What causes heartburn during pregnancy, and how can I treat it?

Heartburn feels like a burning in the heart and throat.  It is most often caused by stomach acid flowing back up from the stomach into the esophagus.  Heartburn is very common in pregnancy, particularly in the third trimester.  Many women will experience heartburn for the first time during pregnancy.

During pregnancy, hormone and physical changes may cause stomach acid to flow up into the esophagus.  The hormone progesterone, produced by the placenta, relaxes the valve that separates the esophagus from the stomach.  This allows gastric acids to seep back up the pipe, causing that unpleasant burning sensation. Progesterone also slows down the wavelike contractions of the stomach, making digestion sluggish.  In later pregnancy, your growing baby crowds your abdominal cavity, slowing elimination and pushing up the stomach acids to cause heartburn.

Eating habits can help relieve or prevent heartburn during pregnancy.  For example, if you eat several small meals each day instead of three large ones you may find that your heartburn is reduced and that you have more energy.  Eating slowly will reduce heartburn.  You should also avoid fried, spicy, or rich foods, or any foods that seem to increase heartburn. 

There are several medications you can take during pregnancy to combat heartburn.  As always, check with your physician before using any of them.  Mylanta, Maalox, and other magnesium-based antacids seem to give longer lasting relief of symptoms.  Over-the-counter antacids such as Pepsid, Tagamet and Zantac are also considered safe in pregnancy.  For severe cases, your physician may prescribe Sucralfate liquid for your heartburn, although this product may cause or increase constipation.

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