Your pregnant body

• Your body goes through major changes during pregnancy.
• Weight gain, breast changes and aches and pains are common.
• There are ways to deal with common discomforts and changes.

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Many women have heartburn for the first time during pregnancy, particularly during the second and third trimesters. Although this is not usually a sign of a serious problem, it can be uncomfortable or painful. Gastroesophageal reflux is often called "acid reflux" or "heartburn." But this condition has nothing to do with the heart!

Indigestion is also common during pregnancy and can occur with heartburn. Also known as "dyspepsia," indigestion is just another name for an upset stomach. You'll know you have indigestion if you feel very full, bloated or gassy.

Causes of heartburn and indigestion during pregnancy
Heartburn occurs when digested food from your stomach, which contains acid, is pushed up toward your esophagus (the pipe between your mouth and your stomach). This causes a burning sensation behind your breastbone or a burning sensation that starts in your stomach and seems to rise up. You may also have a sour taste in your mouth or a feeling that vomit is rising in your throat.

• Normally, food moves down the esophagus between your mouth and your stomach.
• When you're not eating, a circular valve around the bottom of your esophagus closes off the connection between your esophagus and your stomach.
• This valve keeps the acids in your stomach from rising up.
• When you swallow, the valve relaxes to allow food and liquid to flow through.
• If the valve relaxes when you're not eating, the acids from your stomach can flow back up into your esophagus, irritating it and causing a burning sensation.

Several things can cause heartburn and indigestion, such as:

• Greasy or fatty foods
• Chocolate, coffee and other drinks containing caffeine
• Onions, garlic or spicy foods
• Certain medications
• Eating a very large meal
• Eating too quickly
• Lying down after eating

Pregnancy hormones
During pregnancy, hormones relax the muscles in your digestive tract, including the valve in the esophagus. This allows stomach acids to more easily seep back up the esophagus, especially when you're lying down. Heartburn can be worse in the second and third trimesters, when your growing uterus presses on your stomach. This sometimes pushes food back up into the esophagus. 

 Pregnancy hormones also slow down:

• The muscles that push food from your esophagus into your stomach
• The muscles that contract to digest food in your stomach, which slows down your digestion
• These changes can also lead to indigestion, which can make you feel very full, bloated or gassy.

What you can do
Follow these tips to prevent heartburn:

Eat smaller meals.

• Eat five or six small meals a day instead of eating three large meals.
• This can help your body digest food better.

Drink less while eating.

• Avoid drinking large amounts of fluids with your meals.
• Drink fluids between meals instead.

Avoid foods that trigger heartburn.

• Avoid spicy, greasy or fatty foods, chocolate and caffeine.
• These kinds of food can cause heartburn.

Avoid bending or lying down right after eating.

• Sit up, do light housework, or take a walk until your body has had a chance to digest.
• Be sure to eat your last meal of the day several hours before bedtime.
• If you need to lie down, prop your upper body up with a few pillows.

Don't gain too much weight.

• Gain a sensible amount of weight.
• Stay within the guidelines your health care provider sets.
• Excess pounds put extra pressure on your abdomen, increasing your chances of getting heartburn.

Wear comfortable clothes.

• Tight clothing can increase the pressure on your stomach and abdomen.
• Wear loose clothing to feel more comfortable.

Raise your head when you lie down.

• Prop your head up a few inches with pillows.
• If possible, keep the foot of your bed lower than the head of your bed.
• If you need an antacid to relieve symptoms, talk to your health care provider to choose the right one for you.

When to talk to your health care provider
For most people, heartburn is temporary and mild. But severe heartburn can be the sign of a more serious problem. Talk to your health care provider if you have any of the following:

• Heartburn that returns as soon as your antacid wears off
• Heartburn that often wakes you up at night
• Difficulty swallowing
• Spitting up blood
• Black stools
• Weight loss

August 2009