Where’s All My Pregnant Mamas Out There?
For any of you who have been pregnant- there is a good chance that you have experienced some unpleasant symptoms at some point during your pregnancy. Research has revealed that reflux develops in approximately 30-50% of pregnant women with even higher chances in some patient groups.
Personally, during my pregnancy, reflux is one issue I have dealt with. So I can say with confidence that I am right there with you.
During pregnancy, there are increased levels of the hormones estrogen and progesterone. There is also increased intra-abdominal pressure from the growing uterus (think baby growing + less room for stomach) which pushes all of your organs upwards. These combining factors make up the perfect storm for reflux to occur.
Increased levels of hormones can weaken the lower esophageal sphincter (LES) and slow gastric motility (the rate at which your food digests) and when combined with increased pressure it is difficult to keep food and acid in the stomach.
Who’s at higher risk for reflux in pregnancy?
- Women with pre-existing heartburn or reflux
- Women carrying multiples
- Gestational age (reflux is more common in the 2nd and 3rd trimesters)
- Younger women
How do I alleviate my symptoms of reflux?
- Keep a food and symptom log and avoid these common foods that trigger reflux until you identify what your personal triggers are:
- Avoid drinking while eating- you want to separate food and fluid intake by 30 minutes if possible and avoid using straws which can caused trapped air/gas in stomach increasing the pressure
- Avoid eating 2-3 hours before bedtime
- Do not consume alcohol or tobacco products
- Talk to your doctor about any medications you are on. Some medications can decrease LES pressure allowing it to open more freely
- Avoid tight fitting clothes
- Elevate the head of the bed or sleep on your left side
- Get some light physical activity after eating as this may help to increase digestion and move things along
During pregnancy, first-line treatment is always lifestyle modifications and dietary interventions as mentioned above. Typically with this approach, symptoms of reflux can be controlled. However, if you experience ongoing symptoms even after trying this approach there are medications that you can take to help control reflux.
Make sure to always talk with your healthcare provider before starting any over-the-counter medication as you will want to make sure it is safe for both you and your baby.
Goral V. (2018). Ideal Approach to gastroesophageal reflux in pregnancy. M J Gast. 3(1): 011
Thélin CS, Richter JE. Review article: The Management of Heartburn during pregnancy and lactation. Alimentary Pharmacology & Therapeutics. 2020;51(4):421-434. doi:10.1111/apt.15611
VĂRȘA RG, CIOBANU AM, CIMPOCA-RAPTIS BA, et al. Gastroesophageal reflux disease in pregnancy. Romanian Journal of Medical Practice. 2021;16(S3):28-31. doi:10.37897/rjmp.2021.s3.6