Provided by: Marian Thompson - BeHereSoon.com
Certainly, anyone who has been pregnant or has been close to someone who is pregnant knows that heartburn becomes a significant challenge especially in late pregnancy. Many common complaints from pregnancy stem from the physiologic adaptation that a mom's body undergoes during pregnancy. Heartburn is certainly no exception.
In order to make the environment better for the developing baby; the body undergoes significant changes when it comes to the GI system. The developing baby needs extra nutrition and water to help support its growth and development in the womb. The mom's GI system helps comply with these needs by slowing down the transit time of all its contents from the stomach throughout the entire intestine. The reason that the transit is slowed is to allow more time for the mom's body to extract essential vitamins, minerals, fluids and other nutrients that are beneficial to the baby. The emptying time of the stomach for mom is quite delayed.
Hormonal changes, particularly the increase in progesterone, is primarily responsible for the slowing in the intestines. Other problems that are created during pregnancy aside from heartburn are constipation and the feeling of being bloated. Progesterone also causes a relaxation in the pyloric sphincter, which is an anatomic functional separation between the stomach and the esophagus. The relaxation of the sphincter allows the acids in the stomach to splash upward and to affect the lining of the esophagus in an adverse manner. When the acid splashes to the esophagus, it creates a sensation of heartburn. Therefore, with the relaxation of the pyloric sphincter and the delayed emptying time in the stomach there is typically more fluid in the stomach to splash upward into the esophagus and cause heartburn. This is certainly not a dangerous phenomenon, however it represents one of the more common complaints in late pregnancy.
Strategies to help reduce problems with heartburn would include the following:
- Change from eating three large meals daily to eating multiple meals throughout the day of lesser content and bulk. Eating multiple small meals will be better handled by the digestive system and less likely to cause heartburn.
- Separate out drinking from the time of eating. A common behavior is to sit down at a meal and to drink a large amount of fluid during the time of eating. Certainly, drinking fluid is very important to pregnancy, however, if one drinks a significant volume of fluid while eating that simply just fills up the stomach with fluid and food which prompts acid release for digestion and increases the likelihood of splashing the esophagus causing heartburn.
- It is important to sit upright for approximately 30 to 45 minutes after eating. A common behavior is to "plop down" in a large easy chair or couch after eating meals to rest during pregnancy. This phenomenon causes more likelihood of the stomach that has just been filled with fluid and food to splash upwards toward the esophagus because of the reclining position. Therefore, it would be important to keep upright for at least 30 to 45 minutes after eating. Taking a walk after a meal is often a good idea to help facilitate appropriate movement of the fluid and food from the stomach into the small intestine.
- Taking antacids approximately 30 minutes before and 30 minutes after meals would also help reducing the pH of the stomach and therefore the acid content that is responsible for the heartburn. Other medications can be used in this situation if the above methods are not working and the heartburn is becoming disabling to a normal lifestyle.
Therefore, in general, heartburn is a common experience in late pregnancy. Eating more frequent smaller meals and avoiding large intakes of fluid at the time of the meal as well as sitting upright for 30 to 45 minutes after meals are all prudent exercises to help reduce the problem of heartburn. Taking antacids before and after meals has also proved beneficial in reducing this problem. If these strategies are ineffective, certainly speaking with your doctor regarding other methods, including medications, would be indicated.
For all of you who are pregnant during this hot summer good luck, keep cool and keep your smile!
**The following is a correction that should be noted in the above article**
"The pyloric sphincter separates the stomach from the duodenum. The esophagus and stomach junction or esophagogastric junction is controlled by the cardiac sphincter."
About the Author:
Michael R. Foley, M.D.
Medical Director
Phoenix Perinatal Associates
an Affiliate of Obstetrix Medical Group of Phoenix, PC
Re-print permission granted to Marian @ BeHereSoon.com by Dr. Michael Foley.Originally written in 2001 by Dr. Michael Foley for special delivery section of Marty Hames @ Azfamily.com
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