Dealing with heartburn during pregnancy.
IT begins with a queasy feeling in the chest, which becomes a burning sensation soon after. You’ll feel a tightness inside your chest and acute pain that can leave you gasping for breath. This uncomfortable condition is what is known as heartburn which, unfortunately, is prevalent among pregnant women. Up to 72% of women experience heartburn during pregnancy; surprisingly, many do not know what causes the condition and even more are unclear on how to treat it. In fact, many pregnant women don’t know what heartburn is, and sadly, suffer unnecessarily.
Contrary to its name, heartburn has nothing to do with the heart. Instead, it is a burning sensation felt in the chest behind the sternum. Often, the pain may spread up the throat and leave a sour or acidic taste in the mouth. It may also be a feeling of food stuck in the middle of the throat.
Heartburn occurs when the lower oesophageal sphincter (LES) at the top of the stomach relaxes, allowing the stomach contents to flow back (reflux) up the food pipe. It causes burping, nausea, feeling of bloating or difficulty swallowing, which can last for two hours, or sometimes longer. For many pregnant women, heartburn symptoms can be severe enough to affect appetite and disrupt sleep. If discomfort is prolonged, this can affect her health over the course of her pregnancy.
What causes heartburn during pregnancy?
Pregnancy hormones act to relax various muscles to accommodate the growing baby and prepare the body for birth. Unfortunately, this relaxing effect is also felt in the LES. Hence, when the muscle between the stomach and food pipe fails to tighten, stomach contents easily reflux up the food pipe and irritate it.
Hormonal upheaval is one reason heartburn can occur even at the start of the pregnancy. It has been a common misconception that heartburn only occurs during the third trimester, but this is not true. Heartburn can occur any time during pregnancy, although symptoms are more frequent during the later trimesters. This is because of the growing baby, which exerts intra-abdominal pressure upwards. This causes stomach contents to be pushed upwards, raising the risk of heartburn.
Relieving the pain
Continuous exposure to heartburn symptoms can take its toll on a woman, especially when she faces other discomforts. There are treatments that can alleviate heartburn symptoms that are suitable for pregnant women, namely alginates and antacids.
Alginates are naturally derived from brown seaweed and have been clinically tested to provide symptomatic relief for heartburn in pregnant women without adverse effects on the baby. You may be familiar with Gaviscon, which is an alginate. Upon contact with the stomach acid, alginates form a strong raft-like physical barrier that floats to the top of the stomach contents. This prevents acid from coming into contact with the food pipe.
Clinical trials have shown that 90% of pregnant women experienced symptom relief with Gaviscon. Symptom relief is fast – within five minutes – and can last up to four hours. Alginates are not absorbed into the bloodstream but are eliminated naturally from the body, making this treatment particularly suitable for pregnant women.
Antacids neutralise stomach acid so it doesn’t irritate the food pipe when it flows up from the stomach. While it is fast acting, relief does not last as long as alginates. It is best to avoid antacids that contain sodium and aluminium as it may cause constipation in pregnant women. Every pregnancy is unique so please remember to always consult your doctor to get the most appropriate treatment for you and your baby.
A healthy pregnancy
Ignoring heartburn symptoms won’t make it go away; instead, they can have adverse effects if discomfort is prolonged. The state of your health before and during pregnancy influences your baby’s well-being at birth and beyond.
Hence, if pregnancy discomforts, such as heartburn, are affecting your ability to maintain optimal health, you should seek ways to alleviate the discomfort with minimal risk to you and your baby. Medication is effective in alleviating heartburn symptoms, but it is not the be all and end all. There are simple things you can do to minimise the symptoms of heartburn, such as:
- Eat several smaller meals to reduce stomach pressure
- Chew every mouthful slowly
- Take a moderately paced walk after eating to help digestion
- Avoid lying down within two hours after eating
- Don’t fold yourself up on the couch as this squashes your tummy
- Wear loose clothing around your tummy
- Bend from your knees, not the waist to pick things up
- Develop effective ways to handle stress – stress can cause digestive slow down
- Avoid spicy, highly seasoned, fried or fatty foods, coffee, alcohol, carbonated drinks, and anything with chemical additives
It is especially important to proactively manage your health during pregnancy. By keeping a healthy body, you’re keeping your baby healthy from conception to birth and that’s the best start you can give your child. Pregnancy is one of the most joyous times that we as women will ever experience. Yes, the nine months that follow may be plagued with discomforts as we adjust to bearing life within us, but don’t let discomforts get in the way of enjoying your little miracle.
- Uzan M et al. Rev Fr Gynae Obstet. 1z988;83(7-9);569-572
- Aubertin G et al. Dietology n 4. 1995;27-30
The Star Newspaper, Sunday February 8, 2009
By DR NOR ASHIKIN MOKHTAR