Acid Reflux During Pregnancy

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Gastroesophageal reflux disease occurs in up to 50% of pregnant women. Many women experience heartburn for the first time during pregnancy — and though it's common and generally harmless, it can be quite uncomfortable.

Heartburn (also called acid indigestion or acid reflux) is a burning sensation that often extends from the bottom of the breastbone to the lower throat. It's caused by some of the hormonal and physical changes in your body.

During pregnancy, the placenta produces the hormone progesterone, which relaxes the smooth muscles of the uterus. This hormone also relaxes the valve that separates the esophagus from the stomach, allowing gastric acids to seep back up, which causes that unpleasant burning sensation. Additionally, the growing fetus causes an increase in intra-abdominal pressure, resulting in an increase in the development of reflux.

Progesterone also slows down the wavelike contractions of your esophagus and intestines, making digestion sluggish. Later in pregnancy, your growing baby crowds your abdominal cavity, pushing the stomach acids back up into the esophagus.

Many women start experiencing heartburn and other gastrointestinal discomforts in the second half of pregnancy. Unfortunately, it usually comes and goes until your baby is born.

It can be tough when you get pregnant. Acid reflux during pregnancy can be one problem that you will have to take care of. The discomforts are common when you are pregnant and some time you may even get pain. You can not use medicine since you are now pregnant. Most of medicines are not tested to the pregnant ladies to prove their safety. They can not do that. You have to bear in mind that using medicines is not safe.

What Causes Acid Reflux During Pregnancy?

Acid reflux during pregnancy can make it difficult for you to get the nutrition you need for yourself and your growing baby. The causes of acid reflux during pregnancy include changes in your hormone levels, the position of your internal organs and your dietary habits. What causes acid reflux during pregnancy.

1. Prenatal Vitamins. Taking prenatal vitamins may irritate your throat and stomach and cause you to have acid reflux.
2. Hormones. Heartburn during pregnancy occurs for a number of reasons. Increased levels of hormones in your body while pregnant can soften the ligaments that normally keep the lower esophageal sphincter (LES) tightly closed. If the LES relaxes at inappropriate times, food and stomach acids can reflux back up into your esophagus and throat. Also more pressure is put on your stomach as your body changes and your baby grows. This, in turn, can force stomach contents through the LES and into your esophagus.
3. Foods. Your food cravings during pregnancy may cause acid reflux, especially if you eat greasy, fatty or spicy foods.
4. Caffeine. Although you may not be drinking coffee while pregnant, the caffeine in chocolate, hot cocoa and black tea may cause you to have acid reflux.
5. Eating Too Much. During pregnancy, the capacity of your stomach is smaller and acid reflux may result from eating too much at once.
6. Fetal Position. The position of your baby may trigger your acid reflux, especially once your baby turns head down and the feet push into your ribs.
7. Uterine Growth. As your uterus gets larger in the last few months of pregnancy, it pushes your other internal organs into a smaller amount of space, resulting in acid reflux.
   

source : Mayo Clinic

How to prevent or Treat Acid Reflux during Pregnancy?

What can be done to prevent or treat gastroesophageal reflux disease in pregnancy? Lifestyle modifications can prevent increases in intra-abdominal pressure and decreases in lower esophageal sphincter pressure that promote reflux. Here's a list of both ways to prevent and treat gastroesophageal reflux in pregnancy. Though you may not be able to eliminate heartburn completely, you can take some steps to minimize your discomfort.

