Indigestion (known as dyspepsia) is general pain or discomfort in the stomach. Heartburn (or reflux) is the “burning” discomfort felt behind the breastbone when acid moves from the stomach into the gullet.
Indigestion and heartburn are very common in pregnancy, with up to 8 in of every 10 women experiencing symptoms at some time during their pregnancy. You may experience indigestion or heartburn at any time during your pregnancy, however it is most common during the last 13 weeks (known as the last trimester) of pregnancy. As your uterus gets larger, it increases the pressure on the stomach, which may lead to indigestion or heartburn. The increased and changing hormone levels during pregnancy can also contribute to the development of these symptoms. Normally, the symptoms of indigestion settle completely after you have delivered your baby.
The symptoms of indigestion and heartburn are the same whether you are pregnant or not. Common symptoms include pain or discomfort at the top of your stomach below the breast bone (and sometimes behind the lower breast bone), a burning sensation in the same area, belching or burping, nausea, and regurgitated food or acid coming back into your mouth. These symptoms most commonly occur after food, but are also common when lying down flat, or bending forward.
There are two main explanations for these symptoms:
If you experience any of these symptoms of indigestion in pregnancy, it is advisable to talk to your doctor or midwife so that they can confirm they are due to indigestion and/or reflux and advise appropriate treatment.
There are several dietary and lifestyle changes which can help to improve your symptoms of indigestion in pregnancy:
If dietary and lifestyle changes aren’t enough, there are over the counter medicines called antacids and alginates that can help the symptoms of indigestion and reflux. Antacids (such as Maalox) neutralise the acid in the stomach, while alginates (such as Gaviscon Advance) form a layer on the top of the stomach, reducing acid reflux into the oesophagus. These are usually fine for short term use but extended use can sometimes affect your bowels, e.g. they may result in diarrhoea or constipation. It is advisable to consult your doctor or midwife who can safely advise the correct medication for you and continue to review you to ensure you remain well.
If your symptoms persist despite the above, there are other medications which are available on prescription in pregnancy. The most commonly used one is raniditine. Although it is not licensed for use in pregnancy, it has been used for many years without any reports of harm to the developing baby. It is routinely used and recommended by NICE during labour in women who have received any opioid analgesia or who have risk factors where a general anaesthetic might be needed. Another option is omeprazole, which works via a different mechanism to reduce acid production. Your doctor will be able to discuss these options with you to choose the right treatment for you, and your unborn baby.