When does acid reflux start in pregnancy

Some of the hormonal and physical changes in your body during pregnancy can cause heartburn (also called acid indigestion or acid reflux.) Prevention is your best bet in avoiding the gnawing, burning feeling that comes with pregnancy heartburn. Though you may not be able to avoid the condition entirely, there are some ways to prevent it and minimize any discomfort.

What does pregnancy heartburn feel like?

Heartburn is a burning sensation that often extends from the bottom of the breastbone to the lower throat. Many women experience heartburn for the first time during pregnancy, and although it's common and generally harmless, it can be quite uncomfortable. More than two-thirds of women suffer from heartburn or acid reflux during pregnancy.

Heartburn and related issues like gas and bloating during pregnancy usually start in the second or third trimester, but it can be sooner for some women. The discomfort will probably come and go until your baby is born, but in most cases heartburn is no longer a problem after delivery.

What causes heartburn during pregnancy?

Some of the hormonal and physical changes in your body during pregnancy can cause heartburn. For example, the placenta produces the hormone progesterone, which relaxes the smooth muscles of the uterus. This hormone also relaxes the valve that separates the esophagus from the stomach, which can make gastric acid seep back up and cause that unpleasant burning sensation in your throat.

Progesterone can also make digestion sluggish by slowing down the wavelike contractions of your esophagus and intestines. Later in pregnancy, your growing baby crowds your abdominal cavity, pushing stomach acid back up into the esophagus.

What helps with heartburn during pregnancy?

Prevention is your best bet to reduce heartburn during your pregnancy. Though you may not be able to avoid the condition entirely, here are some ways to prevent it and minimize any discomfort:

• Avoid food and drinks that upset your stomach. These include carbonated drinks, alcohol, caffeine, chocolate, citrus fruits and juices, tomatoes, mustard, vinegar, mint products, processed meats, and foods that are fatty, spicy, fried, or highly seasoned.
• Eat small meals. Instead of three large meals, eat several small ones throughout the day. Take your time eating and chew thoroughly.
• Drink water in between meals. It's important to drink plenty of water daily during pregnancy, but too much liquid can distend your stomach. Stay hydrated by drinking most of your water in between meals.
• Chew gum after eating. Chewing gum stimulates your salivary glands, and saliva can help neutralize acid.
• Eat two or three hours before bedtime. This gives your body time to digest before you lie down.
• Sleep propped up. Elevate your upper body by about 6 inches with several pillows or a wedge when you sleep. This helps stomach acid stay down and aids digestion.
• Dress comfortably. Wear loose, relaxed clothing. Don't wear clothes that are tight around your waist and tummy.
• Ask your provider about heartburn medicines. An antacid that contains magnesium or calcium may ease discomfort. Check with your provider before taking one because some brands are high in sodium or contain aluminum or aspirin. You can also talk to your provider about prescription heartburn medications that are safe during pregnancy.
• Don't smoke. In addition to contributing to serious health problems, smoking boosts the acid in the stomach. (If you're having trouble quitting, ask your provider for a referral to a smoking cessation program.)

Learn more:

• Why prenatal vitamins are important
• Your pregnancy diet: The 12 best foods

Overview

What is heartburn?

Heartburn is when you have a burning feeling in your chest. The uncomfortable sensation can move up your throat. You may also have a bitter or sour taste in the back of your throat.

Though it’s called “heartburn,” it’s not related to your heart. It happens because of acid reflux, which occurs when stomach acid moves from your stomach up to your esophagus. The esophagus is the tube that carries food, liquid and saliva to your stomach.

A muscle called the lower esophageal sphincter (LES) sits between the esophagus and stomach. It opens to allow food to pass, then closes so acid doesn’t travel back up your esophagus. But if the LES doesn’t close properly, the acid can move into your esophagus, causing heartburn.

Why does heartburn happen during pregnancy?

Heartburn is a common symptom that women experience during pregnancy. Changing hormones and shifts in body shape can lead to heartburn.

What is acid reflux during pregnancy?

