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What is indigestion during pregnancy?

Indigestion, heartburn and acid reflux, is very common during pregnancy, affecting nearly two-thirds of women. It can occur due to hormonal changes and may be caused by the increasing size of the baby. This increases the pressure on the uterus pushing it up against the stomach. Serious complications for indigestion are very rare but symptoms may be recurrent, severe and discomforting.

What are its main associated signs and symptoms?

Pregnant women experience some symptoms, specifically after having food or drinking which include

  • Burning sensation around the sternum extending to the throat.
  • Feeling bloated
  • Burping or belching
  • Acid reflux

These symptoms occur at any point during pregnancy but are commonly reported in the third trimester. In older women and in women experiencing their second or subsequent pregnancies, regardless of the trimester, this event is very common.

What are the main causes?

The chief reasons for an increase in indigestion during pregnancy include

  • Increased pressure in the abdomen applied by the expanding uterus which ultimately causes relaxation of the oesophageal sphincter, thereby allowing gastric contents to flow back into the oesophagus.
  • Pregnancy hormones play a vital role. In the presence of oestrogen, elevated levels of circulating progesterone may impact the general pressure, or pattern of relaxation, of the lower oesophageal sphincter causing gastric acid reflux. Also, progesterone acts on smooth muscles of the stomach causing delayed food clearance from the stomach.

How is it diagnosed and treated?

Diagnosis is mainly made on symptoms. Pregnant women who have a severe illness may be advised to undergo upper gastrointestinal endoscopy after a history taking and physical examination.

Changes in diet and lifestyle will assist to mitigate these problems and include

  • Early dinner: The symptoms of indigestion are more likely to be experienced at night. Therefore, eating dinner at least two hours prior to the bedtime will help to avoid heartburn at night.
  • Avoid large meals: Increase the frequency of small meals instead of having a few large meals.
  • Keep upright: Sit up straight when while eating. This will help minimize the pressure on the stomach.
  • Never drink water during a meal: Drinking water during a meal can increase the chances of indigestion as water dilutes the gastric acid.
  • Never rush through meals: Eat slowly and chew the food properly before swallowing which is helpful for rapid digestion.
  • Avoid spicy food, alcohol, and smoking: These factors will exacerbate symptoms.

When the preventive measures are not helpful, symptoms of indigestion continue to distress. A range of medications has been used to treat symptoms which include

  • Antacids to neutralise the acid in stomach.
  • Alginates to relieve indigestion caused by acid reflux.
  • H2-receptor blockers to reduce the secretion of gastric acids.
  • Proton pump inhibitors to inhibit stomach enzymes involved in acid production.
  1. Medicines for Indigestion during pregnancy

Do you or anyone in your family have this disease? Please do a survey and help others

References

  1. National Health Service [Internet]. UK; Indigestion and heartburn in pregnancy
  2. Vazquez JC. Constipation, haemorrhoids, and heartburn in pregnancy. BMJ Clin Evid. 2010 Aug 3;2010:1411. PMID: 21418682
  3. Office on women's health [internet]: US Department of Health and Human Services; Body changes and discomforts
  4. National Health Service [Internet]. UK; Indigestion and heartburn in pregnancy
  5. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Pregnancy and diet
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