Reflux is common in pregnancy and those with pre-existing issues will often find that reflux symptoms are exacerbated by their impending baby. Reflux classically presents as heartburn and the regurgitation of stomach contents into the oesophagus (food pipe) and even the throat and mouth.
The cause in pregnancy is thought to be two-fold; the sheer size of the enlarging uterus impacting on the space and function of the stomach as well as high levels of the hormone progesterone. Progesterone has the role of relaxing smooth muscle in the body, which is important to prevent the uterus from contracting and inducing premature labour, but not so useful when it causes the muscular valve at the top of the stomach to relax, which allows gastric acid and stomach contents to reflux into the oesophagus. Incidentally, this is also the mechanism behind the constipation that plagues so many pregnant women – progesterone inhibits the smooth muscle in the large intestine allowing food to travel too slowly through the bowel and become excessively firm.
The good news is that for most pregnant women reflux can be managed, or at least brought back into control, with some simple dietary and lifestyle modifications.
Avoid foods that may exacerbate symptoms
Foods known to exacerbate reflux include high-fat meals, alcohol, coffee, chocolate, citrus fruit, tomato and tomato products, spicy foods, soft drinks. However try not to take on unnecessary food restrictions – only avoid a food if you notice it causes a problem (excessively restricted diets are not helpful)
Eat smaller meals
Drink fluids between meals, rather than with meals
Avoid lying down immediately after eating
Avoid eating or drinking in the 2-3 hours before bedtime or exercise
Elevate the head of the bed, or sleep on several pillows
Stop smoking (for lots of reasons!!!)
Generally speaking, antacid preparations are safe in pregnancy. Examples include “Mylanta”, “Quickeze”, “Tumms” and “Gaviscon”. Liquid preparations tend to work better than tablets but are not as convenient.
And if pain persists? See your doctor!
Occasionally reflux symptoms are severe enough to warrant medication and there are a number of safe options. Reflux is also implicated in morning sickness. So don’t tough it out – discuss your symptoms with your doctor and ask for help.