Causes of Heartburn in Pregnant Women

The exact causes of heartburn, also known as gastroesophageal reflux or acid reflux, in pregnant women remain somewhat unclear. However, it is believed that hormonal changes, particularly an increase in progesterone levels, play a significant role. Elevated progesterone during pregnancy can relax the valve between the stomach and esophagus, compromising its ability to prevent stomach acid from flowing back into the esophagus. This reflux can irritate the lining of the esophagus. Additionally, progesterone may slow down digestion, causing food to remain in the stomach for a longer period. Alongside hormonal effects, the expanding uterus, especially during the third trimester, exerts increased pressure on the stomach and intestines, pushing food upwards toward the esophagus and triggering heartburn. It is important to note that women who experienced heartburn prior to pregnancy are at a higher risk. Other contributing factors include the consumption of spicy or fatty foods, overeating, eating right before bed, and smoking.

When to Consult a Doctor

Fortunately, heartburn symptoms associated with pregnancy typically resolve after childbirth, and during pregnancy, the symptoms are often mild enough to be managed effectively by many women. However, there are instances when a pregnant woman should seek medical attention, particularly if heartburn is accompanied by significant weight loss, persistent vomiting, or difficulty swallowing. Additional concerning signs include:

Severe heartburn or symptoms accompanied by coughing up blood, or dark-colored stools, as these may indicate gastrointestinal bleeding.
Persisting heartburn symptoms despite the use of medications, which could signal serious complications of pregnancy such as preeclampsia, especially if accompanied by severe headaches unresponsive to medication, visual disturbances like blurred vision, severe pain under the ribs, or sudden swelling in the hands, feet, or face. Preeclampsia requires immediate medical attention due to potential harm to both the mother and fetus.

Tips to Alleviate Heartburn

The best approach to managing heartburn is to prevent it from occurring. Here are some helpful tips to reduce the likelihood of experiencing heartburn:

Consume five to six smaller meals throughout the day instead of three large meals.
Avoid lying down immediately after eating; it is advisable to wait at least an hour before reclining.
Refrain from eating right before bedtime.
Limit coffee consumption, particularly in the evening.
Avoid eating and drinking liquids simultaneously, as this can cause the stomach to feel fuller.
Keep the head elevated about 10-15 centimeters above the rest of the body while sleeping.
Sleep on the left side of the body.
Maintain an upright posture while eating.
Consider chewing gum to stimulate saliva production, which can help neutralize stomach acid.
Avoid smoking, as the chemicals inhaled can relax the muscle ring at the lower end of the esophagus, making it easier for stomach acid to reflux.
Stay away from foods and beverages that worsen heartburn symptoms, such as greasy or fried foods, spicy dishes, citrus fruits, caffeine-containing products, and carbonated drinks.

References:

(*) Preeclampsia: A disorder that develops after the 20th week of pregnancy, it can also occur up to 4-6 weeks postpartum. Clinically, this condition is characterized by high blood pressure and elevated protein levels in the urine and may accompany swelling.

(*) Blurred Vision: This is the most common visual symptom and is characterized by a gradual decline in visual clarity, often correlating with decreased visual acuity.