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Heartburn - a frequent companion of the third trimester of pregnancy

Other articles on topics: heartburn, gynecology, women's health

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Heartburn is a frequent companion of the third trimester of pregnancy, more than half of pregnant women experience it.

During pregnancy, especially from the third trimester, very favorable conditions for the occurrence of heartburn: the internal volume of the abdominal cavity decreases, more and more space is occupied by the pregnant uterus and there is less and less room for the stomach. Due to the increase in the level of progesterone, as pregnancy progresses, the evacuation of gastric contents slows down and the tone of the gastroesophageal sphincter, the circular muscle, the main purpose of which is to prevent the contents of the stomach from being thrown into the esophagus, decreases.

Treatment of heartburn

Fortunately, there are ways to deal with this not too dangerous, but very unpleasant condition. They can be divided into non-drug and drug.

It is worth switching to medication only after all non-drug measures to relieve heartburn have been applied, if they have not brought a clear improvement.

What are these measures (you need to use them simultaneously, not in the order of writing):

• keep a food diary for a week, where to write down what was eaten and when heartburn occurred - this will help you independently identify those that are guaranteed to cause you heartburn products and, if possible, eliminate them from the diet. Very often provokes heartburn fatty, spicy and fried foods;
• change the diet - eat often and in small portions, eat as slowly as possible, reduce the amount of fluid you drink with meals;
• do not lie down or bend over for two hours after eating, maximum - you can sit back, reclining in an armchair or on a sofa;
• Raise the head of the bed 10 centimeters by placing something under the legs of the bed. If this is not possible, at least use pillows in such a way as to achieve the same effect. The upper half of your body should be elevated during sleep;
• learn to sleep on the left side;
• do not wear tight clothing, preferring loose clothing;
• try to avoid constipation;
• Some foods can be used to stop heartburn attacks (they do not help everyone, but they are all worth trying): whole milk (if you can tolerate it), sour-milk products, puddings, grated raw carrots, sunflower seeds.

In case of insufficient effectiveness of the above measures, you should consult a doctor for a prescription drug therapy. Some antacids are used, with preference given to those that cause the least constipation (a common side effect of this group of drugs), as well as proton pump inhibitors, the most studied in terms of safety in pregnancy.

Make an appointment with a gynecologist

For more details, consult a qualified specialist at the Semeynaya clinic.

To find out the prices for a gynecologist's appointment or other questions, follow the link below:

Tags HeartburnWomen's HealthGynecologist

Heartburn during pregnancy - symptoms, causes and treatment of the disease

Contents

• Causes of heartburn during pregnancy
• What to do for heartburn during pregnancy?
• Preparations for heartburn during pregnancy

Heartburn is an unpleasant feeling of burning or warmth behind the breastbone or in the epigastric region. The symptom occurs after eating or on an empty stomach and is associated with food reflux, that is, the reflux of food processed by gastric juice back into the esophagus. Since the mucous membrane of the esophagus is not adapted to the action of gastric juice, it becomes irritated, which is subjectively felt in the form of heartburn.

Heartburn in pregnant women is an independent symptom that appears only during the period of bearing a child against the background of the absence of chronic diseases that cause reflux of gastric juice ¹ . According to statistics, 30-50% of pregnant women suffer from heartburn, there is evidence that more than 80% of pregnant women complain of heartburn, especially in the third trimester ⁴ .

Heartburn in pregnancy is a condition that is caused by the changes that occur to the female body during the period of gestation. All factors that can cause heartburn in women in an interesting position can be divided into physiological (natural) and pathological (disease-related).

Physiological heartburn of pregnant women can occur for two reasons:

• Hormonal - associated with a weakening of the tone of the lower esophageal sphincter. This is the name of the circular muscle between the stomach and the esophagus, which regulates the flow of food into the stomach and prevents its movement in the opposite direction. During pregnancy, the level of progesterone in the blood rises, which relaxes the uterine muscle, simultaneously acting on all other muscles of the body, including the esophageal sphincter. As a result, the sphincter does not close after eating, but remains open. Any change in body position or contraction of the stomach causes food reflux ⁴ . Heartburn also occurs if it is disturbed by the movement of food through the esophagus, for example, if the frequency of "reverse" contractions of the esophagus increases in the direction from the stomach to the esophagus ¹ .
• Physical - due to the increase in the size of the uterus, the location of the internal organs changes and intra-abdominal pressure increases, which is transmitted to the wall of the stomach and contributes to reflux ⁴ .

