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Heartburn During Pregnancy: Causes And Remedies

Pregnancy can turn a woman's life upside down. Along with emotional and hormonal changes within, there are many physical changes that a pregnant woman goes through as well. While the external changes are most noticeable to others around you include a protruding belly, swollen ankles or glowing face, internal changes include an excessive urge to pee, tender breasts and heartburn.

Heartburn, a common problem associated with pregnancy, is caused by the relaxing of the muscles on top of the stomach. This relaxation occurs as the body copes with the need to accommodate the growing baby in the womb, resulting in the muscles not being as efficient in preventing the digestive juices from making their way, from the stomach, all the way back to the oesophagus.

Moreover, as the release of the hormones progesterone and oestrogen affects the valve working as a barrier between the stomach and the oesophagus, there is an increased production of the gastric juices, leading to an unpleasant burning sensation, typically behind the breastbone or sternum, often carrying up to the throat as well. The commonly known heartburn is also referred to scientifically as Gastroesophageal Reflux Disease (GERD).

While heartburn is most commonly experienced during the second half of the pregnancy, certain pregnant women might face the issue throughout. Studies have revealed that the symptoms of heartburn significantly increased around the end of the second trimester. [1]

As acid reflux or heartburn can be quite uncomfortable for an expectant mother, at times even having an adverse effect on the pregnancy as well, doctors have been known to prescribe medication for curbing the same. However, as such medications only offer short-term relief, with acidity coming back as soon as the effect of medication wears off, looking for natural ways to counter acid reflux is a much safer alternative.

For the treatment and control of heartburn during pregnancy, the steps that can be taken include medications, lifestyle modifications and diet. [2]

Common Foods That Cause Heartburn During Pregnancy

1. Caffeinated beverages

Beverages containing caffeine such as, tea, coffee, soft drinks or sodas have been known to cause heartburn in pregnant women. If you are unable to go without your coffee, either limit your daily intake to not more than 1-2 cups a day or opt for the decaf version. Coffee, decaf or regular, must never be consumed on an empty stomach when you are pregnant. Similarly, it is best to completely forgo sodas throughout your pregnancy.

1.

Despite the stigma attached to caffeine consumption in pregnancy, caffeine does not, as it is universally believed, lead to an increased risk of adverse fertility, pregnancy or other neurodevelopmental outcomes. [3] All that caffeinated beverages have been confirmed to lead to is heartburn and acidity in pregnant women. Fresh juices are a much better alternative to caffeinated and/or carbonated beverages.

2. Cheese

While you might really love your daily slice of cheese, it is advisable to stay clear of cheese when you are pregnant. The high-fat content in cheese causes acidity and heartburn when consumed by a pregnant woman. Avocado and nuts are also to be avoided for the same reason. Studies have revealed that heartburn, especially in the third trimester, is brought about by the consumption of polyunsaturated fatty acids. [4]

Food items containing high-fat content slow down the digestion process, leading to an increase in pressure exerted on to the stomach, which in turn pushes the acids back into the oesophagus, causing heartburn.

3. Beef

Being high in fat, beef causes heartburn in pregnant woman and is best avoided throughout the duration of pregnancy. If you must have beef, go for leaner cuts. With comparatively less amount of fat, a lean cut will lead to lesser heartburn.

In some cultures, it is believed that pregnant women should avoid beef, for the simple reason that routine treatments administered to the cattle, such as immunizations and injections, might prove to be a health hazard to the foetus of the pregnant woman who consumes such beef. [5]

4. Chocolate

Known as a reflexogenic or substance causing acid reflux, chocolate consumption is not recommended for pregnant women for a variety of reasons. In addition to containing caffeine, chocolate also has theobromine, a kind of methylxanthine that leads to heartburn and acid reflux.

Similar to other reflexogenics, chocolate causes reflux by a combination of various factors - increasing the secretion of gastric juices, stimulation of sensory receptors to be found in the oesophagus, reducing the tension of the lower esophageal sphincter as well as by delaying the voiding of waste from the stomach. [6]

If you do have an uncontrollable craving for chocolate, consume the same in small quantities or opt for dark chocolate.

5. Spicy food

Consumption of spicy foods is a prominent cause for heartburn in pregnant women. Studies conducted on pregnant women have led to the finding that while spicy food significantly caused heartburn [7] , green vegetables were protective of the same.

Pepper, capsicum and chilly are not recommended to be eaten raw by an expectant mother. If the craving for spicy food strikes, ensure that you consume the same in smaller portions and also keep the spices mild.

6. Processed baked foods

Loaded with artificial colouring as well as preservatives, the processed baked food products available in the market are quite unhealthy for all, especially so for pregnant women. Refined white sugar and all-purpose flour or maida have been known to cause heartburn in pregnant women. However, if you must have baked products, stick to those products that are freshly baked.

7. Alcohol

It goes without saying that alcohol is universally considered to be detrimental to the growing baby in the womb. A known teratogen [8] , or factor or agent causing malformation of an embryo, there are a host of other problems or Fetal Alcohol Spectrum Disorders (FASD) associated with an expectant mother drinking alcoholic drinks, which include premature birth, low birth weight, spontaneous abortion, developmental delay, cognitive deficits and small for gestational age. [8]

As there are no clear guidelines as to what amount of alcohol can be considered safe for consumption while pregnant, alcohol is best avoided altogether throughout the pregnancy. In addition to being detrimental for the growth of the foetus in the womb, alcohol is also known to cause heartburn and acidity in the expectant mother.

