When do you start feeling heartburn during pregnancy

More than half of pregnant women get serious heartburn, particularly during their second and third trimesters. Heartburn, also called acid indigestion, is an irritation or burning sensation of the esophagus (the tube that carries food and liquid to your stomach when you swallow). It’s caused by stomach contents that reflux (come back up).

Symptoms of Heartburn During Pregnancy

If you have heartburn while you’re pregnant, you may:

• Feel burning or pain in your chest or throat, especially after you eat
• Have sensations of fullness, heaviness, or bloating
• Burp or belch
• Have a sour or bitter taste in your mouth
• Cough or have sore throat

Causes of Heartburn During Pregnancy

Heartburn in pregnancy may happen because of changing hormone levels, which can affect the muscles of the digestive tract. 

Pregnancy hormones can cause your lower esophageal sphincter (the muscular valve between the stomach and esophagus) to relax, allowing stomach acids to flow back up into your esophagus. Also, as your baby grows, your enlarged uterus can crowd the abdomen, pushing stomach acids upward. Although it's rare, gallstones can also cause heartburn during pregnancy.

Prevention of Heartburn During Pregnancy

Some tips that may help you cut down on heartburn during your pregnancy include:

• Eat several small meals each day instead of three large ones.
• Eat slowly.
• Avoid fried, spicy, or rich (fatty) foods or any foods that seem to cause relaxation of the lower esophageal sphincter and increase the risk of heartburn.
• Don’t smoke tobacco or drink alcohol, which can make heartburn symptoms worse.
• Drink less while eating. Drinking large amounts while eating may increase the risk of acid reflux and heartburn.
• Don't lie down directly after eating.
• Keep the head of your bed higher than the foot of your bed. Or place pillows under your shoulders to help prevent stomach acids from rising into your esophagus.
• Wear loose-fitting clothing. Tight-fitting clothes can increase the pressure on your stomach and abdomen.
• Try to avoid constipation.

Treatment of Heartburn During Pregnancy

If your heartburn won’t go away, see your doctor. They may prescribe or recommend OTC medications that are safe to take during pregnancy. Heartburn usually disappears following childbirth.

Medications may include:

Over-the-counter antacids such as calcium carbonate or magnesium hydroxide. These are generally safe to use during pregnancy. You may find that liquid heartburn relievers are more effective in treating heartburn, because they coat the esophagus.

H2 blockers. These medications block chemical signals that produce stomach acid. They include cimetidine (Tagamet) and famotidine (Pepcid, Zantac 360), and they’re available in over the counter and prescription strengths.

Proton pump inhibitors (PPIs). Like H2 blockers, these drugs help cut down on stomach acid. PPIs, which include lansoprazole (Prevacid) and omeprazole (Prilosec), are available over the counter and by prescription.

If you take iron supplements, talk to your doctor before you take a PPI or H2 blocker. These medications can make the supplements less effective.

Heartburn Medication to Avoid During Pregnancy

Talk to your doctor before taking any antacids. Some contain ingredients that may harm you or your baby. Be sure to not to take these medications:

Ranitidine. In 2020, the FDA stopped sales of an H2 blocker called ranitidine (the ingredient in older Zantac products) because it was contaminated with a cancer-causing agent. If you take OTC ranitidine, stop your use. If you have a prescription for ranitidine, talk to your doctor about other options before you stop your medication.