Stephanie Seto 
Is heartburn ruining mealtime?
The feeling of acid rushing back up your throat is uncomfortable but not uncommon. Symptoms of acid reflux may affect as many as 80% of pregnant women.
Unfortunately, pregnancy makes heartburn and GERD more likely. But what causes it? And can you prevent it?
In this article, we’ll give you the best tips to prevent heartburn and acid reflux in pregnancy.
What is Acid Reflux in Pregnancy?
Acid reflux, formally called gastroesophageal reflux (GER), is when your stomach acid travels up toward your throat. This can create a burning feeling in your chest, known as heartburn.
Your esophagus connects your throat to your stomach and typically sends food down to your stomach for digestion. The gastroesophageal sphincter acts as a door that lets food into the stomach but stops contents from going back up the esophagus. When this “door” fails, acid is allowed to flow back up toward your throat.
Anyone can experience acid reflux but it’s more common during pregnancy. Some people get acid reflux in pregnancy early on. However, it’s more likely to start in the second or third trimester.
Is heartburn the same as acid reflux in pregnancy?
Heartburn is not the same as acid reflux. Heartburn is a symptom of acid reflux.
Is acid reflux the same as GERD?
Acid reflux is not the same as GERD. Many people experience random episodes of acid reflux. GERD is ongoing acid reflux, typically occurring more than twice a week for several weeks. GERD is a more serious condition that requires treatment; however, it’s very common. About 20% of Americans have GERD.
Acid Reflux Pregnancy Symptoms
You can usually feel acid reflux symptoms soon after eating or drinking. However, sometimes there’s a delay between eating and symptoms.
The most common acid reflux pregnancy symptoms include:
- Heartburn feels like a burning sensation in the center of your chest. It moves upward to the neck and throat.
- Bitter taste in mouth. A bitter or sour taste in your mouth could be caused by the stomach acid traveling up.
- Bringing up food. Food you swallowed may also travel back up to your mouth.
Acid Reflux in Pregnancy Early On
Acid reflux is more common during the second and third trimesters. But can still happen during early pregnancy. About 26% of people have GERD symptoms during the first trimester, according to a survey.
So why do you have acid reflux in pregnancy early on?
One reason could be that you’re just more prone to it. You’re more likely to experience acid reflux if it was a problem pre-pregnancy.
Although researchers aren’t clear on exactly why acid reflux is more common during pregnancy, they believe hormones could play a role. The hormone progesterone slows down the body’s digestion to allow extra time for your baby to get nutrients. The downside is that the relaxing of the digestive system can create a variety of issues. One of those issues is the malfunction of the gastroesophageal sphincter. As we described above, this “doorway” can accidentally allow stomach acid to travel up.
Slower digestion, thanks to progesterone, has another effect: It keeps food in your stomach for a longer period. This gives more opportunity for acid reflux.
Acid Reflux in the Third Trimester
Most commonly, acid reflux in pregnancy happens in the second and third trimesters. About 36% of women in the second trimester and 51% in the third trimester experience GERD symptoms, according to a survey.
As we described in the section above, progesterone slows digestion, relaxing the gastroesophageal sphincter, encouraging it to malfunction. It also creates more opportunities for heartburn by keeping food in the stomach longer.
There’s another reason acid reflux in the third trimester is so common: Your growing uterus. Researchers theorize that the upward pressure of your big uterus can contribute to acid reflux. The increased pressure on your stomach can worsen symptoms like heartburn and a bitter taste in the mouth.
How to Prevent Acid Reflux in Pregnancy
Although acid reflux in pregnancy is common, there’s steps you can take to reduce the likelihood of symptoms. According to researchers, most pregnant people can manage acid reflux symptoms with lifestyle changes and intermittent use of antacids.
Below are some lifestyle changes you can try.
Smaller, Frequent Meals
Many digestive problems can be alleviated by eating smaller but more frequent meals. Think of it as grazing throughout the day whenever you’re hungry. For example, instead of having 3 big meals a day, eat 6 smaller-sized portions. This puts less strain on your digestion and leaves less food in your stomach, reducing acid reflux.
