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Heartburn during pregnancy - maternity hospital "Leleka"

Heartburn in pregnant women is a fairly common occurrence. Even if a woman has never experienced this phenomenon before, during pregnancy she may regularly feel a burning sensation in the esophagus, the urge to vomit, and a bitter and sour taste in her mouth. It is not dangerous for the life and health of the mother and child, but unpleasant. In addition, heartburn can be a harbinger of more serious diseases of the digestive system. Digestive juices, getting from the stomach into the esophagus, irritate and injure the walls, creating a risk of developing esophageal ulcers and cancer. nine0003

There are two main causes of pregnancy heartburn, hormonal changes and intrauterine pressure.

In the body of a pregnant woman, the content of the hormone progesterone increases. Under the influence of this natural steroid, the wall of the uterus acquires the ability to implant a fertilized egg. But the same hormone slightly relaxes the sphincter, which blocks the entrance to the esophagus. This causes digestive juices to leak from the stomach up the digestive tract. Such heartburn occurs only in the first semester and quickly passes by itself. nine0003

In the second half of pregnancy, heartburn is usually associated with increased intrauterine pressure. The growing fetus presses down on the stomach and causes gastric juices to rise up the esophagus. These symptoms are more difficult to get rid of. Of course, they will naturally go away after childbirth, but up to this point, the attacks can be quite unpleasant.

In order to make them rarer and less painful, you can take the following measures:

• Eliminate foods that cause heartburn from the menu. As a rule, these are pickles and smoked meats, fried and fatty foods, which are not indicated during pregnancy anyway. nine0014
• Switch to fractional meals: eat more often, but less. After a dense meal, the volume of the stomach increases sharply, and intrauterine pressure also increases. If the portion is smaller, this does not happen.
• Fractional nutrition will also prevent heartburn attacks that occur on an empty stomach, when digestive juices spread along its walls under the weight of the stomach.
• It is also recommended to give up coffee, alcohol, smoking and other bad habits. They can adversely affect the health of the fetus, and they also provoke seizures. nine0014
• Do not lie down after eating, especially on your back. In this position, the fetus presses down on a full stomach. It is better to rest in a half-sitting position, leaning on a pillow.
• Do not wear clothing that constricts or constricts the abdomen. It also increases intrauterine pressure.

For expectant mothers who continue to play sports during pregnancy, it would be wise to review the usual set of exercises, and exclude those in which the stomach is squeezed: squats, forward bends. nine0003

From folk remedies, pregnant women are advised to take flax seeds. If you add them to a salad, they will harmoniously combine with vegetables and prevent heartburn attacks. You can also brew flaxseed jelly: grind 50 grams of seeds in a coffee grinder and pour 100 ml of boiling water. The cocktail is not very pleasant in taste, but effective.

It is also advised to eat seeds, nuts and milk. But these products can both relieve an attack and provoke an increase in it, so you need to use these products with caution. nine0003

Antacids can be taken if heartburn is particularly painful or unpleasant. They reduce the acidity of the stomach, remove unpleasant symptoms. Some of them contain additives with a slight analgesic and cooling effect. But you shouldn't get too carried away with them either.

Do not ingest baking soda solution. Yes, for a while soda neutralizes stomach acid, but then the discomfort will resume. And soda can provoke puffiness. In the last trimester of pregnancy, many women already suffer from edema and swollen legs; it is not worth aggravating the situation with soda. nine0003

It should be noted that these changes occur in all pregnant women, but not everyone develops heartburn. If a pregnant woman does not complain of such symptoms, this is not a cause for concern.

why it occurs and how to get rid of it

The prevalence of heartburn increases from the 20th week of pregnancy and covers the vast majority of women by the time of delivery. Usually, the symptom is provoked by the "heavy" food eaten the day before, so it can be repeated many times throughout the day, and one episode of heartburn lasts minutes or even hours. In addition to heartburn itself, there may be belching of air, pain behind the sternum, and swallowing is disturbed ¹ .

Causes of heartburn in pregnant women

There are a number of factors that predispose to heartburn during pregnancy. These include2:

episodes
heartburn before pregnancy

multiple pregnancy

overweight before or
significant weight gain
during pregnancy

The main causes of heartburn in pregnant women are divided into: mechanical (physical) and hormonal ² .

The mechanical cause of is an increase in the size of the pregnant uterus. The growing uterus displaces and compresses other organs in the abdomen, which increases intra-abdominal pressure. At the same time, the stomach is “squeezed” to the diaphragm, the locking mechanism that separates the esophagus from the stomach is weakened, which predisposes to the development of hiatal hernia. In general, the described mechanisms often lead to acid reflux - the backflow of gastric contents into the esophagus, accompanied by heartburn ² .

Hormonal causes include an increase in progesterone production. Progesterone reduces the tone of the smooth muscles of the uterus, protecting the pregnancy from the threat of termination. In the same way, progesterone acts on other smooth muscle organs. Under the influence of hormones during pregnancy, there may be a decrease in the tone of the lower esophageal sphincter and a weakening of intestinal motility, including due to a violation of the sensitivity of intestinal receptors to biologically active substances - serotonin and histamine. As a result, food can linger in the stomach, increasing the likelihood of acid reflux. Due to the weakening of peristalsis, there is also a risk of constipation and changes in the intestinal microflora ² .

