A topic I’ve had plenty of experience with- as if expectant mums don’t have enough to contend with!
Heartburn is the name given to the feeling of burning in your chest which arises due to the stomach acid passing up from your stomach into your oesophagus. It can occur on its own or with indigestion. Indigestion (also referred to as dyspepsia) describes a collection of symptoms which include bloating, nausea, feeling full, burping a lot, or feeling sick. Indigestion and heartburn usually arrive just after meal time! In pregnancy though it may occur more frequently – especially in the last trimester. In fact up to 8 out of 10 women will suffer from indigestion at some part of their pregnancy according to the HSE.
Pregnancy heartburn and indigestion arises due to several reasons which include:
- Hormonal changes (increased progesterone)
- Expanding uterus taking up all the room and not leaving as much for your stomach!
- The muscles in the top of your stomach/lower oesophagus not working as effectively at keeping acid down where it should be (blame progesterone again)
How to ease the symptoms of heartburn naturally:
- Eat small meals often rather than large meals.
- Avoid eating foods or drinking fluids which increase the risk of heartburn such as spices, caffeine, fizzy drinks, fried, or rich foods.
- Eat your food slowly and drink less water with meals.
- Once more in pregnancy….pillows are your friend! Either prop yourself up in bed using several pillows to help gravity keep your stomach contents down or even put a book or two under the legs of your bed so that your head is more elevated than your stomach!
- This is extremely impractical….avoid bending over! The easiest way to manage this in reality is to go down on your hunkers to pick things up rather than leaning straight over which causes pressure on your stomach.
- Wear loose clothes – again this is all about keeping any unnecessary pressure off your stomach.
- Try to eat a balanced diet rich in fruit (not so much citrus fruits as these can cause irritation), vegetables and fibre to avoid constipation as this can also worsen heartburn.
- Don’t eat close to bed time.
- Sit up straight when you eat and just after to help take pressure off your stomach.
- Some people find having a little cup of milk helps but just be aware that drinking milk also increases your stomachs activity which can produce more acid – so sometimes its a short term gain and longer term pain!
How to treat your medicine with ‘over the counter’ medicines:
- Antacids – Meet your new best friends 🙂 These work by neutralising acid in your stomach which stops it from irritating the mucosa of your oesophagus which causes the burning feeling. Don’t take iron at the same time of day as antacids – try to leave two hours between them as the antacids may prevent the iron from being absorbed.
- Alginates – These often come in antacid preparations to relieve heartburn by forming a ‘raft’ over your stomach contents which prevents the acid from creeping up into your oesophagus to cause the burning sensation.
Both of these types of medications can be really effective at treating heartburn during pregnancy and are available to buy over the counter in your local pharmacy. Remember to read the instructions on the packaging to find out the most up to date information on dosage and safety. Only take them as needed and not for prolonged periods of time. Here are the highlights of the main brands on the Irish market which you can safely choose from as of June 2015:
- Rennie – These are a range of antacids which neutralise acid. They are chewable tablets and come in peppermint, spearmint (plain and sugar free), orange and Ice (a personal favourite!). These products do not enter the babies blood stream and are a good choice if heartburn occurs in pregnancy. As they are calcium based its important not to eat or drink excessive amounts of dairy if using them – everything in moderation as they say. Chew one or two tablets as required up to a maximum of eleven tablets per day. I would recommend taking them 30-60mins after a meal and before bed. Please ask your pharmacist (or me through the WonderBaba facebook page – details below) if you take other medication or suffer from an existing health problem to ensure these are safe to take.
- Gaviscon Original – This range contains antacids and alginates. It comes in chewable tablets in peppermint or strawberry flavour and you can take two to four tablets after meals up to four times per day. It also comes in aniseed or peppermint flavour liquid which is taken at a dosage of 10-20mls after meals and at bedtime.
- Gaviscon Advance – This comes in Liquid form and is twice as concentrated as the original liquid and forms a really good raft over the stomach contents. As it is a more concentrated formulation the dosage is only 5-10mls after meals and at bedtime.
- Gaviscon Extra – This range of tablets and liquid contains two antacids and an alginate to effectively neutralise stomach acid and form a raft over the stomach contents. The liquid can be taken at a dosage of 10-20mls after meals and before bed (up to four times a day) and the tablets can be taken at a dosage of two to four tablets after meals and before bed (up to four times a day). It should only be taken as required.
There are other antacids and alginates on the market but they are unlicensed for use in pregnancy due to insufficient clinical data such as Maalox and Bisodol.
When to see the Doctor?
If you have been self treating your symptoms for seven days with no success I would advise a visit to your Doctor. There are several prescription medications which are suitable for use during pregnancy under medical supervision such as ranitidine and omeprazole. Heartburn during pregnancy can be extremely uncomfortable and can be quite debilitating and effect your ability to eat properly so I really would urge you to seek further help if these measures do not relieve your discomfort.
I hope you have found this article helpful and if you have any questions at all please don’t hesitate to contact me by sending a private message to the WonderBaba facebook page (www.facebook.com/wonderbabacare) or by calling me (Sheena) at Milltown totalhealth Pharmacy in Dublin 6 on 01-2600262. I’m always happy to help!