I’m Pregnant and Have Terrible Heartburn and Acid Reflux, What Can I Do?
- During pregnancy, more than 50% of women complain of heartburn and respiratory reflux (LPR); although most pregnant women who develop reflux do not report having symptoms prior to pregnancy. Interestingly, at least 50% of older Americans have reflux, and some women date the onset of their reflux to pregnancy.
- The reflux risk factors during pregnancy include hormonal shifts, morning sickness, weight gain, and the ever-enlarging baby. As the uterus gets big late in pregnancy, the mass of the baby pushes on and compresses the stomach, and this causes reflux.
- Although many physicians prescribe PPIs (proton pump inhibitors) like Nexium and Prilosec for pregnant patients, I feel that they should be completely avoided. There are some data that PPIs increase the risk of birth defects; and PPIs have other terrible health risks. The best alternative medicines for pregnant women are: (1) anti-acids, e.g., Tums, Rolaids, Maalox, (2) H2-antagonists, e.g., famotidine (Pepcid) or cimetidine (Tagamet), and (3) alginates, e.g. Gaviscon Advance aniseed liquid.
- Dietary, lifestyle and natural remedies include: eating several small meals throughout the day, avoiding eating close to bedtime, avoiding spicy, high-fat, or high-acid foods (and beverages), limiting caffeine, and no tobacco or alcohol. Beneficial for reflux are chewing gum, probiotics, Manuka honey and/or ginger tea, aloe vera, and a half-teaspoon of baking soda in warm water for heartburn.
Why Do Pregnant Women Get Acid Reflux?
The hormonal shifts that occur early in pregnancy lead to morning sickness, and both factors increase the chance of developing reflux. Of course, the big reflux risk factors are weight gain, and the ever-enlarging baby. As the uterus gets big in pregnancy, the mass of the baby pushes on and compresses the stomach, and this causes reflux.
Which Anti-Reflux Medicines Are Safe for Me and My Baby?
Many doctors still prescribe PPIs (proton pump inhibitors) during pregnancy; however, I urge you to avoid them completely. There are some data that PPIs increase the risk of birth defects; and PPIs have other terrible health risks.
If you need the help of anti-reflux medication, take a (non-PPI) acid-suppressant and antacids. For decades I have used H2-antagonists like famotidine 20 mg. before meals and at bedtime in pregnant patients. These meds are safe, and you can get these over-the-counter at your pharmacy or on line.
Also, take a swallow of Gaviscon Advance aniseed after meals and before bed; this (the good version) is not available in the U.S. and you will have to order it on-line.
Over the counter anti-acids are a great help to women with heartburn during pregnancy, e.g., Tums, Rolaids, Maalox.
Are There Diet and Lifestyle Things that Will Help My Heartburn and Acid Reflux? My Recommendations:
Eat slowly and chew your food well
Avoid big meals
Eat several small meals throughout the day
Avoid eating close to bedtime (3-5 hours is best)
Avoid spicy or fatty foods
Avoid high-acid foods and beverages
Avoid all soft drinks or fruit juices already in bottles or cans
Avoid all citrus fruit in all forms as well as other acidic fruits such as papaya and pomegranate
Avoid apple cider vinegar … way too acidic
Avoid Chocolate … sorry, it is a big reflux trigger
Drink between meals, not so much at meals
Limit caffeine, 1-2 cups of Coffee per day is okay
No tobacco or alcohol … NONE!
And also, sleep on an incline and your left side if you can.
Are There Natural Remedies for Acid Reflux?
Chewing Gum. Chewing sugar-free gum (preferably not mint) or sucking on a hard candy after eating helps combat reflux.
Probiotics. There are no scientific data on this, but many of my pregnant patients swear by probiotics as helping their reflux symptoms … and I believe that they can do no harm.
Milk. Low-fat cow’s milk is okay, that is skim-to2%, but better are almond milk, soy, or rice milks.
Honey. Honey, especially Manuka honey, seems to be good for reflux. You can make honey tea by putting a half-teaspoon of it in a cup of warm water. with honey
Best Snacks. Almonds, bananas, melons, and Manuka Honey and Ginger Lozenges