1. Don't eat foods that are known heartburn triggers. These include chocolate, citrus fruits and juices, tomatoes and tomato-based products, mustard, vinegar, mint products, and spicy, highly seasoned, fried, and fatty foods. For a complete list of foods to avoid, check out this chart. For foods that have a low risk of causing heartburn, check out this chart.
2. Avoiding caffeine (coffee, tea, cola), chocolate and peppermints. These food groups all lead to a decrease in lower esophageal sphincter pressure.
3. Avoid alcohol. Alcohol relaxes the LES. Read the article on alcohol and heartburn for more information.
4. Chewing gum. This increases saliva production and swallowing frequency, which can help clear away acid that has refluxed from the stomach into the esophagus. A clear reduction in acidic esophageal reflux has been documented in patients who chewed sugar-free gum for 30 minutes after a meal.
5. Avoid drinking large quantities of fluids during meals — you don't want to distend your stomach. (It's important to drink eight to ten glasses of water daily during pregnancy, but sip it between meals.)
6. Eating frequent, small meals. Eating smaller meals empties the stomach more rapidly. Eating more frequently increases stomach contractions. If the stomach is contracting and empty this will decrease the incidence of reflux. After meals, pregnant women are not supposed to lie down.
7. Don't eat close to bedtime. Give yourself two to three hours to digest before you lie down.
8. Don't rush through your meals. Take your time eating, and chew thoroughly.
9. Wait at least three hours after your last meal before going to bed.
10. It's important to drink plenty of water during pregnancy (8-10 glasses daily) along with other fluids, but don't drink these only at mealtimes. Large quantities of fluids can distend your stomach, putting more pressure on the LES and forcing it to open inappropriately. Drink some of your fluids in between meals.
11. You need to make your head higher than your body. Use the wedge pillow or elevate the head of your bed 6-8 inches higher. This means the two feet of your upper part must be elevated while sleeping. This will allow gravity to work for you and it will help keep your stomach acids where they should be--in your stomach and not in your esophagus. Acid reflux during pregnacy can be greatly reduced by the right sleeping position in the pregnant women. Studies have documented that, as compared with patients who sleep flat on their backs, patients who elevate the head of the bed have significantly fewer reflux episodes, and when they do, the episodes that do occur are shorter and produce generally milder symptoms.
12. Occasionally, reclining chair may be needed if you want a day nap.
13. Wear loose, comfortable clothing. You need to avoid any tightness around your waist and stomach.
14. Bend at the knees instead of at the waist. Bending at the waist puts more pressure on your stomach.
15. Lying on one's left side at night. Sleeping on the left side as opposed to the right side may reduce the frequency and duration of reflux episodes in patients prone to symptoms during the night. It is felt that there are more frequent episodes of decreases in lower esophageal sphincter pressure when patients lie on the left side as opposed to the right side.
16. Gain a sensible amount of weight and stay within the guidelines your doctor suggests. Too much of a weight, and obesity, puts more pressure on your stomach, and can force stomach contents through the LES and into your esophagus.
17. Don't smoke. While your doctor may urge you break the habit because you're pregnant, smoking can also increase your odds of experiencing heartburn. Read about smoking and heartburn to find out the reasons smoking increases heartburn.
18. You should always check with your doctor before taking any over-the-counter remedies while pregnant, but there are a few choices you have that can help eliminate heartburn.
19. You can try Rolaids, Maalox or Tums. However, anything that contains sodium bicarbonate can cause fluid retention and should only be used under the supervision of a physician. During the third trimester, any antacid that contains magnesium should be avoided because they have been known to interfere with contractions.
20. Antacids such as Mylanta and Maalox are effective and very safe as they are not absorbed into the bloodstream.
21. H2 blockers Zantac, Pepcid and Tagamet are effective. These medicines include Pepcid AC and Zantac. While they are absorbed into the bloodstream, studies have not revealed any adverse effects on the developing fetus. H2 receptors work by shutting off the production of acid in the stomach and are effective in cases of mild reflux. H2 receptors: They are relatively inexpensive and provide longer-lasting relief than antacids. Women take them a half-hour before meals or at bedtime.
22. Proton pump inhibitors Nexium, Aciphex and Prevacid should be used only in severe cases that are not responsive to H2 blockers. While they are felt to be safe, there are no long-term studies available confirming this.
    

In most cases, acid reflux is easily treated, even in pregnancy. If there are however, more refractory symptoms that result in complications such as gastrointestinal bleeding, difficulty swallowing or weight loss, your obstetrician may refer you to a gastroenterologist. Other conditions such as gallbladder disease, pancreatitis or even cancers of the esophagus and stomach can mimic gastroesophageal reflux disease.

Beware of:

* Tomatoes and Related Sauces (Pizza, Spaghetti, etc.)

* Ketchup

* Mustard

* Horseradish

* Salad Dressings

* Vinegar

* Fried Foods

* Caffeine

* Coffee and Tea (Even decaffeinated products can instigate acid production).

* Chocolate

* Citrus Juices/Foods

* Caffeine

* Products flavored with peppermint (candy, cocoa, etc.)

* Processed Meats

* Cream Sauces (Alfredo)

* Alcohol and Tobacco (Of Course)

Pregnancy is something to be celebrated but it can also be an overwhelming state. If you arm yourself with these remedies for acid reflux during pregnancy you’ll be prepared regardless of what Mother Nature throws your way.

Remember that an increased incidence of GERD episodes during pregnancy is quite common and there are many preventative measures that you can take to avoid those annoying and painful occurrences. The changes may seem small but, collectively, they will make a big difference.

Reflux Medications Taken During Pregnancy Linked to Asthma in Children
By : Jan Gambino

A new study indicates that moms who took reflux medications during pregnancy may increase the risk of having a child with asthma symptoms. The study, presented at the American Academy of Allergy, Asthma and Immunology this week examined the health records of 30,000 children. It was found that mothers who took prescription reflux medications such as H2 blockers (Zantac, Axid, Pepcid, and Tagament) and Proton Pump Inhibitors (PPI's) such as Nexium, Prevacid, Prilosec, and Aciphex were significantly more likely (51%) to have a child with asthma symptoms such as wheezing. The study did not look at the effect of taking over the counter antacid medications.

It is estimated that approximately half of all pregnant mothers experience reflux symptoms during pregnancy. However, my own survey of moms indicates that the statistic is closer to 100%! My small frame combined with over sized babies gave me my first real experience with what heartburn and reflux felt like. I remember eating like a bird and propping up my pillows at night so I could sleep. Along with stretch marks and hormone swings, I accepted heartburn as part of the package deal.


Sources:

- "Healthy Pregnancy - Pregnancy - Pregnancy Basics." U.S. Department of Health & Human Services. 21 Jan 2007

- "Heartburn, Hiatal Hernia, and Gastroesophageal Reflux Disease (GERD)." NIH Publication No. 03­0882 June 2003. NIH Publication No. 03­0882 June 2003. National Digestive Diseases Information Clearinghouse (NDDIC). 21 Jan 2007

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