It tends to get worse when lying down or bending over. It can last for several hours and often worsens after eating food. Any reflux is then relatively harmless as it consists of alginic acid and not damaging stomach acid. For people who experience heartburn or indigestion infrequently, perhaps in association with occasional food and drink triggers, OTC treatments to reduce the acidity of the stomach contents are available.
Women may also have a difficult time distinguishing the difference between GERD and symptoms of pregnancy, like morning sickness, particularly in the first trimester. Proton pump inhibitors should be reserved for pregnant patients with more severe heartburn symptoms and those not responding to antacids and lifestyle and dietary changes. Lansoprazole (PrevacidÂ®) is the preferred PPI because of case reports of safety in pregnant women. Limited data exists about human safety during pregnancy with the newer PPIs.
Calcium products have been reported to cause rebound acid reflux on discontinuation [BNF 72, 2016], and rarely, excessive calcium intake can cause milk-alkali syndrome (characterized by hypercalcaemia, alkalosis, and renal failure) [American Gastroenterological Association, 2006; Schaefer et al, 2015]. This recommendation is pragmatic and is based on what CKS considers to be good clinical practice. Although dyspepsia in pregnancy is a common symptom, other treatments are available if symptoms are not controlled by self-care and lifestyle measures. It is also important to bear in mind differential diagnoses. The severity and frequency of gastro-oesophageal reflux symptoms are thought to increase as pregnancy advances, but these findings are not consistent in all studies.
But talk to your OB or midwife before beginning an OTC med like Tagamet to treat acid reflux. â€œWe want to make sure that it wonâ€™t interact with anything else you might be taking,â€ Collins says.
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Women with persistent or more severe symptoms may also require advice about specific treatments. If you had gastroesophageal reflux disease (GERD) before pregnancy, heartburn is nothing new – but treating it during pregnancy might be. Now that you’re expecting, talk to your practitioner about whether the prescription meds you’re taking are still okay now that you’re pregnant. Many of the tips for fighting heartburn can also help with your reflux.
Which heartburn medications are used during pregnancy?
This can help maintain good gut flora, but there is some controversy over how effective it is for acid reflux in pregnancy because nothing can change the fact that you have an 8-pound baby pressing on your stomach! But thereâ€™s no harm in taking one. If itâ€™s too costly, Graves recommends either eating good yogurt with active cultures or taking Â¼ teaspoon of baking yeast. If you smoke, try to stop (NICE 2017) .
Dyspepsia or indigestion is not a disease; it is a group of symptoms that cause pain and discomfort in the upper abdomen. Dyspepsia is caused by overeating, particularly spicy and fatty foods. Lifestyle changes can ease symptoms, but treatments are available for more severe cases.
Heartburn in pregnancy
If you find yourself downing bottles of antacids, your heartburn may have progressed to gastroesophageal acid reflux disease (GERD). In that case, you may need a stronger treatment. Take a probiotic.
This recommendation to refer to an obstetrician if symptoms suggest a pregnancy-related disorder other than dyspepsia is extrapolated from the NICE guideline on Antenatal care for uncomplicated pregnancies which advises the management and treatment of pregnant women by the appropriate specialist teams when problems are identified [NICE, 2008]. It is also pragmatic, based on what CKS considers to be good clinical practice.