Pregnancy: heartburn and gastric reflux: what is it? What are the causes and what are the remedies to appease this annoying pregnancy symptom

In pregnancy one of the symptoms that many future mothers suffer the most is heartburn and gastric reflux. One of the symptoms of pregnancy that does not leave women waiting peacefully from the beginning of pregnancy and, often, until the end. But why does it happen? What are the causes that lead to this odious gravid nuisance? And how is it possible to remedy heartburn and gastric reflux ? We try to understand something more, remembering that every pregnancy is a matter of course, so not for all mothers-to-be, this symptom is the same. There are those women who do not suffer from heartburn and reflux in the slightest, while others, more “unlucky” feel the discomfort already from the very first weeks of pregnancy and carry the disorder with them until the day of delivery. Can it be remedied? Considering that in pregnancy you can not take drugs, the answer is to be found in some natural remedies but not only, even in the lifestyle that the future mother must absolutely adopt. What is of primary importance, in this case is the diet that must be as natural and genuine as possible, consisting of fruit and vegetables but also of meat and carbohydrates. In short, a healthy and balanced diet that can certainly alleviate the annoying symptom in question: heartburn. But let’s see specifically how this annoyance arises and why, obviously not neglecting the causes and natural remedies.

Pregnancy: the heartburn and gastric reflux, what is it?

 maternity and months of pregnancy

Heartburn is one of the clear symptoms of a pregnancy in progress. As specified before, this symptom is normal for the pregnant woman and even if it is terribly annoying, it is necessary to “get used to it” because it does not always disappear with the progress of pregnancy and, even if this were the case, heartburn is better , gastroesophageal reflux could recur at the end of pregnancy. Why? We explain the reasons and what this heartburn is.

Commonly known as “heartburn”, this symptom, in medicine, is called “pyrosis “, and is described as an annoying sensation or a real pain located at a retrosternal level ( behind the sternum) and / or in the epigastric area, ie in the upper portion of the abdomen commonly called “mouth of the stomach”. This type of pain is perceived by the patient as “burning” and can appear in association or away from meals. When pregnancy occurs pregnancy this disorder is more specifically referred to as pyrosis gravidic . More than half of pregnant women report symptoms of heartburn, with an increasing incidence from the first to third trimester. In most cases the symptoms appear in the second or third trimester, are perpetuated throughout the pregnancy and resolve after delivery. Pregnancy is in fact characterized by numerous modifications and physiological adaptations of the maternal body that can produce gastrointestinal symptoms, among which the most frequent is precisely the heartburn . If heartburn was present before the pregnancy, most likely during the nine months the disorder will tend to worsen. Gastrointestinal symptoms are usually more frequent in the first pregnancy, while they are reduced in the following ones.

What is the cause of heartburn in pregnancy? Causes


Heartburn in pregnant women is generally due to gastro-oesophageal reflux disease ; this phenomenon, which consists in the ascent of acidic gastric material from the stomach towards the esophagus, is favored in pregnancy by multiple factors. Heartburn can also be caused by abnormal gastric emptying, delay in the passage of the small intestine or by certain drugs taken during pregnancy, such as anti-emetics. But in general the causes that lead to the accentuation of the symptoms of heartburn are other. In fact, during pregnancy, stomach acid is a rather frequent problem. At first, the origin of the disorder is attributable to the elevated levels of progesterone, which can:

  • Slow down the digestive processes;
  • Reduce the sphincter tone between the esophagus and stomach: the esophageal sphincter rises towards the thoracic cavity, an area where there is negative pressure. This pressure, through a “suction” mechanism, facilitates the return of food and acid material from the stomach to the esophagus. This continuous ascent leads to esophageal inflammation which creates the classic ‘burning’ sensation
  • Hormonal balance in pregnancy: One of these is the new hormonal situation of the pregnant woman. At the border between the esophagus and the stomach we find the lower esophageal sphincter, a muscular thickening which, together with other anatomical-functional systems called “anti-reflux”, prevents the gastric material from rising up to the esophageal level. Normally the lower esophageal sphincter releases (and therefore opens) to allow the passage of food from the stomach esophagus or to allow eruption; and then it tends to close again. If the lower esophageal sphincter undergoes relaxation too often or its tone is diminished, stomach acid can flow back into the esophagus and cause a burning sensation. In pregnancy the increase in the quantity of progesterone causes the relaxation of the smooth muscles, which results in a reduction in the tone of the lower esophageal sphincter. The reduction of the tone of the lower esophageal sphincter favors the ascent of gastric material.
  • The increase in the volume of the uterus: It is also fundamental to consider that the uterus, increasing in volume, occupies more and more space in the cavity abdominal, producing a pressure that with the progression of pregnancy can worsen heartburn. In fact, not surprisingly, those suffering from heartburn in pregnancy, notice a worsening of the disorder towards the end.
  • Greater space for the child: the difficulty in digesting is a very common symptom in pregnancy. Gastric burning and acidity have depended on displacement of your internal organs with the progression of your child’s weight. The organs make room for your little baby and this leads to greater difficulty in the gastrointestinal tract. Follow a balanced diet, preferring vegetables and fruits and highly digestible foods. Avoid eating fried foods and pasta at night.
  • Stress : stress causes heartburn and subsequent gastric reflux. Especially in pregnancy, adopting a lifestyle as calm and peaceful as possible is recommended for the well-being of women but also of the fetus. A strong emotional stress can, in fact, lead to the birth of the annoying symptom. On the other hand, the second brain is the stomach, which explains one of the triggering causes. So making a life without stress – at least for those nine months – is essential for mother and child health.
  • Alcohol and smoking use: both alcohol and smoking are highly discouraged during pregnancy. A use of alcohol as well as smoking in the nine months of gestation, has serious consequences for the fetus both on a physical and a neural level. A cause of the gastric disorder is therefore also represented by the use of chemical and alcoholic substances. Basically banned from the lives of future mothers: NO to smoke and NO to alcohol
From the fourth month onwards, when the fetus begins to significantly increase its size, the pressure exerted on the walls of the stomach can aggravate the problem, favoring the ascent of acids into the esophagus.

