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Belching during pregnancy - causes, diagnosis and treatment

Belching during pregnancy is the release of gastric gases in a pregnant woman with a characteristic sound, which occurs due to contraction of the smooth muscles of the stomach with an open cardiac sphincter. The symptom is more often caused by physiological causes: hormonal changes, errors in diet, physical inactivity, but may also indicate the presence of a disease. To identify the root cause of erection during gestation, safe studies are prescribed - ultrasound, tests, pH-metry. To reduce belching, non-drug methods, prokinetics, and sedatives are used.

Causes of belching during pregnancy

During normal pregnancy

The release of a small amount of air through the oral cavity is a physiological process that is observed in absolutely healthy people. During the bearing of a child in a woman's body, changes occur in various organs and systems that can affect the frequency of belching. Physiological erection is characterized by belching of air with a specific sound, while the pregnant woman does not feel an unpleasant odor or taste in her mouth. The following factors contribute to the frequent release of gastric gases during pregnancy:

• Hormonal changes . From the first trimester, a woman has an increased synthesis of progesterone, which is necessary for normal gestation and a decrease in uterine tone. The hormone also affects the smooth muscles of the stomach and esophagus, causing them to relax excessively. Due to the stretching of the organs, an accumulation of gases occurs, provoking a reflex opening of the cardiac sphincter, a spasm of the pylorus and the release of air.
• Uterine growth . A significant increase in the volume of the uterus is detected in the second and third trimesters of pregnancy, which is accompanied by a displacement of neighboring organs. The stomach is pushed back to the diaphragm, compressed, as a result of which its contractile activity and coordination of the work of muscle sphincters are disturbed. This leads to frequent burping. Also, women note shortness of breath associated with insufficient expansion of the lungs.
• Reduced physical activity . At late gestational periods, it becomes difficult for a pregnant woman to do her usual work, so women often lead a hypodynamic lifestyle. The reduction in physical activity provokes hypotension of the muscles of the stomach and intestines, slow progress of the chyme through the alimentary canal. Belching occurs as a reflex act due to overstretching of the walls of the digestive tract, sometimes combined with heaviness in the stomach after eating.
• Aerophagy . Swallowing air while eating is a common cause of erections during pregnancy. This condition develops when talking while eating, insufficient chewing of food, snacking in a hurry. Due to the excess amount of air that has entered the stomach, the walls of the organ are overstretched, followed by a sharp contraction. This is manifested by prolonged erection with characteristic sounds, a feeling of fullness in the epigastrium.
• Use of certain foods . Failure to follow the recommendations of a gynecologist on nutrition during pregnancy can lead to belching. The symptom is often provoked by the use of fresh fruits and berries, black bread, legumes. The mechanism of development is associated with increased gas formation, which, against the background of a slowdown in gastric motility, causes flatulence and erection of gastric gases. Belching is also provoked by the use of chewing gum.
• Autonomic innervation changes . During pregnancy, a restructuring of all body systems, including the autonomic nervous system, occurs. The regulation of gastrointestinal motility is mainly realized through the parasympathetic fibers of the vagus nerve, with a change in neuro-reflex interactions, mild dyspeptic disorders are possible. Belching of gastric gases occurs at different times of the day, regardless of food intake.

Specific pathologies of pregnancy

Dyspeptic disorders are one of the manifestations of specific diseases of the gestational period. These conditions have different etiologies and mechanisms of development; they can be caused by an immunological conflict, pathological visceral impulses from the uterus, and serious dysfunctions of the peripheral nerve plexuses. A sharp deterioration in the condition of a woman and the appearance of atypical symptoms are indications for seeking qualified help. Belching is observed in such pathological conditions as:

• Pregnancy cholestasis . Idiopathic bile stasis, according to various sources, affects 0.1-2% of pregnant women. It is believed that cholestasis is caused by increased synthesis of cholesterol and a violation of the colloidal balance of bile under the influence of estrogens. The disorder is manifested by intense itching of the skin, which is combined with jaundice, dark urine, dyspeptic disorders (eructation, nausea, flatulence).
• Toxicosis . Belching during pregnancy is one of the symptoms of early toxicosis, which is detected in 50-60% of patients, starting from the 5th week of gestation. With a mild degree, the general condition of the pregnant woman is not disturbed, she is worried about nausea, salivation, and erection. Moderate and severe forms of the disease are characterized by repeated vomiting up to 20 times a day, up to the impossibility of enteral nutrition, dehydration.
• Intestinal atony . Difficulties with bowel movements are common, affecting about 60% of women during pregnancy. Constipation of pregnant women has neurogenic and hormonal prerequisites, the situation is aggravated by the pressure of the enlarged uterus on the intestines. Belching occurs reflexively in response to stagnation of feces, stretching of the intestinal walls, and a decrease in peristaltic activity. With intestinal atony, gastric gases have a fetid odor.