People use the terms “heartburn” and “acid reflux” to mean the same thing. But they have different definitions:

• Acid reflux refers to the LES not tightening as it should. This allows the stomach acid to travel from your stomach up to your esophagus. (Gastroesophageal reflux disease, or GERD, is a severe form of acid reflux.)
• Heartburn, the feeling of pain or burning in your chest, is a symptom of acid reflux.

Women may have acid reflux during pregnancy and experience heartburn due to changing hormone levels and the baby growing.

What does heartburn during pregnancy feel like?

If you have heartburn, you may:

• Feel burning or pain in your chest.
• Feel bloated or full.
• Burp frequently.
• Feel sick.
• Bring up food.

How common is heartburn during pregnancy?

More than half of all pregnant women report severe heartburn, especially during the third trimester. It’s more common in people who have been pregnant before and those who had heartburn before pregnancy.

Symptoms and Causes

What causes heartburn during pregnancy?

Causes of heartburn during pregnancy include:

• Hormone levels changing: Your hormone levels change during pregnancy, affecting how you tolerate and digest foods. The hormones often slow down your digestive system. Food moves slower, causing bloating and heartburn.
• Esophageal sphincter relaxing: Progesterone, known as the pregnancy hormone, can cause the lower esophageal sphincter to relax. When it relaxes, stomach acid can move up into the esophagus.
• Uterus enlarging: As your baby grows, your uterus gets bigger. It can crowd your stomach and push stomach acids upward, into your esophagus. That’s why heartburn is more common during the third trimester, the last few months of pregnancy. The baby and uterus are biggest then, crowding your other organs.

Management and Treatment

How can I get relief from pregnancy heartburn?

Try these natural remedies for pregnancy heartburn relief:

• Eat yogurt or drink some milk.
• Stir in a tablespoon of honey into warm milk and drink it.

Can I take over-the-counter antacids to relieve heartburn during pregnancy?

Nonprescription heartburn relievers, such as Tums® or Maalox®, can help you feel better. But talk to your healthcare provider before taking antacids. They may contain high sodium levels, which can cause you to retain water. Some also have aluminum in them, which isn’t safe to consume during pregnancy. Your provider can recommend an antacid that’s safe during pregnancy.

Prevention

How can heartburn during pregnancy be prevented?

You can take steps to reduce heartburn symptoms without hurting your baby.

Dietary changes:

• Eat several small meals throughout the day instead of three large ones.
• Eat slowly.
• Drink between your meals, but not with meals.
• Avoid fried, spicy or fatty foods.
• Avoid citrus fruits and juices.
• Limit caffeine.
• Don’t smoke and avoid alcohol. Besides causing heartburn, smoking and drinking during pregnancy can cause health problems for the baby.

Other tips to avoid heartburn during pregnancy:

• Sit up straight when you eat.
• Don’t eat late at night.
• Don’t lie down right after eating.
• Keep the head of your bed higher than the foot of the bed. Or try placing pillows under your shoulders. Doing so helps prevent stomach acids from rising into your chest.

Living With

When should I call my healthcare provider about heartburn during pregnancy?

If heartburn isn’t going away, talk to your provider. They can prescribe medications that are safe to take while pregnant.

You should also call your provider if you:

• Have heartburn that wakes you up at night.
• Have trouble swallowing.
• Spit up blood.
• Have black poop.
• Are losing weight.

Heartburn can have similar symptoms to a heart attack. If you’ve never had heartburn before and you’re having chest pains, call your provider or head to the nearest ER.

A note from Cleveland Clinic

Heartburn during pregnancy is a common pregnancy symptom, especially in the third trimester. You can prevent or get relief from heartburn during pregnancy by making a few changes to your diet, like eating more frequent but smaller meals and avoiding spicy or fried foods. Some yogurt or milk may also help relieve symptoms. Before you take antacids, be sure to check with your provider for the safest option to take during pregnancy.

Do you get acid reflux during early pregnancy?

What trimester do you get acid reflux?

How do you know if you have acid reflux while pregnant?