Heartburn and gastric reflux: symptoms in pregnancy

 symptoms pregnancy The symptoms commonly associated with heartburn reported by pregnant women include: chest pain, especially after bending, lying down or after eating

  • throat burning,
  • hoarseness,
  • feeling of regurgitation of swallowed material, ie rising spontaneous gastric contents up to the oral cavity, not associated with vomiting,
  • belching,
  • chronic cough,
  • asthma.

For what it entails of the possible complications that the burning of stomach can lead to the pregnant woman, we highlight:

  • erosive esophagitis: that is presence of erosions of the esophageal mucosa,
  • esophageal stenosis: that is the formation of a scar that narrows the esophageal lumen.
  • Pregnancy: heartburn and gastric reflux, what to do and what to avoid

    The first thing to do is contact your doctor carer or gynecologist who follows you during pregnancy. A careful collection of information regarding the symptomatology and an objective examination carried out by the trusted gynecologist are normally sufficient to diagnose gastric disorder during pregnancy. No further instrumental diagnostic tests are required. In the event of major gastrointestinal disorders such as haemorrhage and / or dysphagia (inability or difficulty swallowing) it is possible to subject the woman to the esophagus-gastro-duodenoscopy an endoscopic technique considered safe in pregnancy which allows to visualize the esophageal walls. However, drug therapy should always be undertaken with caution and exclusively under medical supervision. Given the potential risk to the fetus, to keep acidity and burns under control, it is advisable to follow simple rules of a general nature:

    • Avoid meals that are too abundant, especially in the evening: No at night or frying
    • Avoid overeating with fatty foods, alcohol and coffee
    • Avoid going to bed immediately after eating. A walk can be useful;
    • Avoid those movements that increase abdominal pressure (bending of the torso) and clothing that is too tight
    • Elevate the headboard by 10-15 cm during night rest It is not recommended to sleep with two / three cushions as increasing the abdominal pressure would facilitate the reflux mechanism
    • Undertake a daily physical activity: if your state allows it, perform an hour of physical activity in the open air or a pre-natal course is fundamental for good digestion. The movement will help you a lot
    • Eat ginger: in the pharmacy or herbalist’s shop there are natural ginger-based tablets. It seems that chewing ginger in pregnancy helps alleviate heartburn by alleviating the discomfort of gastric reflux. Before you run to the pharmacy, however, always ask your doctor for advice.

    If acidity and heartburn become unbearable, it is appropriate to seek medical attention to consider the use of specific drugs, supported by studies proving safety for the fetus.

    Heartburn in pregnancy: antacids, yes or no?


    As we have already said, changes to diet and lifestyle may be sufficient to control symptoms, especially when mild. It is therefore useful to follow the advice above. While for antacids first-line treatment is usually based on such antacid drugs. Antacids containing calcium and magnesium are considered safe in pregnancy because they are not absorbed, while ensuring immediate relief from heartburn. The use of aluminum-based antacids and sodium bicarbonate is not recommended

    Therapeutic management of gravid reflux oesophagitis due to a different cause than gastro-oesophageal reflux disease is instead more complex, as the use of conventional drugs for the treatment of these disorders is limited in pregnancy, therefore it is necessary to contact a specialist to identify the correct therapy and not to do it by itself!

    Heartburn and gravid reflux: The remedies in the kitchen, what to eat and what to avoid


    Natural remedies for heartburn and digestive problems consist of small tricks and the use of s no toxic issues for the mother and her baby. First of all, during pregnancy it is necessary to try, as much as possible, to resolve the disorders linked to changes in the period, through diet and food. The future mother must try to change some eating behaviors and intervene with dietary precautions. Break down your meals into 5 or 6 a day by eating in small quantities chewing slowly; and above all, wait at least 1 hour, after a meal, to rest in a horizontal or semi-sitting position.

    1. Foods Yes

     rib chard  

    Prefer fruit easily digestible, like bananas, apples and pears; the same advice also applies to the vegetables better those with green leaves, such as chard and spinach, and then zucchini carrots, fennel and potatoes. Try to cook the food easily and without much seasoning.

    2. Foods No


    If you suffer from heartburn and reflux in pregnancy you must absolutely avoid acidic foods such as peppers, tomatoes , citrus fruits, yogurt and spices, because they irritate the walls of the stomach; moderate consumption of fried elaborate dishes, cheeses and chocolate . And moderate the consumption of coffee tea and carbonated soft drinks .

    3. The officinal plants

     decoction of lettuce  

    One can resort to the help of herbs to relieve the burning of stomach and promote digestion. The decoction of mallow and fennel seeds for example, is excellent for promoting digestion and calming acidity, thanks to the presence of mucilages which perform an anti-inflammatory action and protective on the mucous membranes of the gastrointestinal system

    Also ventilated green clay can be taken to extinguish burns and absorb excess gastric juices.


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