Other diseases of the digestive system

Belching during pregnancy may occur against the background of concomitant pathology of the digestive system, which is aggravated during gestation. The manifestation of chronic diseases during the period of bearing a child is caused by the influence of sex hormones, an increased load on the digestive system, and a violation of homeostasis reactions. With organic pathologies of the gastrointestinal tract, erection is usually accompanied by other symptoms (pain, stool instability), which requires a visit to a specialist. Lead to the development of belching:

• GERD. The appearance of reflux of aggressive gastric contents is associated with a decrease in the sensitivity of receptors to histamine, a slowdown in gallstone motility and an increase in intra-abdominal pressure. Symptoms are aggravated in the second or third trimester of pregnancy: women complain of acid erection, heartburn, periodic chest pains that appear after diet errors, being in a horizontal position.
• Chronic gastritis . If a woman had chronic inflammation of the stomach before pregnancy, then the probability of exacerbation is more than 75%. The severity of symptoms depends on the variant of gastritis. In a hyperacid state, there are pains in the epigastric region, sour eructation, stool disorders with a predominance of diarrhea. With reduced acidity, pregnant women complain of erection with a rotten smell, a feeling of heaviness and fullness of the stomach after eating.
• Chronic pancreatitis . Pregnant women are characterized by a decrease in the synthesis of digestive enzymes and a violation of their activation in the lumen of the duodenum, partial obstruction of the pancreatic ducts, so chronic pancreatitis is exacerbated in 1/3 of patients. For the disease, dyspeptic disorders are typical - nausea and periodic vomiting, belching, an increase in the volume of feces and the appearance of particles of undigested food in them.
• Irritable bowel syndrome . In pregnant women, the symptoms of functional pathologies of the digestive tract may be aggravated. This is due to changes in autonomic innervation and a special psycho-emotional state of a woman, predisposing to dysregulation of intestinal motility. The disorder is manifested by polymorphic symptoms, which quickly arise and disappear. The condition often worsens with stress.
• Crohn's disease . This inflammatory bowel disease is classified as rare. According to statistics, in women, the disease often manifests itself during pregnancy. Crohn's disease is caused by immunological disorders, which are often triggered by an increase in estrogen levels. Belching is combined with pain in the abdomen (especially in the right iliac region), instability of the stool, nausea, and other dyspeptic symptoms.

Examination

The appearance of belching during pregnancy often indicates a specific gestational pathology or an exacerbation of a chronic gastrointestinal disease against the background of hormonal changes. The examination is prescribed by a gastroenterologist with the obligatory participation of an obstetrician-gynecologist in the diagnosis and selection of therapy. All patients are shown a comprehensive examination using laboratory and instrumental methods that do not pose a danger to either the mother or the fetus. For diagnostic purposes, the following are used:

• Ultrasound . Ultrasound of the abdominal cavity is the main instrumental diagnostic method, since this study is absolutely harmless to the child. Sonography reveals signs of inflammatory processes and morphological changes in the gastrointestinal tract. The study is not informative enough in late pregnancy due to a significant increase in the uterus.
• Intragastric pH . The occurrence of acid eructation during gestation usually occurs against the background of impaired secretion of hydrochloric acid, therefore a 24-hour measurement of acidity in the stomach is recommended. Additionally, pH-metry of the esophagus is performed - a decrease in the level of less than 4 indicates gastroesophageal reflux.
• Breath test . To exclude gastrointestinal pathology against the background of H. Pylori infection, a non-invasive respiratory study is prescribed, based on the ability of the bacterium to break down urea in the stomach. The method sometimes gives false-negative results, therefore, to clarify the diagnosis, a specific fecal antigen in the blood is additionally determined.
• Laboratory blood tests . All patients are shown a standard biochemical blood test, which allows you to detect signs of protein-energy deficiency, detect problems in the functioning of the hepatobiliary system. According to the indications, it is recommended to study the blood plasma for the level of gastrin and pepsinogen, the determination of the main hormones.
• Endoscopy . EGDS is used for gestation according to strict indications, in cases where belching is accompanied by other dyspeptic disorders. The study allows you to examine the mucous membrane of the esophagus and stomach, visualize inflammatory foci. The endoscopic method is highly informative in assessing the contractile function of muscle sphincters.

The list of mandatory examination methods also includes a coprogram that detects specific changes in feces during inflammation, fermentopathy, maldigestion and malabsorption, analysis for helminth eggs, Gregersen's test for occult blood. If inflammatory bowel disease is suspected, pregnant women should be especially careful with sigmoidoscopy and colonoscopy.

Diet needs to be reviewed during pregnancy

Symptomatic treatment

In most cases, belching during pregnancy is physiologically understandable and does not require special treatment. To reduce the frequency of erection, women are advised to adjust their eating habits: eat fractionally, in small portions, do not talk while eating, exclude foods that increase gas formation from the diet. Pregnant women should avoid sharp torso bending, it is undesirable to take a horizontal position immediately after eating.

