How Do You Know If You Have Heartburn When Pregnant?

Reviewed on 12/30/2020

Heartburn during pregnancy

Heartburn (acid reflux) is caused by stomach acid that is forced back up into the esophagus causing a burning pain in the chest. Spicy foods are a common cause but hormonal changes and a growing uterus during pregancy are also causes. Symptoms include bloating, burping, and a bitter or sour taste in the mouth.
Heartburn (acid reflux) is caused by stomach acid that is forced back up into the esophagus causing a burning pain in the chest. Spicy foods are a common cause but hormonal changes and a growing uterus during pregancy are also causes. Symptoms include bloating, burping, and a bitter or sour taste in the mouth.

Heartburn is a common problem during pregnancy. It's estimated that between 40% to 85% of pregnant people experience heartburn. About 20% will experience it over the course of their pregnancy.

It can occur anytime during all trimesters of pregnancy but is most common during the second and third trimesters {University of Rochester Medical Center: "Pregnancy and Heartburn."}. It also may get worse as the pregnancy progresses.

Heartburn is officially known as gastroesophageal reflux or acid reflux. Many people who have heartburn while pregnant may not have had problems before. However, if you had heartburn before pregnancy, there's a higher likelihood of getting heartburn while pregnant.

Recognizing the signs of heartburn is important so that you can manage symptoms early on with lifestyle changes or over-the-counter medications. For most people, heartburn will disappear after giving birth. 

Signs and symptoms of heartburn in pregnancy

Heartburn has nothing to do with the heart, but one of the symptoms does begin in the chest area. 

Heartburn is a burning feeling that begins in the lower chest area then moves up toward the neck and throat. This usually occurs after eating or at bedtime and can last anywhere between a few minutes to a few hours.

Other signs of heartburn include:

Bloating

Bloating is that too-full feeling where your stomach feels tight. Bloating happens when the gas that’s supposed to be passed out of your body by burping or flatulence stays in your intestines and stomach instead. 

Burping or belching

When you swallow food or a carbonated drink, gas enters the stomach. The air usually stays in the stomach because the lower esophageal sphincter is closed. Belching is when the air escapes from the stomach to the mouth. 

Bitter or sour taste 

The stomach acids and food coming back up your throat can leave a sour or bitter taste in your mouth that can signal heartburn.

Causes of heartburn in pregnancy

Heartburn is commonly caused by eating spicy foods, which can irritate the stomach or esophagus or slow the rate of digestion. This can be true during pregnancy, too, but many of the causes of heartburn in pregnancy are simply natural parts of pregnancy, such as:

Hormonal changes

Experts believe that heartburn in pregnancy is caused by hormonal changes. Pregnant people have high levels of the hormone progesterone which causes muscles in the body to relax. One of these muscles is the lower esophageal sphincter, which seals the stomach off from the esophagus, the long tube connecting the throat with the stomach.

Usually when we swallow our food, the lower esophageal sphincter opens up to allow food to enter our stomachs, but the rest of the time, it's squeezed shut. Because of the increased levels of hormones in pregnant people, the muscle relaxes, allowing stomach acids and partially digested food to move backward into the esophagus. The esophagus lining is more sensitive than stomach lining which is why it feels like it's burning.

Hormonal changes also cause the digestive system to slow down, so the food moves more slowly through the body and stays in the stomach longer.

Growing uterus

As the baby grows, especially during the third trimester, the uterus pushes on the abdomen, adding pressure or blocking parts of the digestive tract. This sometimes pushes stomach acid up into the esophagus. It also adds to the slowing down of the digestive system.

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When to see a doctor for heartburn in pregnancy

Talk to your doctor if you spit up blood or have dark-coloured stool, as these are signs that there may be blood in your digestive system.

Diagnosing heartburn in pregnancy

Your doctor will talk to you about your symptoms. Usually, understanding your symptoms will be enough for your doctor to confirm the diagnosis, and you’re not likely to need tests before starting treatment.

Treatments for heartburn in pregnancy

There are some lifestyle changes you can make to relieve your heartburn.

Eat multiple smaller meals instead of three big ones as food doesn't digest as easily when you are pregnant.

Eat and drink less of the foods that may trigger heartburn such as:

Try not to lie down, slouch, or bend down for a few hours after eating.

Try to eat at least three hours before going to bed. 

Don't smoke. Smoking makes heartburn worse.

Raise the head of your bed by about 6 to 8 inches so you aren’t lying flat when sleeping. You can try placing a styrofoam wedge under the pillow or some blocks of wood between the box spring and the mattress.

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References
Canadian Journal of Gastroenterology and Hepatology: "The effect of heartburn and acid reflux on the severity of nausea and vomiting of pregnancy."

Cochrane Systematic Review: "Interventions for heartburn in pregnancy."

Gastroenterology & Hepatology: "Treatment of Gastroesophageal Reflux Disease During Pregnancy."

Harvard Health Publishing: "Gastroesophageal Reflux Disease (GERD): What Is It?"

International Foundation for Gastrointestinal Disorders: "Heartburn and GERD."

Journal of Gastroenterology and Hepatology: "The effect of chilli on gastrointestinal transit."

MedlinePlus: "Abdominal bloating."

Merck Manuals: "Physical Changes During Pregnancy."

Mount Sinai: "Belching."

University of Rochester Medical Center: "Digestive and Liver Disorders Overview."

University of Rochester Medical Center: "Pregnancy and Heartburn."

Vancouver Clinic: "What can I do to handle heartburn in pregnancy?"

UTSouthwestern Medical Center: "Feeling the burn? Tips to manage heartburn, GERD in pregnancy."

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