In connection with such changes in the gastrointestinal tract during pregnancy, all pathologies that cause heartburn can worsen.

Pathological causes of heartburn during pregnancy include the following:

• Gastroesophageal reflux disease (reflux esophagitis) is a pathology of the esophageal sphincter, which occurs more often with diaphragmatic hernia, when the natural curve between the esophagus and stomach disappears, preventing reverse reflux ⁴ .
• Other diseases of the gastrointestinal tract - gastritis, peptic ulcer of the stomach and duodenum, pancreatitis, diseases of the liver and biliary tract, inflammatory bowel disease ² . With gastritis and ulcers, the acidity of the stomach increases, and pathologies of other digestive organs cause bloating, constipation, enlargement of the liver, which increases intra-abdominal pressure.
• Taking drugs that relax the lower esophageal sphincter - heart drugs, theophylline, anti-inflammatory drugs, progesterone, antidepressants ⁴ .

In the first two hours after eating, hydrochloric acid is produced in the stomach, which is needed for food processing. It is at this time that heartburn is more likely to torment, especially if a woman consumes fatty, fried and spicy foods ⁷ . Burning behind the sternum can last for several minutes or several hours. Heartburn may recur several times during the day. It is characterized by its strengthening in a horizontal position, with torso tilts, as well as when turning to the other side.

To reduce the severity of heartburn, you first need to adjust the diet and some habits. This helps to reduce the increased acidity of the stomach and prevent the reflux of food back into the esophagus.

Pregnant women should follow the following dietary recommendations ⁴ :

• Do not eat excessively high-calorie foods.
• Eliminate night snacks and especially overeating.
• Eat often and in small portions.
• Do not lie down immediately after eating, do not sleep in a strictly horizontal position, it is necessary to raise the head end of the bed.
• Walk for 30 minutes after eating.
• Eat dinner no later than 3-4 hours before going to bed.
• Do not lift weights, do not make strong and frequent torso bends, do not overstrain the abdominal muscles.
• Do not wear corsets, bandages, tight belts that increase intra-abdominal pressure.

From the diet for heartburn should be excluded ⁴ :

• Carbonated drinks (they increase pressure in the stomach and stimulate the formation of hydrochloric acid).
• Cream, whole milk, fatty meats, fatty fish, goose, pork (fatty foods take a long time to digest).
• Chocolate, cakes, pastries, spices (relaxes the lower esophageal sphincter).
• Citrus fruits, tomatoes, onions, garlic (irritate the mucous membrane of the esophagus).

For heartburn, pregnant women can eat the following foods ⁶ :

• wheat bread, dry biscuits, dry biscuits;
• baked pies with apples, boiled meat or fish;
• soups of meat, fish, vegetables;
• lean beef, poultry, fish;
• soft-boiled eggs and scrambled eggs;
• sugar, copper, butter cream;
• tea, cocoa, sweet fruit juices, jams, compotes.

In 80% of pregnant women, heartburn disappears after childbirth, but severe heartburn during pregnancy, especially if it lasts for several weeks, may persist after the birth of a child ⁴ .

Often, proper nutrition and adherence to lifestyle recommendations do not always help get rid of heartburn. If heartburn is caused by any disease, adequate treatment of the underlying pathology with medications helps to eliminate unpleasant symptoms.

The use of folk and non-traditional ways to eliminate heartburn during pregnancy is also not effective enough and even potentially dangerous. Many of the medicinal herbs during pregnancy can harm both the woman and her unborn child ⁴ .

Therefore, it is advisable to discuss the choice of a drug with a doctor who will help you choose the right remedy for heartburn during pregnancy, paying attention from the standpoint of safety for the fetus and potential impact on the course of pregnancy ⁴

The results of epidemiological studies of Omez ^® 10 mg in the treatment of heartburn in pregnant women show no clinically significant adverse effects on pregnancy and the health of the fetus or newborn ⁵ .

Omez ^® 10 mg is dispensed without a doctor's prescription, but you can take it yourself without specialist advice for no longer than 14 days ⁵ .

THERE ARE CONTRAINDICATIONS, READ THE INSTRUCTIONS FOR MEDICAL USE OR CONSULT A DOCTOR.

1. Vyuchnova E.S., Yurenev G.

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