Don’t Eat Before Bed
While a little bedtime snack is enticing, it’s best avoided if you’re struggling from acid reflux during pregnancy. Eating before lying down for the night makes it easier for the stomach acid to travel back up to your throat.
Stay Upright for 4 Hours After Eating
Laying down to watch TV after a meal can encourage heartburn. You can help your digestion by staying upright after eating for about 4 hours. Sitting straight or standing are your best options.
Incline When Sleeping
Sleeping on an incline can stop stomach acid from traveling into your lower esophagus. Consider propping yourself up using a pillow or wedge. Pregnancy pillows are perfect for this because they’re large and customizable to your comfort.
Identify Trigger Foods
Try to identify foods that trigger your acid reflux. If it helps, start a journal of what you eat and your symptoms. After a week, observe your entries and spot any patterns. For example, perhaps tomato sauce always leads to heartburn.
Alternatively, you can avoid common trigger foods and see if the problem continues.
Here are some common foods that trigger acid reflux:
- Spicy foods
- Fatty foods
- Greasy foods
- Cheesy foods
- Tomato sauce
- Tomato-based dishes
- Citrus
- Chocolate
- Coffee and other caffeinated drinks
- Peppermint
Don’t Overeat
During pregnancy, you’ll be eating a little more for your baby. But while it can be tempting to continuously snack, it’s not a good idea for your acid reflux. The more you overeat, the more food will be in your stomach—giving more opportunity for heartburn.
Drink Between Meals
Some people find that their acid reflux in pregnancy is better if they drink between meals. Drinking while eating can add to the contents in your stomach, possibly contributing to heartburn.
Chew Gum
Chewing gum can help prevent heartburn. According to a 2005 study, chewing sugar-free gum a half-hour after a meal can reduce the acid in your esophagus.
Avoid Tight Clothing
During pregnancy, you’ll likely want to avoid tight clothing anyway because it’s uncomfortable and pushing against your growing belly. There’s another reason to avoid tight-fitted pants: They can contribute to gastrointestinal issues. If clothing puts too much pressure on the abdomen, it can affect digestion, leading to acid reflux in pregnancy. Even a pair of yoga pants should be traded in for looser, comfortable track pants.
Antacids
Antacids (ex. Tums) usually come in chewable tablets or liquids. These over-the-counter medications neutralize stomach acid and coat the esophagus and stomach.
Talk to your doctor before taking an antacid. Some doctors recommend taking antacids when your symptoms start, while others recommend taking them before a meal.
Keep in mind, antacids decrease iron absorption. For this reason, you shouldn’t take antacids at the same time as an iron supplement.
Proton pump inhibitors (PPIs)
PPIs (ex. Prevacid) are over-the-counter medications that block enzymes from producing acid. These usually take a few days to work at maximum effect. PPIs are considered safe during pregnancy and showed no increased risk of major birth defects.
PPIs can also affect iron absorption.
Treatment for Pregnancy Acid Reflux
If lifestyle changes and antacids aren’t enough to improve your acid reflux, talk to your doctor. They may recommend H2-blockers—medications that reduce the production of stomach acid. Most of these medications are considered safe during pregnancy but should be avoided in the first trimester.
If your heartburn is severe or you’re spitting up blood, seek medication attention ASAP.
Summary: Pregnancy Acid Reflux
Acid reflux during pregnancy is one of the most commonly experienced symptoms. It’s more likely to happen while you’re expecting because of pregnancy hormones relaxing and slowing digestion. Your growing baby belly also adds pressure to the stomach. For most people, lifestyle changes can alleviate acid reflux in pregnancy. Eating smaller meals and staying upright after eating can have a big impact. You should also make an effort to avoid trigger foods and sleep on an incline.
If that doesn’t help, over-the-counter medications, like antacids, can improve symptoms. In cases of severe acid reflux, or acid reflux that cannot be relieved, contact your doctor.
Have You Tried a Fetal Doppler Yet?
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