Pregnant women in particular can tell you a thing or two about it: Heartburn! After eating, when taking a little nap in between, often at night, when bending over and especially more often in the last trimester of pregnancy, this sometimes unpleasant pain occurs behind the breastbone, burns in the oesophagus and rises up into the oral cavity as a sour burp. At least this "burp" provides a little relief until it starts all over again. At least half of all pregnant women - other sources claim that up to 80 per cent are affected - are plagued by this annoying phenomenon.
How does heartburn develop during pregnancy?
Every bite of food that we eat, chew and swallow passes through our oesophagus into the stomach. In this pouch-like, muscular stomach, the ingested food is broken down further with the help of movements, enzymes and acidic gastric juices, mixed into a chyme and pre-digested. A ring-shaped sphincter muscle at the point where the oesophagus opens into the stomach ensures that none of the stomach acid can slide up into the oesophagus. This so-called oesophageal sphincter opens to release the chyme into the stomach and then closes again. It therefore acts as a kind of barrier so that our digestive tract remains a one-way street.
However, if this muscle does not close properly or is too "relaxed", acidic gastric fluid can still rise into the oesophagus. This reflux is called reflux. It causes the heartburn that is so unpleasant.
Why do pregnant women suffer from heartburn so often?
During pregnancy, the female body has important characteristics that unfortunately favour heartburn:
- Hormone levels change and more hormones are produced, including progesterone. From early pregnancy onwards, it primarily causes the smooth muscles to loosen and relax so that, for example, the uterus does not produce contractions too early and the birth canal can give way for the baby's passage into the world. However, progesterone also causes the muscles in other parts of the body to "slacken" - and this also affects the sphincter muscle between the oesophagus and stomach. For this reason, it can no longer fulfil its function as well, which makes it easier for acidic gastric juices to reflux, resulting in heartburn.
- In addition, the stomach is also loosened up and works more slowly. Meals therefore remain in the stomach for longer during pregnancy. This means that the stomach contents can still return to the oesophagus several hours after the last meal. This is particularly noticeable if you have eaten hard-to-digest foods or particularly sumptuous meals as a pregnant woman.
- As the pregnancy progresses, the uterus needs more and more space and increasingly "squeezes" the stomach. This growing pressure in turn encourages gastric juices to be pushed into the oesophagus. Heartburn again! Many pregnant women suffer from heartburn, especially in the third trimester. It gets better shortly before the birth, when the baby has moved lower towards the pelvis. This reduces the pressure on the stomach.
- What a wonderful feeling for pregnant women when they feel their unborn child moving inside them! But these movements can also put pressure on the stomach, especially if they are small kicks. This can also favour heartburn.
In most cases, heartburn during pregnancy is caused by a combination of several of these causes.
However, heartburn is not dangerous for either the mother or the child. In rare cases, however, it can also be a reflux disease.illness act. In this case, acidic and non-acidic stomach contents flow back into the oesophagus not just occasionally, but almost constantly.
What are the symptoms of heartburn?
A common symptom of heartburn is a burning or pressing sensation behind the breastbone, which often rises up into the throat and can also lead to pain and an irritating cough in the morning. Many sufferers also describe severe pressure in the upper abdomen, a sour or bitter taste in the mouth, a feeling of fullness and "sour" belching. Sometimes heartburn can also be accompanied by nausea and vomiting.
In some cases, heartburn can also cause pain that feels similar to heart pain. It is therefore important to seek medical advice if symptoms persist in order to rule out other possible causes.
How can heartburn be avoided?
It is clear that this unpleasant symptom is related to food intake. That's why you can do a lot to ensure that you suffer from heartburn less often, both through your eating behaviour and the right diet. Here are my tips:
- Eat less, but more often: You can easily imagine that the ring muscle at the entrance to your stomach, which has become flabbier due to the progesterone, finds it much more difficult to perform its closing function properly after a very sumptuous meal. This is because a full stomach also pushes upwards. And the growing uterus also presses on it. It is therefore better to eat several small meals rather than a few large ones. Then the gastric juices are more likely to stay where they belong.
- Chew the food well: If you take your time at every meal, eat slowly and chew every bite thoroughly, you are already doing a lot of work for your stomach. This is because the food is ground into a pulp in the mouth and pre-digested.
