Heartburn (indigestion / acid reflux / dyspepsia) affects a significant number of the population, even more so during pregnancy. Symptoms usually emerge during the second and third trimesters, but can occur at any stage. Oh, the joys!
Heartburn in pregnancy can be mediated by both hormonal and physical changes.
Hormonal changes: natural increases in hormones such as progesterone promote the relaxation of smooth muscles around the uterus, which is important as your baby grows. However, it can also affect smooth muscles elsewhere in the body, such as the lower oesophageal sphincter (the valve separating the stomach from the oesophagus). This laxity allows gastric acid to escape out of the stomach and into the oesophagus, leading to a burning sensation in the chest and throat. It can also slow the rythmic contractions of the stomach, contributing to sluggish digestion.
Physical changes: as pregnancy progresses, your baby starts taking up more and more room in your abdomen, which places strain on the surrounding organs. This also creates less space in your stomach as your diaphragm is pushed upwards, and often contributes to the reflux of gastric acid and partially digested food.
Happily, there are a number of things you can do for heartburn, here are my top five:
- Small meals – don’t gorge on large amounts of food in one sitting (no matter how delicious!) and try to slow down while you’re eating. This will help your stomach break down your meal, improving digestion generally and preventing reflux.
- Sip your drinks, even more so between meals – try not to guzzle large amounts of water or herbal tea in one sitting. Instead, sip on these regularly throughout the day to will help you avoid ‘flooding’ your stomach. Also try to avoid drinking while you’re eating a meal, as this can dilute gastric acid, which will slow down your digestion further.
- Stay upright – particularly after you’ve just eaten. I know I’m sometimes guilty of lying down almost directly after dinner, particularly in this later stage of pregnancy when I feel tired and preferentially horizontal by evening. However, if you are experiencing heartburn, this is not a good idea as gravity is going to work against you and encourage the backflow of gastric acid. Stay upright, or if you must lie down, do so with your back propped up by several pillows.
- Recognise (and avoid) foods that trigger heartburn – for some women this will be spicy food, for others chocolate or meat-heavy meals. Not everyone is the same and as such you do not need to avoid a long list of potential triggers. However, be aware of when you react most and aim to avoid those foods as much as possible.
- Herbal medicines – there are a number herbs that can help significantly with heartburn and are fine to use in pregnancy. As such, your naturopath or herbalist may give you liquid or tablet formulation to improve your symptoms. Alongside this, the regular consumption of herbal teas can and should be included, particularly after a meal; my picks include Peppermint, Ginger, Chamomile and Nettle.
Another excellent herb for heartburn, and digestion more generally, is Slippery elm. This is a powder than can be taken in a glass of water, or made into easy-as lozenges. Slippery elm lozenges take no time to make at home and travel very well – I will share the recipe with you in my next post so you can make your own.
Have you experienced pregnancy heartburn? What’s worked best for you?