Wake up with heartburn pregnancy

Indigestion and heartburn in pregnancy

Indigestion, also called heartburn or acid reflux, is common in pregnancy. It can be caused by hormonal changes and the growing baby pressing against your stomach.

You can help ease indigestion and heartburn by making changes to your diet and lifestyle, and there are medicines that are safe to take in pregnancy.

Symptoms of indigestion and heartburn

Symptoms of indigestion and heartburn include:

a burning sensation or pain in the chest
feeling full, heavy or bloated
burping or belching
feeling or being sick
bringing up food

Symptoms usually come on soon after eating or drinking, but there can sometimes be a delay between eating and developing indigestion.

You can get symptoms at any point during your pregnancy, but they are more common from 27 weeks onwards.

Things you can do to help with indigestion and heartburn

Changes to your diet and lifestyle may be enough to control your symptoms, particularly if they are mild.

Eat healthily

You're more likely to get indigestion if you're very full.

If you're pregnant, it may be tempting to eat more than you would normally, but this may not be good for you or your baby.

Find out more about a healthy diet in pregnancy and foods to avoid.

Change your eating and drinking habits

You may be able to control your indigestion with changes to your eating habits.

It can help to eat small meals often, rather than larger meals 3 times a day, and to not eat within 3 hours of going to bed at night.

Cutting down on drinks containing caffeine, and foods that are rich, spicy or fatty, can also ease symptoms.

Keep upright

Sit up straight when you eat. This will take the pressure off your stomach. Propping your head and shoulders up when you go to bed can stop stomach acid coming up while you sleep.

Stop smoking

Smoking when pregnant can cause indigestion, and can seriously affect the health of you and your unborn baby.

When you smoke, the chemicals you inhale can contribute to your indigestion. These chemicals can cause the ring of muscle at the lower end of your gullet to relax, which allows stomach acid to come back up more easily. This is known as acid reflux.

Smoking also increases the risk of:

your baby being born prematurely (before week 37 of your pregnancy)
your baby being born with a low birthweight
sudden infant death syndrome (SIDS), or "cot death"

There's lots of help available to stop smoking. Talk to your midwife or call the NHS Smokefree helpline on 0300 123 1044. Find out more about stopping smoking in pregnancy.

Avoid alcohol

Drinking alcohol can cause indigestion. During pregnancy, it can also lead to long-term harm to the baby. It's safest to not drink alcohol at all in pregnancy.

Find out more about alcohol and pregnancy

When to get medical help

See your midwife or GP if you need help managing your symptoms or if changes to your diet and lifestyle do not work. They may recommend medicine to ease your symptoms.

You should also see your midwife or GP if you have any of the following:

difficulty eating or keeping food down
weight loss
stomach pains

Your midwife or GP may ask about your symptoms and examine you by pressing gently on different areas of your chest and stomach to see whether it's painful.

If you're taking prescription medicines

Speak to your GP if you're taking medicine for another condition, such as antidepressants, and you think it may be making your indigestion worse. They may be able to prescribe an alternative medicine.

Never stop taking a prescribed medicine unless you're advised to do so by your GP or another qualified healthcare professional who's responsible for your care.

Medicines for indigestion and heartburn

Medicines for indigestion and heartburn during pregnancy include:

antacids – to neutralise the acid in your stomach (some are available over the counter from a pharmacist)
alginates – to relieve indigestion caused by acid reflux by stopping the acid in your stomach coming back up your gullet

You may only need to take antacids and alginates when you start getting symptoms. However, your GP may recommend taking them before symptoms come on – for example, before a meal or before bed.

If you're taking iron supplements as well as antacids, do not take them at the same time. Antacids can stop iron from being absorbed by your body.