If belching bothers a woman very often or is accompanied by pain in the abdomen, stool disorders, other signs of dyspepsia, this may indicate the development of a disease of the digestive organs. In this situation, it is necessary to visit a gastroenterologist as soon as possible. Until an accurate diagnosis is established, it is allowed to take medications that are allowed during pregnancy - prokinetics, mild sedatives that help reduce unpleasant symptoms, but do not harm the baby's body.

Toxemia, Intestinal Problems & Heartburn

Find out how pregnancy affects your digestive tract, which trimesters are more likely to cause indigestion and nausea, and what to do to manage them.

During pregnancy, the burden on the mother's body increases. The body needs more nutrients, the body produces additional hormones. And the growing fetus puts pressure on neighboring organs, including the stomach and intestines. We tell you what symptoms are observed in each trimester, how to cope with toxicosis and get rid of heartburn.

Contents:

• 2. Toxicosis and pregnancy
• 3. Causes, risks and treatment of diarrhea during pregnancy
• 4. Heartburn and stomach pain during pregnancy
• 5. Bloating, constipation and microbiota during pregnancy
• 6. Note

Changes in the functioning of the gastrointestinal tract by trimesters of pregnancy

The average duration of pregnancy is 40 weeks, which are usually divided into trimesters in accordance with the stages of intrauterine development of the child.

Each trimester is accompanied by a number of changes in the body, including in the gastrointestinal tract:

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Causes of gastrointestinal problems during pregnancy

Every pregnancy is accompanied by inevitable changes in the functioning of the digestive system. They are more often caused by hormonal changes and increased stress on the organs, but they can also be associated with lifestyle and health conditions, for example:

• Sedentary lifestyle and unbalanced diet;
• Certain drugs, including calcium or aluminum antacids;
• Viral and bacterial infections;
• Intolerance to certain nutrients and allergic reactions;
• Stress;
• Diseases of the thyroid gland.

If you have chronic diseases of the gastrointestinal tract and you are planning a pregnancy, try to consult your doctor in advance. Symptoms of conditions such as irritable bowel syndrome (IBS) or acid reflux are more likely to get worse during pregnancy. Your doctor will help prepare your body and create a prevention plan to help relieve symptoms during this time.

Irritable bowel syndrome, or IBS, is a functional bowel disease that causes frequent abdominal pain, impaired peristalsis, bloating, constipation, or diarrhea.

Morning sickness, vomiting and general malaise during pregnancy

Morning sickness and morning sickness during early pregnancy are common, because the body undergoes important changes necessary for the development of the child.

up to 90%

women experience nausea during pregnancy

Doctors find it difficult to say with certainty why pregnant women feel sick in the morning. The main theory is hormonal changes. But there are some patterns associated with an increased risk of morning sickness:

• Multiple pregnancy;
• Toxicosis during previous pregnancy;
• History of morning sickness during pregnancy in close relatives;
• Tendency to motion sickness in transport;
• Use of oral contraceptives containing estrogen before pregnancy;
• Frequent migraines;
• BMI 30 and above;
• Elevated levels of stress hormones

Risks of severe morning sickness and how to reduce nausea

Nausea and vomiting are usually not associated with a risk for mother and child and disappear by 16-20 weeks of pregnancy, but it is not necessary to wait so long - there are ways that can help reduce nausea and enjoy the process of waiting for a new person:

• Get plenty of rest - fatigue increases toxicosis;
• Avoid smells and foods that cause nausea;
• Eat something right after waking up. A toast or a slice of bread will help reduce nausea;
• Avoid hunger - empty stomach increases nausea. Eat small meals often, prefer low-fat, high-carbohydrate foods;
• Try ginger - studies show it helps with nausea;
• Sip as often as possible and prefer still water.

Rarely, pregnant women may develop hyperemesis gestationis or excessive vomiting. This is a serious condition that can lead to dehydration, kidney damage, seizures, abnormal heart rhythms, and even death.

Signs of dehydration include dry mouth, dizziness, dark urine, infrequent urination and/or dizziness.

Symptoms of excessive pregnancy vomiting:

• frequent nausea for a long time and regular vomiting after meals;
• dry skin and lips;
• sudden weight loss;
• low blood pressure (below 90/60).

If symptoms of excessive pregnancy vomiting occur, do not wait until the condition resolves on its own. It is necessary to seek medical help as soon as possible - the doctor will prescribe treatment, help adjust the diet and lifestyle of the expectant mother.

0.5–2%

pregnant women experience excessive vomiting

Diarrhea in pregnancy

The word "diarrhea" comes from the Greek language and literally means "to flow through". This is a condition during which bowel movements or bowel movements occur three times a day or more often. This phenomenon is especially typical for the third trimester of pregnancy, but it can also occur earlier.

Symptoms of diarrhea:

• Three or more bowel movements per day
• Urgent urge to have a bowel movement
• Abdominal pain and cramps
• Bloating

Causes of diarrhea during pregnancy poisoning, dysbacteriosis, bacterial and viral infections: