Heartburn in pregnancy: what to do and what to take

Heartburn – often accompanied by gastroesophageal acid reflux – is a common disorder in pregnancy. It can be caused by hormonal changes and the growing uterus pressing against the stomach.

When you are pregnant, you can relieve and prevent heartburn by making some changes to your diet and lifestyle, or – but only on the recommendation of your doctor – you can also take medicines.

Heartburn and gastroesophageal reflux: differences

Heartburn (or heartburn) is a retrosternal burning that arises in the stomach and radiates up to the neck. Pregnancy is one of the risk factors that can trigger heartburn.

Unlike the simplest heartburn, gastroesophageal reflux is characterized by the malfunction of the lower esophageal sphincter which determines an abnormal ascent of acidic material coming from the stomach.

Heartburn is therefore distinguished from reflux in that it does not necessarily involve the ascent of an acid regurgitation.


When you’re pregnant, you’re more likely to have heartburn and reflux due to:

  • Hormonal changes: The hormone progesterone causes relaxation of the esophagus and cardia, the valve that connects it to the stomach. When this valve opens, acid in the stomach can flow back into the esophagus causing a burning in the sternum and reflux that many expectant mothers experience during the nine months;
  • the uterus grows up to reach below the costal arch: especially during the third trimester the abdominal pressure caused by the enlargement of the uterus pushes the stomach acid through the esophageal sphincter;

Other causes of heartburn during pregnancy:

  • eating fatty foods, due to increased acid production;
  • eating spicy foods;
  • pre-existing medical conditions (diagnosis of gastroesophageal reflux disease and hiatal hernia);
  • multiple pregnancies (twins, triplets);
  • H. pylori infection, a bacterium that has been associated with stomach ulcers.

You may be more likely to have heartburn during pregnancy if:

  • you had heartburn before you were pregnant;
  • you are not in your first pregnancy;
  • you are in the late stages of pregnancy.

Since the main causes of heartburn during pregnancy – hormonal and anatomical – cannot be avoided, burning management can be practiced above all in terms of prevention.


The main symptoms of heartburn include:

  • a burning sensation or pain in the chest;
  • the feeling of fullness, bloating, heaviness in the stomach;
  • belching.

Symptoms usually occur soon after eating or drinking, but can sometimes occur late. Although they can occur at any stage of pregnancy, they are generally more frequent from the .

Remedies and prevention

Dietary and lifestyle changes may be enough to manage symptoms, particularly if they are mild.

1 Diet and diet

You may be able to control heartburn by changing your eating habits.

Gastric emptying is affected by the influence of progesterone and is therefore slower. Try to eat and do not overload your stomach.

For the same reason, avoid fatty and fried foods whenever possible. Fatty or fried foods take a long time to digest and can increase the chances of heartburn and indigestion.

Due to a simple lack of space in your stomach — due to the compression caused by your uterus — as you progress through your third trimester, your stomach won’t be able to hold as much, so avoid eating Fast .

Relax and sip water between bites , avoiding drinking a full glass of liquid all at once.

Avoid carbonated drinks or foods and beverages that cause more abdominal distension from gas. Some other foods that can cause gas and bloating are broccoli, beans and onions.

Do not eat before going to bed at night: wait three hours between the meal and the time you go to bed. Avoid lying down for a few hours after eating. Going for a walk can help you fight the tiredness that often sets in after eating.

Also avoid foods known to relax the esophageal sphincter :

  • peppermint;
  • chocolate;
  • citrus fruits;
  • coffee.

Adding high-fiber foods is an essential part of treating and preventing heartburn. The recommended amount of fiber in an adult diet is 25-35 grams per day. Fiber-rich foods include whole grains, popcorn, and raw vegetables. Fiber supplements can also be added to your diet, but make sure they don’t contain laxative chemicals.

Drinking alcohol can cause heartburn. During pregnancy, it can also cause long-term harm to the baby. It’s safer not to drink alcohol while pregnant . Learn more about alcohol and pregnancy .

If necessary, take group B vitamins. Vitamins B1 and B2 can be useful to aid digestion: they promote digestive processes through the correct use of sugars, fats and proteins.

Sit up straight while eating: don’t eat in bed or sitting on an armchair: gravity will help your food move along the digestive system in the right direction!

2 drinks

Drinking enough fluids during pregnancy is extremely important: staying well hydrated will help prevent abdominal cramps and heartburn. Fluids are also essential for the baby.

The recommended daily intake is 1.5-2 liters or the equivalent of 6-8 glasses of fluid per day .

If you don’t like drinking plain water, you can try flavoring your water with fruit or drinking fruit juices (watch the sugar content, though, and make sure they’re pasteurized), but broths and soups are also good options tags. Just be careful not to drink too many caffeinated beverages or diet sodas that contain artificial sweeteners.

3 Physical activity

Walking after a meal has many benefits: it helps digestion and can lower blood sugar.

A regular exercise routine can be very helpful in preventing heartburn after meals. In addition to walking, activities such as swimming and bicycling can help speed gastric emptying.

Avoid lifting heavy objects or any activity that puts strain on the abdominal muscles – this increases pressure in the abdomen and will cause gastric contents to reflux into the esophagus.

Wearing tight clothing when you exercise (but also in moments of relaxation) can increase pressure on the abdomen and increase the chances of having reflux: wear loose and comfortable clothes in which you can move freely.

4 Sleep and rest

It is good to pay attention to the sleeping position: this should not be the supine one, because it favors the stagnation of acidic material and reflux. Instead, try to lie down to the side or with your head raised from a second pillow so that you have a slightly more upright position. In this sense, full body pregnancy pillows can be very useful.

Remember not to go to bed immediately after eating, but only after digesting.

5 Smoking

Smoking during pregnancy can cause heartburn and can seriously affect your health and that of your future baby.

When you smoke, the chemicals you inhale can contribute to heartburn. In addition, these chemicals can cause the muscle ring at the lower end of the esophagus to relax, which allows stomach acid to rise more easily.

When to consult your doctor

See your doctor if you need help managing heartburn or if the changes you’ve introduced into your lifestyle aren’t working. This may recommend medications to relieve your symptoms.

You should also see your midwife or GP if you have any of the following:

  • difficulty eating or holding swallowed
  • weight loss
  • stomach pains

Also talk to your GP if you are already taking medicine for another condition, such as antidepressants, and think these are making your heartburn worse. Your doctor may be able to prescribe alternative medicine.

Never stop taking a prescribed medicine unless advised to do so by your GP or other qualified healthcare professional responsible for your care.

Relieve heartburn with medicines

During pregnancy, medications that are often recommended to treat or prevent heartburn include:

  • antacids, to neutralize the acid in the stomach;
  • alginates , to relieve acid reflux by preventing the acid in the stomach from backing up into the esophagus.

If antacids and alginates don’t improve your symptoms, your doctor may prescribe a medicine to reduce the amount of acid in your stomach. Two that are widely used in pregnancy and not known to be harmful to the unborn baby are:

  • ranitidine;
  • omeprazole.

Stomach pain in pregnancy, conclusions

If you suffer from heartburn during pregnancy it is possible that with simple precautions and lifestyle changes you will be able to manage the symptoms. If this weren’t enough, there are a wide variety of active ingredients that can help. But before taking any heartburn medication (even over-the-counter medications), call your doctor.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform, Maternicity.com.

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