If antacids and alginates do not improve your symptoms, your GP may prescribe a medicine to reduce the amount of acid in your stomach. 2 that are widely used in pregnancy and not known to be harmful to an unborn baby are:

ranitidine – a tablet you take twice a day
omeprazole – a tablet you take once a day

Causes of indigestion in pregnancy

Symptoms of indigestion come when the acid in your stomach irritates your stomach lining or your gullet. This causes pain and a burning feeling.

When you're pregnant, you're more likely to have indigestion because of:

hormonal changes
the growing baby pressing on your stomach
the muscles between your stomach and gullet relaxing, allowing stomach acid to come back up

You may be more likely to get indigestion in pregnancy if:

you had indigestion before you were pregnant
you've been pregnant before
you're in the later stages of pregnancy

Video: Eating well on a budget

In this video, a dietitian gives advice on how to eat healthily on a budget.

Media last reviewed: 13 January 2021
Media review due: 13 January 2024

Heartburn and indigestion (pregnancy sleep)

If your sleep is being disturbed by an uncomfortable burning sensation in your chest, you're not alone. Up to eight out of 10 mums-to-be experience heartburn and indigestion during pregnancy, particularly in the second and third trimesters. As well as the physical discomfort, it can be pretty annoying if you're trying to get to sleep. Try cutting down on fatty foods, eat small meals more often and don't eat too close to bedtime. Read on for more tips on relieving your symptoms.

What can cause heartburn at night?

Heartburn happens when your natural stomach acid comes up towards your throat. During pregnancy, your growing womb presses on your stomach, pushing the acid upwards. At the same time, pregnancy hormones relax the valve that normally keeps the acid in your stomach, so more of it can get through.

You may find that your indigestion and heartburn symptoms get worse when you're bending forwards, or when you're lying down at night. In these positions, it's easier for acid to make its way upwards.

What are the symptoms of heartburn and indigestion?

When heartburn strikes, you may feel a burning sensation in your chest or stomach. Symptoms of indigestion include burping, bloating and feeling generally uncomfortable. Unfortunately, digestion problems can also make pregnancy sickness worse.

The good news is that heartburn and indigestion are likely to go away once your baby is born.

Heartburn in pregnancy

Heartburn can be uncomfortable, but there are plenty of things you can try to relieve your symptoms. More pregnancy videos

How can I avoid getting heartburn and indigestion at night?

There's no certain way to avoid getting heartburn or indigestion. But you can make simple lifestyle changes to lower your chances of being disturbed by them at night.

Your first step could be to cut down on foods that are known to trigger digestive problems. These include:

rich, fatty or spicy foods
tomato-based foods
tea, coffee and other caffeinated drinks
fruit juice
fizzy drinks
chocolate
alcohol

Try keeping a food diary to see which foods are more likely to trigger heartburn.

If you smoke, stop. Smoking is dangerous for your health and the health of your growing baby, and among many side-effects, it also makes heartburn worse.

Here are some more practical tips to help you avoid pregnancy heartburn and indigestion:

Instead of having three large meals, try eating smaller meals more often – about every three hours.
Don't eat close to bedtime. Give yourself at least three hours to digest food before you lie down.
Sit up as straight as you can while you’re eating. This helps to take the pressure off your stomach.
Prop your head and shoulders up in bed using pillows, to stop stomach acid coming up while you sleep. Or raise the head of your bed using bricks, books or other sturdy objects. Most studies suggest that the ideal height of bed head elevation (the angle of the head of the bed) is between 15cm and 20cm (6in and 8in). This way, you’ll still be able to sleep on your side, but gravity might give you a little relief from your symptoms.

If you’re interested in complementary therapies, you could try acupuncture. There's very little evidence that it helps to relieve heartburn and indigestion in pregnancy, but some women say it helps them to sleep. Just make sure you find a qualified practitioner with experience of treating pregnant women.

If you've tried everything you can think of, and you’re still suffering, seek medical advice. Ask your midwife or pharmacist about an over-the-counter antacid or alginate that's safe to use during pregnancy. If these don't help, your GP may be able to prescribe you a different type of medicine to tackle your symptoms.

