Question: I have really bad heartburn. I thought it would get better as I moved into the third trimester but it seems to be getting worse. Can I take over [...]]]>

Question: I have really bad heartburn. I thought it would get better as I moved into the third trimester but it seems to be getting worse. Can I take over the counter heartburn remedies or antacids?

Answer:

You are not alone, pregnant women are particularly susceptible to heartburn, a form of indigestion. Unfortunately, the problem is made worse in the late stages of pregnancy by the uterus pushing everything upwards. Women who find heartburn particularly uncomfortable can opt for an over the counter indigestion remedy, but get your health practitioner to check them out first.

Before reaching for medication you could try some natural remedies including;  almonds, a tablespoon of honey in warm milk, ginger, apple or some fresh or dried papaya.

Here are some helpful tips on how to combat heartburn during your pregnancy.

Why does heartburn worsen during pregnancy?

When pregnant your body produces the hormones progesterone and relaxin which relax muscle tissue everywhere in the body including your gastrointestinal tract. As a result, food moves more slowly through your system and can result in you feeling full earlier and bloating in the upper abdomen and chest area. Heartburn occurs when the valve between the bottom of the gullet (oesophagus) and the stomach relaxes allowing food and stomach acids back into the oesophagus. The stomach acid irritates the sensitive oesophageal lining causing the burning sensation where the heart is.

What natural remedies can I use to relieve the pain and discomfort of heartburn?

Before trying medicines to relieve heartburn try out these natural remedies:

• Fresh or dried papaya contains papain which is a digestive enzyme that positively aids in digestion and soothes the stomach.
• Almonds, a handful of seven almonds when you feel an attack coming on may relieve the symptoms of heartburn.
• Warm milk with a tablespoon of honey.
• Ginger can be taken in capsules, as a tea or candied ginger.
• Apples contains acid neutralising substances. Consume one after a meal to relieve heartburn and one throughout the day to prevent heartburn.

What can I do to avoid heartburn?

• Avoid eating before you go to bed.
• At night, try propping yourself up on a couple of pillows.
• Avoid eating large meals. It may be better to eat frequently, say four to five little meals, rather than two to three large meals.
• If you get heartburn during the day, try sitting in an upright chair, leaning forward slightly, rather than lounging back on a sofa.
• When you’re bending over, particularly to pick things up, try bending your knees and crouching rather than suddenly leaning over.
• Avoid eating and drinking at the same time. Make the most of your liquids between meals.
• Try and work out which foods might be triggering off your symptoms and avoid them.
• Avoid wearing tight-fitting clothes if you’re feeling uncomfortable.

What foods should I avoid to reduce heartburn?

• Citrus & tomatoes are high in acid which can exacerbate heartburn. Eat these foods with other foods such as bread.
• Caffeine drinks such as coffee and tea can increase stomach acidity, so opt for herbal tea instead.
• Alcohol can trigger heartburn and should be avoided during pregnancy.
• Fatty, spicy or greasy foods can bring on heartburn so try baking food instead of frying.
• Chocolate can trigger heartburn. Do your best to limit the amount of chocolate that you consume and do not eat it on an empty belly.

What can I do to relieve heartburn pain as it happens?

• Stand tall, with arms raised above head to increase chest space during an attack for immediate relief.
• Try drinking milk or peppermint tea for relief. If it doesn’t work for you avoid.
• Chewing gum can stimulate saliva, which helps neutralise stomach acid.
• Get advice from a homeopathic who may recommend remedies such as Arsenicum 6c and Natrum Phosphoricum 6c, taken three times daily.

Can I take heartburn medicine whilst pregnant?

Whilst there are a number of indigestion medicines deemed safe by the NHS in the UK you should always check with your GP, midwife or pharmacist before taking anything when you are pregnant.

• Antacids and alginates work by neutralising acid in your stomach so that it no longer irritates the protective lining (mucosa) of your digestive system.
• Alginates are sometimes combined with antacids to relieve indigestion caused by acid reflux. Acid reflux occurs when stomach acid leaks back up into your oesophagus (gullet) and irritates its protective lining (mucosa).

The NHS believe it is safe to use antacids and alginates while you are pregnant, as long as you do not take more than the recommended dosage. But always follow the instructions on the enclosed patient information leaflet to ensure you take it correctly.

If you are prescribed an antacid and you are also taking iron supplements, you should not take them at the same time. This is because antacids can prevent iron from being properly absorbed by your body. You should make sure that you take your antacid at least two hours before or after you take your iron supplement.

• Acid-suppressing medicines normally require a prescription. These medicines work by suppressing the acid in your stomach. Ranitidine and omeprazole acid suppressing medicines are thought to be safe by the NHS. As with antacids and alginates, you should always follow the dosage instructions on the packet of your medicine.

If you are still suffering from heartburn after taking these measures speak to your midwife or doctor.

References:

• NHS Clinical Knowledge: Indigestion (dyspepsia) in pregnancy (Accessed May 2010)

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