First trimester

A complaint in pregnant women at an early stage appears due to toxicosis with repeated vomiting, when the mucosa of the esophagus is constantly irritated by vomit ¹ .

First trimester

A complaint in pregnant women at an early stage appears due to toxicosis with repeated vomiting, when the mucosa of the esophagus is constantly irritated by vomit ¹ . nine0003

Second and third trimesters

In the second and third trimesters, symptoms may occur due to decreased pressure in the esophagogastric sphincter and functional failure of the upper stomach ¹ . Also, in late pregnancy, the factors provoking heartburn may include an increase in intra-abdominal pressure due to an increase in the volume of the uterus and an increase in the level of gastrin in the blood of pregnant women ¹ .

Second and third trimesters

In the second and third trimesters, symptoms may occur due to decreased pressure in the esophagogastric sphincter and functional insufficiency of the upper stomach ¹ . Also, in late pregnancy, the factors provoking heartburn may include an increase in intra-abdominal pressure due to an increase in the volume of the uterus and an increase in the level of gastrin in the blood of pregnant women ¹ .

postpartum period nine0046

Unfortunately, the symptoms of heartburn do not always disappear without a trace after childbirth: about 20% of women who experience heartburn during pregnancy also experience heartburn in the postpartum period ² . It is possible that the development of heartburn in the postpartum period may be associated with the lactation period, this relationship has yet to be established. According to the instructions for the medical use of the drug Maalox®, the absorption of combinations of aluminum hydroxide and magnesium salts in the mother is limited, therefore, Maalox® can be used during lactation after consulting a doctor. For occasional heartburn, use 15 ml each or 1-2 tablets of Maalox® once . ^4-6

Unfortunately, the symptoms of heartburn do not always disappear without a trace after childbirth: about 20% of women who experience heartburn during pregnancy also notice it in the postpartum period ² . It is possible that the development of heartburn in the postpartum period may be associated with the lactation period, this relationship has yet to be established. According to the instructions for the medical use of the drug Maalox®, the absorption of combinations of aluminum hydroxide and magnesium salts in the mother is limited, therefore, Maalox® can be used during lactation after consulting a doctor. For occasional heartburn, use 15 ml each or 1-2 tablets of Maalox® once . ^4-6

Symptoms of heartburn in pregnant women

Heartburn is an unpleasant sensation of burning, warmth behind the sternum, which can spread to the neck area ³ . The symptom may appear about an hour after eating. Often entails heartburn eating fried, spicy, fatty, sour foods, as well as overeating. Physical activity and changes in body position, such as leaning forward or lying down, may increase heartburn symptoms ³ . In pregnant women, heartburn is often accompanied by belching and difficulty swallowing ¹ .

Heartburn is an unpleasant sensation of burning, warmth behind the sternum, which can spread to the neck ³ . The symptom may appear about an hour after eating. Often entails heartburn eating fried, spicy, fatty, sour foods, as well as overeating. Physical activity and changes in body position, such as leaning forward or lying down, may increase heartburn symptoms ³ . In pregnant women, heartburn is often accompanied by belching and difficulty swallowing ¹ .

Why is heartburn dangerous in pregnant women?

Heartburn that occurs during pregnancy may increase the chance of developing GERD after childbirth. Moreover, the risk of developing the disease is proportional to the number of births. It was noted that in the presence of heartburn in the 1st pregnancy, GERD subsequently develops in 17.7% of women , and two pregnancies with heartburn increase this figure to 36% ² .

It is important to note that if heartburn occurs during pregnancy, it is necessary to consult a doctor, since heartburn can manifest other diseases of the digestive system, including severe pathology of the gestation period - acute fatty liver of pregnant women. In this case, heartburn is short-lived at first, then its intensity and duration increase, accompanied by painful swallowing of not only food, but also liquids. Heartburn in this case is often accompanied by vomiting of the color of "coffee grounds", weakness, lethargy. Such a dangerous condition requires close medical attention and control ¹ .

Heartburn that occurs during pregnancy may increase the chance of developing GERD after childbirth. Moreover, the risk of developing the disease is proportional to the number of births. It has been noted that in the presence of heartburn in the 1st pregnancy, GERD subsequently develops in 17.7% of women , and two pregnancies with heartburn increase this figure to 36% ² .

It is important to note that if heartburn occurs during pregnancy, it is necessary to consult a doctor, since heartburn can manifest other diseases of the digestive system, including severe pathology of the gestation period - acute fatty liver of pregnant women. In this case, heartburn is short-lived at first, then its intensity and duration increase, accompanied by painful swallowing of not only food, but also liquids. Heartburn in this case is often accompanied by vomiting of the color of "coffee grounds", weakness, lethargy. Such a dangerous condition requires close medical attention and control ¹ .

Diagnostics

In most cases, a doctor will only need information from a questioning and examination of a pregnant woman to determine the cause of heartburn.

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