Is heartburn ever a sign of something more serious?

In most cases, heartburn is a perfectly normal symptom of pregnancy that should go away after your baby is born. So it shouldn’t be anything to worry about.

However, heartburn, when accompanied by other symptoms, can sometimes be a sign of a potentially serious condition called pre-eclampsia.

Talk to your midwife immediately if your heartburn doesn’t go away with antacids and is accompanied by other symptoms, such as:

a bad headache
vision problems such as blurring or flashing
pain below the ribs
feeling sick or vomiting
feeling very unwell
sudden swelling of the face, hands or feet

References

Knott L. 2020. Acid reflux and oesophagitis. Patient, Health Information. patient.info [Accessed March 2021]

Murray I, Hendley J. 2020. Change and adaptation in pregnancy. In: Marshall J, Raynor M. eds. Myles textbook for midwives. 17th ed. Elsevier, 197-245 [Accessed March 2021]

NHS 2018. Pre-eclampsia. NHS Choices, Health A-Z. www.nhs.uk [Accessed March 2021]

NHS. 2020. Indigestion and heartburn in pregnancy. NHS Choices, Health A-Z. www.nhs.uk [Accessed March 2021]

NICE. 2017. Dyspepsia – pregnancy-associated. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.uk [Accessed March 2021]

OPA. Nd. How to relieve acid reflux with a raised bed. Oesophageal Patients Association. opa.org.uk [Accessed May 2021]

Park J, Sohn Y, White AR et al. 2014. The safety of acupuncture during pregnancy: a systematic review. Acupunct Med 32(3): 257-66. www.ncbi.nlm.nih.gov [Accessed March 2021]

Phupong V, Hanprasertpong T. 2015. Interventions for heartburn in pregnancy. Cochrane Database Syst Rev 9: CD011379. onlinelibrary.wiley.com [Accessed March 2021]

Wilson S, Anderson K, Baldwin D, et al. 2019. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update. J Psychopharmacol 33(8): 923-947. www.bap.org.uk [Accessed March 2021]

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Morning heartburn ⛑ symptoms of morning heartburn

If the morning starts not with coffee, but with an unpleasant burning pain in the stomach or esophagus, this may indicate diseases of the gastrointestinal tract (GIT). Morning heartburn can occur after a heavy dinner, a party with excessive alcohol consumption. But regular bouts of heartburn in the morning may indicate health problems and require examination.

What is heartburn

Heartburn is a very broad concept. These are sensations of discomfort, which can manifest themselves in different ways for everyone. People describe it as “burning”, “irritation”, some experience pain and nausea, they say that it bakes in the throat.

Medically, heartburn is not considered a disease, but the condition may indicate the presence of other disorders. Unpleasant sensations usually occur after eating, but there is a special condition - heartburn in the morning. A person wakes up already with discomfort in the stomach and a “burning” throat.

The most common cause of heartburn is reflux, which is the reflux of stomach contents back into the esophagus. The mucous membrane of the esophagus is irritated by the acids of the gastric juice and heartburn occurs. Reflux disease in medical terminology is called GERD (gastroesophageal reflux disease). In addition to it, heartburn is caused by other diseases of the gastrointestinal tract: ulcers, gastritis, esophagitis, increased acidity of the stomach. With these pathologies, heartburn often occurs on an empty stomach and morning burning in the esophagus.

Heartburn in the morning: causes

Food enters the stomach through a kind of gate - the lower esophageal sphincter. These are multiple pleats that open and close like a flap. Gastric juice contains hydrochloric acid, ammonia, nitrogen-containing substances and digestive enzymes - these substances are responsible for the digestion of food. If the sphincter is relaxed, food is thrown back from the stomach along with acids that irritate the esophageal mucosa, from which it becomes inflamed, bakes and hurts.

Active production of gastric juice occurs during meals, as well as when the body wakes up, that is, in the morning.