8. Peppermint

Peppermint, when consumed, leads to relaxation of the sphincter muscle present between the stomach and the oesophagus. As during pregnancy, these muscles are already quite lax, the stomach juices or acids flow back into the oesophagus quite easily, causing heartburn. It is for this reason that pregnant women are advised against consuming peppermint as well as peppermint-flavoured foods.

9. Garlic

Fructans, a main component of garlic, are not completely digested by the human body. Leading to indigestion, fructans can cause heartburn in pregnant women. The safest way would be to fully avoid garlic throughout pregnancy. If, for any reason, complete avoidance is not feasible, then to at least limit its intake to keep heartburn at bay.

Home Remedies For Heartburn

While antacids provide temporary relief, medications should generally be avoided as much as possible during pregnancy. Some home remedies for heartburn as as follows:

1. Lemonade

As per Dr Theodore Baroody in the book Alkalize or Die, heartburn can be effectively treated with lemon. Lemon, when ingested, neutralizes the gastric juices and acids, thereby creating an alkaline environment that controls acid reflux. For this reason, lemonade is a quick fix solution when you are suffering from heartburn during pregnancy.

2. Chewing gum

While it seems too simple to be effective, chewing gum can actually control heartburn. On chewing gum, our salivary glands go into an overdrive, producing more saliva. When this excess saliva reaches the stomach, it effectively neutralizes the acids, thereby checking heartburn.

3. Ginger

Acting as a tonic, ginger is widely used by Chinese herbalists for the treatment of various ailments connected with the stomach and digestion. For relief from heartburn, a pregnant woman can safely consume ginger tea prepared by soaking a small piece of raw ginger in heated water. Add a bit of sugar, if required. This concoction will give you relief from heartburn.

4. Dietary changes

Little alterations in the diet can effectively curb the occurrence of heartburn in pregnant women. As caffeinated beverages, spicy dishes and oily food have been proven to trigger heartburn, avoidance of such things can greatly reduce acidity.

5. Lie down and elevate upper body

This is probably the quickest and easiest way to get relief from heartburn. Elevating the upper body while lying down checks the reflux of stomach acid to the oesophagus, thereby reducing heartburn.

To Conclude...

Heartburn is a fairly commonplace complaint, affecting between 17% to 45%[9] of all pregnant women. Medications given to combat heartburn in pregnant women include sucralfate or antacids[10] . Usually, there are six interventions that can address the problem of heartburn in pregnant women - antacids either with or without the presence of alginates, restricting the intake of caffeine, reducing the consumption of fatty foods, raising the head of the bed while lying down, reducing the size as well as the frequency of meals. [11]

Though a commonly held old wives' tale, studies have unexpectedly confirmed that there is indeed a correlation between the severity of heartburn experienced by a pregnant woman and newborn hair. [12]

View Article References
  1. [1] Marrero, J. M., Goggin, P. M., De Caestecker, J. S., Pearce, J. M., & Maxwell, J. D. (1992). Determinants of pregnancy heartburn. BJOG: An International Journal of Obstetrics & Gynaecology, 99(9), 731-734.
  2. [2] Neilson, J. P. (2008). Interventions for heartburn in pregnancy. Cochrane Database of Systematic Reviews, (4).
  3. [3] Morgan, S., Koren, G., & Bozzo, P. (2013). Is caffeine consumption safe during pregnancy?. Canadian family physician Medecin de famille canadien, 59(4), 361-362.
  4. [4] Dall’Alba, V., Fornari, F., Krahe, C., Callegari-Jacques, S. M., & De Barros, S. G. S. (2010). Heartburn and regurgitation in pregnancy: the effect of fat ingestion. Digestive diseases and sciences, 55(6), 1610-1614.
  5. [5] Riang'a, R. M., Broerse, J., & Nangulu, A. K. (2017). Food beliefs and practices among the Kalenjin pregnant women in rural Uasin Gishu County, Kenya. Journal of ethnobiology and ethnomedicine, 13(1), 29.
  6. [6] Jarosz, M., & Taraszewska, A. (2014). Risk factors for gastroesophageal reflux disease: the role of diet. Przeglad gastroenterologiczny, 9(5), 297-301.
  7. [7] Rey, E., Rodriguez-Artalejo, F., Herraiz, M. A., Sanchez, P., Alvarez-Sanchez, A., Escudero, M., & Diaz-Rubio, M. (2007). Gastroesophageal reflux symptoms during and after pregnancy: a longitudinal study. The American journal of gastroenterology, 102(11), 2395.
  8. [8] DeVido, J., Bogunovic, O., & Weiss, R. D. (2015). Alcohol use disorders in pregnancy. Harvard review of psychiatry, 23(2), 112-121.
  9. [9] Vazquez J. C. (2015). Heartburn in pregnancy. BMJ clinical evidence, 2015, 1411.
  10. [10] Richter, J. E. (2005). The management of heartburn in pregnancy. Alimentary pharmacology & therapeutics, 22(9), 749-757.
  11. [11] Van Thiel, D. H., Gavaler, J. S., Joshi, S. N., Sara, R. K., & Stremple, J. (1977). Heartburn of pregnancy. Gastroenterology, 72(4), 666-668.
  12. [12] Costigan, K. A., Sipsma, H. L., & DiPietro, J. A. (2006). Pregnancy folklore revisited: the case of heartburn and hair. Birth, 33(4), 311-314.

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