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acid reflux and pregnancy

Acid Reflux and Pregnancy

It is estimated that as many as 80% of women experience acid reflux during pregnancy as a result of a temporary GERD condition that produces symptoms ranging from mild to severe and will typically persistent for the length of the pregnancy.

Pregnancy provides a unique set of conditions which contribute to acid reflux symptoms.

According to Disabled World:

Although nausea and vomiting are common in the first trimester, mainly due to the rising level of the female hormones, estrogen and progesterone in the blood stream, acid reflux symptoms are more common in the third trimester.

In the third trimester, the uterus is large and has pushed up into the upper abdomen distorting the configuration of the organs in the abdomen. The stomach is pushed up against the diaphragm. This can affect the function of the Lower Esophageal Sphincter (LES) and cause acid reflux. It can also force part of the stomach up through the diaphragmatic hiatus. This is a hiatus hernia. A hiatus hernia can result in acid reflux.

In addition, weight gain during pregnancy will settle around the waist. This weight will press on the abdomen and increase the intra-abdominal pressure and pressure on the LES may force food up into the esophagus.

Acid reflux in pregnancy

During pregnancy estrogen and progesterone levels need to be high to maintain the pregnancy. These two female hormones are produced by the ovaries until the placenta takes over. These hormones relax smooth muscles of the uterus and are necessary to allow the uterus to stretch to accommodate the developing pregnancy.

Unfortunately this muscle relaxation is not confined to the uterus. The muscles of the GI tract are affected. In the large bowel reduced strength of peristaltic contraction leads to slow transit time and likely constipation. In the esophagus it reduces the tone of the LES allowing reflux and slows down peristalsis along the esophagus. The food swallowed is cleared slower and the LES is lax.

Patients who have had GERD symptoms before becoming pregnant tend to have severe GERD during pregnancy. Sometimes GERD during pregnancy can be so severe that hospitalization is necessary. Also vomiting can be so severe that weight loss follows. During pregnancy regular weight gain is expected.

And Therefore…

Severe GERD can lead to mal-nutrition and unhealthy weight loss, which can be harmful to the mother and in turn may put the fetus at risk at a time of vital development.

As For Coping With the Symptoms of Acid Reflux in Pregnancy,

acid reflux symptoms

Antacids are safe in pregnancy because they do not cross the placenta into the baby’s circulation. However, antacids containing sodium (sodium bicarbonate) can cause fluid retention.

Aluminum containing antacids can make constipation of pregnancy worse. Magnesium can slow down labor. These drugs are in Category A. The categories were laid down by the FDA in 1979 and are related to safety profile and potential harm to the fetus. Category A is safe in pregnancy.

However,

The H2-receptor antagonists and proton pump inhibitors are in Category B except Omeprazole, which is in Category C.  These drugs do cross the placenta but trials results are not adequate to consider them safe during pregnancy.

Instead, you may want to consider these tips for safely dealing with the discomfort of acid reflux during pregnancy.

Ginger is a good safe treatment for GERD during pregnancy and you only need a small amount. It can stimulate saliva production. Saliva is a natural antacid. Ginger helps relieve nausea and vomiting and it is a carminative (relieves gas). Lifestyle change is important. If you are still smoking and drinking alcohol, then it is time to stop.

Avoid or reduce your intake of fats, coffee, tea, chocolate, certain citrus fruits, certain spices, tomatoes and garlic. When exercising, avoid bouncing up and down and exercises that involve bending forwards. Stick to exercises that keep you upright. Stretching exercises and power or brisk walking are unlikely to aggravate GERD symptoms.