- Avoid anything that makes your stomach acid boil: Some foods lead to increased production of stomach acid - and therefore more heartburn. Therefore, avoid as often as possible, for example
- Fatty and/or fried food
- Fatty and raw sausage/fatty and raw meat
- spicy or strongly flavoured food
- Processed food (ready meals, ready-made products)
- Crisps and processed nuts
- Acid-rich foods and drinks (e.g. tomatoes, citrus fruits, fruit juices)
- Carbonated drinks
- Caffeinated drinks
- Peppermint tea, black tea
- Sweets
- and of course cigarettes and alcohol
- Always eat sitting down and not lying down: It's actually logical - when sitting down, smaller meals tend to end up at the bottom of the stomach. This is simply due to gravity. When lying down, on the other hand, the food pulp is distributed horizontally in the stomach and thus exerts more pressure on the weak sphincter muscle to the oesophagus.
- Take a "digestive walk": It helps the stomach to do its work.
- Try not to go to bed with a full stomach in the evening: On the one hand, because the horizontal position can trigger heartburn, as explained in the previous point. Secondly, because the stomach digests "more slowly" at night anyway and the food literally "sits in your stomach" for longer. Therefore: If possible, have your last meal two to three hours before you go to bed.
- If you are still sleeping on your back, sleep with your upper body slightly elevated: As already explained, this makes it harder for the gastric juices to rise into the oesophagus. Later in pregnancy, however, you should definitely sleep on your side.
- As a side sleeper, sleep on your left side if possible: For anatomical reasons, the gastric juices cannot flow back into the oesophagus as easily.
- Wear loose clothing that does not restrict your body: This will prevent additional pressure being exerted on your stomach area.
What can relieve acute heartburn during pregnancy?
Frequent heartburn can really spoil a pregnant woman's days. That's why all sufferers are grateful for recipes for relief - and can really find a lot of advice on this. But not every home remedy necessarily works for every woman, so I can only recommend that you try: Trial makes perfect! Just try out what helps you - but not all at once.
Here is a small list of different ways to treat heartburn during pregnancy:
- Chew a few almonds or nuts thoroughly before eating or in case of acute heartburn.
- Chew oat flakes directly or as cooked oatmeal/Oat porridge meals.
- (low-fat!) milk or low-fat yoghurt or quark or other protein-rich (but low-fat) foods.
- Choose foods with a high starch content (rusks, wholemeal products, potatoes, bananas, etc.).
- Drink plenty of still water to dilute the stomach acid, alternatively herbal teas (caraway, fennel, camomile but also ginger).
- Dissolve a teaspoon of healing clay powder (from the pharmacy) in a glass of still water and drink before breakfast, lunch and dinner.
- Eat plenty of vegetables (e.g. carrots, spinach, broccoli, fennel, courgettes, aubergines, pumpkin), salads (especially green salads) and fruit (e.g. bananas, grapes, berries due to their low acid content).
- And a lot of movement to make burping easier and to prevent the burp from causing obstruction somewhere on the way up.
- Some pregnant women report that they have had good experiences with drinking the juice of a raw potato for heartburn during pregnancy. However, as raw potatoes are not healthy and are poisonous in large quantities, I do not advise pregnant women to use this home remedy.
How can the doctor help?
However, if no home remedy for heartburn brings relief, you should consult your doctor. This also applies if you suffer from heartburn very frequently. And this is especially true if you have other symptoms in addition to heartburn. These can include severe stomach pain, frequent nausea and vomiting (also with blood), black stools, sudden loss of appetite or an unexpected aversion to certain foods, as well as general fatigue, paleness and malaise.
In all these cases, do not hesitate to seek medical advice, as there may be other illnesses behind them.
If it has been medically established that it is - as in the vast majority of cases - simply pregnancy-related heartburn, there are also drug treatment options in addition to the lifestyle changes described above.
H2 blockers: These are prescription drugs designed to reduce the production of stomach acid. They can be used to treat heartburn in pregnant women, but should only should only be used in consultation with a doctor.
Proton pump inhibitors: These are also prescription drugs that are designed to block the production of stomach acid. They are more effective than H2 blockers, but are generally only used for severe heartburn and under medical supervision.
However, lifestyle changes may be all you need to get heartburn under control.
Beware of antacids! Such medications, which are intended to neutralise the acid in the stomach, are usually without prescription sometimes even in the supermarket. They are available as tablets, capsules or liquid suspensions. However, pregnant women should always seek medical advice before taking antacids to ensure that the preparation in question is suitable for them!
If you are unsure whether your medication is approved for use during pregnancy, you can here find an answer to this.
