the discomforts you can expect to have to endure. Indigestion and heartburn during pregnancy can be maddening, but here we will discuss what causes these conditions, and how to manage them.

Symptoms of Indigestion and Heartburn During Pregnancy

Indigestion, also known as dyspepsia, is not the same thing as heartburn, although some of the symptoms may sometimes feel the same. Indigestion is characterized by a sensation of heat or pain in the area below the sternum (the breastbone), just above the belly button. There is generally an unpleasant feeling of being too full, which begins immediately after eating, or sometimes even during the meal. In addition to feeling bloated (and possibly gassy), you may feel nauseous, but it is not the same as morning sickness.

Indigestion during pregnancy affects eight out of ten pregnant women, and it can become more frequent and severe later in the pregnancy, especially after the 27th week or so.

Heartburn, of course, takes its name from its most distinctive symptom—a burning sensation that emanates from the center to upper part of the abdomen, which is approximately where the heart is located. As you probably already know, this condition has nothing to do with your heart. Heartburn during pregnancy, as at other times, is caused by stomach acid coming up through the esophagus and burning tissue that is not as well protected as the lining of the stomach—hence the medical term for this condition, acid reflux.

Both conditions—indigestion and heartburn during pregnancy—are often characterized by involuntary and uncomfortable belching.

Causes of Indigestion and Heartburn During Pregnancy

The causes of morning sickness are unrelated to the causes of indigestion and heartburn during pregnancy. The nausea and vomiting that occur throughout the first trimester are caused mostly by hormonal changes, but the causes of pregnancy indigestion and heartburn, while partly hormonal, are in some ways more direct.

Indigestion during pregnancy is often caused by the same things that can cause indigestion at any other time:

  • Fatty food
  • Greasy food
  • Spicy foods such as onions, peppers, or garlic
  • Alcohol
  • Eating too much too quickly
  • Gallstones
  • Ulcers
  • Gastritis

All these ordinary conditions are exacerbated by the effect of pregnancy hormones (particularly progesterone), which slow the action of the muscles that push food down into the stomach, as well as the stomach muscles that contract to grind up food.

Heartburn during pregnancy is likewise caused by many of the normal causes of heartburn—mostly the same kinds of foods that tend to cause indigestion. Heartburn occurs when the valve muscle that blocks food from coming back up the esophagus opens when it is not supposed to, allowing partially digested food and acid to come up. Here again progesterone is the primary culprit during pregnancy, as it relaxes muscles, including this valve. The growing uterus also exerts pressure on the stomach, further contributing to the problem (this is one of the biggest reasons why indigestion and heartburn during pregnancy are worse during the third trimester).

Indigestion and heartburn during pregnancy can also both be brought on by too much stress. (As if you didn’t have enough worry about!) Diabetes can also be a factor in both conditions.

Treatment for Indigestion During Pregnancy

If your symptoms are not too severe, you may be able to manage your pregnancy indigestion symptoms by making a few simple lifestyle and diet changes. If you’re pregnant, you have likely already given up tobacco and alcohol (and if you haven’t, you should). Changes in your diet are the next step in treating indigestion during pregnancy. Lay off the obvious triggers—onions, garlic, peppers, etc.—as well as the less obvious ones, such as chocolate, fruit juice, and caffeine, and make sure your diet is balanced in order to ensure proper nutrition.

Additional steps for treating indigestion during pregnancy include:

  • Avoid taking aspirin or ibuprofen if possible (this is another unfair pregnancy catch-22, as pregnant women can be prone to headaches)
  • Try to avoid bending over or becoming excited or stressed immediately after eating
  • Yoga can be helpful for stress management, and a quick Internet search should yield plenty of local results for prenatal yoga classes
  • Don’t take pregnancy as an excuse to gain too much weight; your doctor can advise you on healthy pregnancy weight gain
  • Wear loose-fitting clothes

Treatment for Heartburn During Pregnancy

Antacids are generally considered perfectly safe during pregnancy, but check with your doctor to make sure you aren’t using them excessively, and to make sure the antacids you’re using don’t contain excessive amounts of sodium, which can cause fluid retention in your body’s tissues.

Again, lifestyle and diet changes are the first method of treatment. In addition to the changes in diet described above, try to make it a habit to wait an hour after you’ve eaten before you lie down. If the problem is severe enough, your doctor may consider acid suppressants such as ranitidine or omeprazole.

Medical References:

    References: The March of Dimes Foundation http://www.marchofdimes.org/pregnancy/heartburn-and-indigestion.aspx The University of California, UC Davis Health System http://www.ucdmc.ucdavis.edu/welcome/features/20081204_heartburn/index.html The National Institutes of Health http://www.nlm.nih.gov/medlineplus/ency/article/003114.htm http://www.nlm.nih.gov/medlineplus/ency/article/003260.htm The University of Maryland Medical Center http://umm.edu/health/medical/ency/articles/indigestion The American Pregnancy Association http://americanpregnancy.org/pregnancy-health/heartburn-during-pregnancy/ The UK National Health Service http://www.nhs.uk/conditions/pregnancy-and-baby/pages/indigestion-heartburn-pregnant.aspx#close
[Page updated April 2016]