If you skip breakfast, the stomach begins to “digest itself”, acids irritate its walls and heartburn sets in. Another point is a cup of morning coffee or some chocolate on an empty stomach. These are aggressor products, they activate the production of gastric juice and in themselves irritate the mucous membrane. These are common causes of heartburn in the morning. Gastrointestinal diseases increase acid secretion and relax the esophageal sphincter.

An unbalanced diet and disturbed daily routine contribute to the development of morning heartburn. Dinner after 19.00, and even more so at 22.00, is not a good solution. If you eat dinner before bed, the pressure on the sphincter in the supine position will be increased, and food will begin to be digested more slowly. This leads to reflux and heartburn. Some simply do not notice it at night, and in the morning it makes itself felt.

Signs of morning heartburn

Signs of heartburn in the morning are hard not to feel: a person gets up already with an unpleasant sensation in the stomach, often heartburn is intertwined with a feeling of hunger, but the discomfort disappears after a hearty breakfast.

Heartburn itself is a symptom in the morning. When it is supplemented by other conditions, this may indicate diseases of the internal organs:

nausea and pain in the upper abdomen are signs of peptic ulcer;
bloating appears with gastritis;
increased acidity of gastric juice accompanies GERD;
cough and perspiration, together with heartburn, may be due to diseases of the bronchi and lungs;
Increasing burning behind the sternum is a common symptom of a heart attack.

Heartburn in the morning can occur in pregnant women.

Some symptoms are classified as “alarming” [1]:

sudden weight loss;
blood in stool;
heartburn for more than 3 weeks;
rapid feeling of fullness of the stomach.

If these symptoms occur, seek specialist advice.

Diagnosis

Diagnosis of morning heartburn includes examinations aimed at identifying the underlying disease:

analysis of gastric acidity;
FGDS (fibrogastroduodenoscopy) - examination of the stomach with a probe or endoscope;
laboratory tests - biochemical blood test, fecal analysis, determination of Helicobacter pylori;
pH-metry - monitoring of daily changes in stomach acidity;
endoscopy with contrast for difficult diagnosis of the disease [2];
esophagomanometry - measurement of pressure inside the esophagus.

Women with heartburn may be advised to take a pregnancy test in the morning (unless, of course, there are other signs of pregnancy).

Treatment

To quickly eliminate heartburn on an empty stomach, you need to have breakfast on time. Food should not be dense, but satisfying and nutritious. Heavy fats and high-calorie chocolate are best replaced with light cereals and fruits. In diseases of the gastrointestinal tract, it is recommended to eat oatmeal in the water, because it has a beneficial effect on the gastric mucosa.

Heartburn in the morning can be removed with antacids, which are salt-based preparations that neutralize the action of hydrochloric acid and increase the pH of gastric juice. For example, calcium carbonate and magnesium carbonate act within a few minutes [3]. Rennie ^® is a preparation containing both of these components. It does not need to be taken with water, these are chewable tablets with a pleasant mint or orange flavor. Rennie ^® - tablets that begin to eliminate heartburn within 2 minutes. It is a drug with a favorable safety profile, even for pregnancy heartburn.

Antacids are recommended by the World Organization of Gastroenterology in the treatment of reflux disease and to eliminate heartburn [4]. But before taking it, you need to read the instructions and visit a doctor.

[1] UMHS GERD Guideline, September, 2013. Guidelines for Clinical Care Ambulatory, University of Michigan Medical.

[2] UNIFICATION OF CLINICAL PROTOCOL OF PRIMARY, SECONDARY (specialized) MEDICAL CARE. GASTROESOPHAGEAL REFLUX ILLNESS. Decree of the Ministry of Health Protection of Ukraine dated 31 July 2013 No. 943.

[3] Mironycheva TS. "Comparative evaluation of the neutralization rate and buffering time of magnesium hydroxoaluminate" Science and Modernity, no. 6-2, 2010, pp. 289-293.

