Suffering From Acidity During Pregnancy? Here’s How You Can Manage It.

Introduction

Severe heartburn, acidity or uncomfortable feeling in the stomach occurring more than twice a week is medically termed as Gastro-Esophageal Reflux Disease (GERD). GERD is so common in pregnant women that according to studies almost 30 – 80% of pregnant women experience it. In fact, data suggests that the majority of pregnant women suffer from acidity in their third trimester even though in others it starts in the first trimester and gradually increases by their third trimester. 

The first thing to do for any pregnant women suffering from acidity is to find a way to manage acidity without harming the baby. In order to do so, you need to know about acidity in the first place and what predisposes pregnant women to acidity? So let us learn about it and different ways to manage it safely during pregnancy.

Acidity in pregnancy is commonly due to hormonal changes and the growing baby pressing against the stomach and it is not usually harmful to the baby, avoiding citrus, spicy, oily foods and carbonated drinks goes a long way to prevent acidity.

Dr. Ashish Bajaj, M.B.B.S., M.D.  in Clinical Pharmacology and Toxicology

What is Acidity?

Normally when we eat food it passes from our mouth to our stomach through a food pipe called the oesophagus. There is a valve where the food pipe ends and the stomach opens, and it is called the Lower oesophagal sphincter (LES). The LES is a muscular band of tissue (like a rubber band) that opens to allow food to enter the stomach and closes as soon as food enters the stomach. As we already know our stomach produces many juices to digest the food and gastric acid is one of those juices. 

When the LES sphincter relaxes without complete closure even after food has entered the stomach, the gastric juices tend to flow back towards the food pipe. These gastric juices (gastric acid) irritate the sensitive lining of the food pipe and as a result, acidity sets in.

Antacidsand Proton Pump Inhibitors like pantaprazole are safe for use in pregnancy, so if life-style modifications fail to manage GERD symptoms, these medications can be added to the antiemetic treatment regimen.

Dr. M.G. Kartheeka, MBBS, MD (Pediatrics)

What are the Symptoms of Acidity?

Pregnant women also experience the same symptoms but the severity may vary depending on the trimester and from person to person.

Common symptoms that you may experience when you have acidity include:

• Feeling of indigestion
• Bloating
• Nausea
• Heat burn 
• Acid regurgitating back up the food pipe and into the mouth 
• Bad taste in the mouth

Most often pregnant women experience an exacerbation of the symptoms soon after they had food and at bedtime. These symptoms as earlier mentioned may start at any time during pregnancy and may continue to increase. 

What Causes Acidity During Pregnancy?

It is important to note that pregnancy does not cause acidity; it only makes one more susceptible to acidity. 

The following are two pregnancy-related contributing factors – 

1. Hormonal Changes

Being pregnant means your body undergoes many hormonal changes to allow the fetus to grow and make your body support and maintain it. Some of these hormones make the muscles relax. During the first trimester, the muscles move in a much-relaxed manner like the food pipe pushes the food much slower and the muscles in your stomach also work in a similar fashion in order to facilitate the absorption of nutrients and supply them to the growing fetus. But as the food stays in the stomach for a longer time you may feel heartburn. 

2. Growing Fetus

In the third trimester, in order to accommodate the growing baby, the uterus pushes your stomach way up thus the stomach will be under constant pressure which also results in acidity. 

Management of Symptoms

Do not worry as acidity during pregnancy rarely causes any serious complications. You can either manage the symptoms by following lifestyle changes or with the help of prescribed medications. 

Lifestyle Changes that can Help you Ease Symptoms

Do’s

• Eat several small meals in a day
• Eat slowly and chew your food thoroughly
• Avoid drinking water when you are eating
• Avoid eating just before bedtime
• Do not lie down after you had food, wait for at least 2 hours
• Have a leisurely walk after your meal
• Wear comfortable clothing
• Eat yoghurt or drink a glass of milk to control symptoms
• Raise the head of your bed by at least 6 inches with the help of pillows

Don’ts

• Eat large meals
• Lie down immediately after your meal
• Eat chocolates, spicy, oily food, acidic fruits like tomatoes and oranges
• Smoke
• Late-night snacking
• Wear tight clothing

Is it Safe to Use Medications for Acidity During Pregnancy?

Many pregnant women suffer from acidity without consulting the doctor as they see it as commonly occurring and consider it as self-limiting. And also they have a strong belief that medications are unsafe for the unborn baby, which is true only to a certain extent. Many medicines are proven to be safe and effective to use under a doctor’s prescription. 

Please consult your doctor before self-medication especially when you are pregnant. Remember that the below-mentioned medicines are only to build your knowledge and trust.

Safe Medications:

• PPIs such as Omeprazole are considered not only effective in treating acidity but also safe to use during pregnancy
• Antacids containing calcium and aluminum, but avoid aluminum-containing antacids during the third trimester as they may cause constipation

Unsafe Medications:

• Aspirin-containing drugs
• Antacids-containing sodium like baking soda, as they buildup fluid in the body
• Antacids-containing magnesium during the third trimester as they may cause contractions

Treatment of Heartburn During Pregnancy

If your heartburn refuses to go away with home medications, 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: OTC medications like calcium carbonate or magnesium hydroxide are generally safe to use during pregnancy. You may find that liquid heartburn relievers are more effective in treating heartburn because they coat the oesophagus.
• 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.

When to Consult Your Doctor?

Most pregnant women with mild to moderate severity of acidity can manage it with lifestyle changes. But many have severe symptoms resulting in weight loss, disturbed sleep, etc. When the symptoms are very severe and bothersome, compromising and severely affecting the quality of life, it is always better to consult the doctor and seek treatment instead of silently suffering or self-medicating.

Final Takeaway

Do not think too much about acidity. As already mentioned you are not alone, almost one-quarter of women suffer from acidity during pregnancy. After delivery, your body comes back to normal and your acidity will subside. Many doctors around the world had successfully treated their patients during pregnancy with safe and effective medicines. 

Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.

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