[4] Global guidelines of the World Gastroenterological Organization. GERD. Global perspective on gastroesophageal reflux disease. 2015

How to get rid of heartburn during pregnancy

Boltovsky Vladimir Anatolievich

Pediatrician, Nephrologist

Children's clinic "Mother and Child" Samara

If, after some time after eating, the expectant mother has a feeling of warmth or burning behind the sternum, then this is heartburn.

Not all antacids can be used during pregnancy. For example, drugs containing bismuth nitrate ( Vikalin and others) should not be taken by expectant mothers due to the fact that the effect of bismuth on the development of the child is unknown.

Heartburn usually appears after the 20th week of pregnancy and torments the expectant mother until the birth of the child.

what she looks like

If after some time after eating, the expectant mother has a feeling of warmth or burning behind the sternum, then this is heartburn. And most often these unpleasant sensations occur in the evening. Heartburn usually appears after the 20th week of pregnancy and torments the expectant mother until the birth of the child. According to popular belief, she worries the expectant mother when the baby's hair grows. In fact, heartburn occurs due to the fact that the acidic contents of the stomach are thrown into the lower esophagus. This happens because during pregnancy, the muscular sphincter, located between the esophagus and stomach, relaxes under the influence of the hormone progesterone. Another cause of heartburn is an enlarged uterus (and it just increases greatly after the 20th week) presses on neighboring organs: the stomach, intestines. As a result, the volume of the stomach decreases and even the usual amount of food leads to its overflow and the reflux of food back into the esophagus.

what will help

If heartburn occurs infrequently and does not bother you much, then in order to reduce its symptoms, you just need to eat right and change your lifestyle. The simplest thing that helps with heartburn:

Fractional nutrition: eat often 5-6 times a day at intervals of 1.5-2 hours and in small portions. Eat slowly, chewing your food thoroughly.
Healthy food: Avoid fatty and fried foods and chocolate. All these products provoke additional relaxation of the esophageal sphincter.
Heartburn usually occurs within the first two hours after eating, so do not lie down immediately after eating.
Sleep with the head of the bed raised by adding another pillow.

simple remedies

The simplest thing that helps with heartburn is some foods. For example, a burning sensation behind the sternum perfectly removes low-fat milk, just a few sips - and heartburn goes away or is significantly reduced. Ice cream works the same way, as well as grapefruit and carrot juices. You can get rid of heartburn by eating nuts (walnuts, hazelnuts, almonds), but they are more likely to prevent heartburn than to eliminate an existing one. And ordinary seeds help someone cope with heartburn. In general, the expectant mother can only choose the right product for herself, but here, as with food in general, one must observe the measure. No need to eat a block of ice cream or a package of seeds every day, drink glasses of juice or endlessly eat nuts. Of course, they will help, but ice cream and nuts are high in fat and calories, and juices in large quantities hit the pancreas and increase sugar levels. A small amount of one of some product will completely cope with an attack of heartburn.

be careful

Some medicines, especially antispasmodics (drugs that relieve spasms of the smooth muscles of the internal organs), such as No-shpa , Papaverine , relax the esophageal sphincter and thus contribute to heartburn. Some herbs, such as mint, also work. Tight clothing under the chest (elastic bands, belts), a change in body position (tilts, turns) can also cause heartburn.

In general, every expectant mother can carefully observe herself and identify her personal cause of heartburn, then it will be much easier to deal with it.

old remedy

Baking soda is often used to treat heartburn. It really helps to relieve the unpleasant burning sensation very quickly, but at the same time it does not last long. In addition, when soda interacts with gastric juice, carbon dioxide is formed, which irritates the stomach - as a result, new portions of hydrochloric acid are produced and heartburn resumes. It turns out that a teaspoon of soda in a glass of water instantly relieves heartburn, but in response to taking soda, the next time the heartburn attack will be even stronger.