You can’t talk about pregnancy symptoms without mentioning morning sickness. While nausea and puking (and how to manage them) get a ton of attention during pregnancy, they aren’t the only tummy troubles you can expect when expecting (womp, womp). Gestational dyspepsia—the fancy term for indigestion during pregnancy—is another common complaint. It happens when you feel pain or discomfort in your stomach after eating. Many pregnant people also deal with heartburn, a burning sensation in your chest or throat that happens when stomach acid travels up your esophagus. Matter of fact, these two conditions are so common, your odds of getting them are 8 in 10 during pregnancy. But don’t panic: While pregnancy indigestion and heartburn aren’t a walk in the park, they are manageable. Read on to learn why pregnant people are prone to indigestion (including what makes it worse), along with the best tips to treat and prevent it.
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Causes of indigestion during pregnancy
Sadly, pregnancy is the perfect storm for digestive discomforts like indigestion and heartburn. That’s largely due to the many changes happening in your body. This includes:
- Hormonal shifts: More specifically, we’re referring to an increase in progesterone. Known as the “pregnancy hormone,” progesterone thickens your uterine lining, prevents you from ovulating, suppresses uterine contractions (to avoid preterm labor), and preps you for breast or chestfeeding, per the Cleveland Clinic. But as progesterone levels rise in pregnancy, they also slow your bowels and, consequently, the digestive process, says Christine Greves, MD, an OB/GYN at Orlando Health Winnie Palmer Hospital. Problem is, when food hangs out in your gut for too long, it can cause indigestion and heartburn. Progesterone also relaxes the lower esophageal sphincter, per the Cleveland Clinic. When it’s working properly, this tight band of muscle keeps food and stomach acid from creeping up into your throat. But thanks to progesterone, it becomes a little loosey-goosey, allowing stomach fluids to flow up into the esophagus, also known as acid reflux. Because the delicate esophageal lining isn’t designed to withstand acidic stuff (like your stomach is), it tends to burn on the way up.
- A growing uterus: Your uterus gets bigger to accommodate your growing baby. But there’s only so much room in there, and your organs can get cramped. This often results in your uterus pushing your stomach (and all its acidic juices) upward, says Dr. Greves. That’s why heartburn and indigestion typically strike as third trimester symptoms, i.e., when your stomach is the most crowded (though they can start as early as the first trimester due to shifting hormones), she says.
Symptoms of pregnancy-related indigestion and heartburn
Heartburn and indigestion are often lumped together because symptoms can overlap, but they’re technically two separate issues. Heartburn is a burning pain in your chest or your throat—due to acid and bile flowing back up the esophagus—while indigestion (dyspepsia) is a feeling of abdominal pain or discomfort usually after you eat. Whether you have one or both (if that’s you, I’m sorry!), here’s how to distinguish between the two, so you can figure out how to manage your symptoms more successfully.
Symptoms of heartburn include the following, per UT Health Austin:
- A burning sensation behind your sternum in the middle of your chest or in your throat
- Regurgitation
- Excessive belching
- Sour taste
Symptoms of indigestion include the following, per UT Health Austin:
- Burning in the stomach or abdomen
- Abdominal pain
- Bloating
- Belching and gas
- Nausea and vomiting
- Acidic taste
- Stomach growling
What makes pregnancy heartburn and indigestion worse?
While every pregnant person is unique, certain foods (and drinks) tend to trigger heartburn and indigestion. These include the following, per the Australian Government Department of Health and Aged Care and UT Health Austin:
- High-fat foods
- Spicy foods
- Onion and garlic
- Chocolate
- Peppermint
- Citrus fruit juices
- Drinks with caffeine, including coffee, tea, and cola
- Carbonated beverages
- Alcohol (which is not recommended in pregnancy)
Other things that may worsen heartburn and indigestion include the following:
- Eating a big meal
- Exercising soon after eating
- Lying down after eating
- Feeling anxious
Because we’re all different, our triggers will be, too. It’s best to keep track of which foods or habits ramp up the heat, says Dr. Greves. This way, you can avoid the things that are problematic for you.
How to treat indigestion during pregnancy
Heartburn and indigestion can often be treated by making a few tweaks to your everyday eating and sleeping habits. Try these simple lifestyle modifications to manage and minimize your symptoms:
- Avoid triggering foods: Some foods to avoid with acid reflux include spicy, fatty, or greasy foods, as well as citrus, chocolate, peppermint, garlic, onion, and caffeinated or carbonated drinks. All are potential triggers for that burning sensation.
- Drink a glass of milk: “Milk can help buffer the stomach lining and [reduce] acidity of the stomach,” Dr. Greves says. (It can be a lactose-free kind if dairy messes with you, FYI.) Stirring in a tablespoon of honey might be helpful, too, according to the Cleveland Clinic.
- Chew gum after meals: When you chew gum, you produce more saliva, which helps neutralize stomach acid, according to the Australian Government Department of Health and Aged Care. Opt for sugar-free kinds because pregnancy makes you more prone to cavities and other dental problems, per the CDC.
- Prop your head up with a few pillows when you sleep: If you get pregnancy indigestion at night, propping your head up makes it harder for stuff in your stomach to wash back up your throat, per Johns Hopkins Medicine.
- Sleep on your left side: This might be one of the best sleeping positions for heartburn. According to research, stomach acid clears much faster from your esophagus in this left-lying position, per Harvard Health Publishing. Sleeping on your left side also promotes return of blood flow (and nutrients) to the heart, lungs, and placenta, which is good for your baby, adds Dr. Greves.
If your symptoms don’t improve by changing how you eat and/or sleep, ask your doctor or midwife about over-the-counter (OTC) medications. There are several safe options, including the following:
- Antacids: Usually the first line of treatment, antacids coat your esophagus and stomach and neutralize stomach acid, per Johns Hopkins Medicine. But not all antacids are made equal. Some have high sodium levels or aluminum, which aren’t safe during pregnancy, according to the Cleveland Clinic. You should also avoid products with magnesium, tristate, sodium bicarbonate, and aspirin, Dr. Greves adds. If in doubt, ask your doc about antacids safety at your upcoming appointment.
- H2-blockers: These heartburn medicines (think: Pepcid AC) reduce the amount of acid made by your stomach, per Johns Hopkins Medicine. If your doctor or midwife gives the “okay,” you can take these twice per day to relieve symptoms, Dr. Greves says. While these OTC drugs are generally safe in pregnancy, always chat with your doctor beforehand and never take more than the recommended dose. Your doctor may recommend to hold off on using meds until your second trimester.
Preventing pregnancy-related indigestion
The best way to manage pregnancy heartburn and indigestion is to prevent them in the first place. While that’s not always possible, here are a few things you can do to reduce your risk (or the intensity) of symptoms, per the Cleveland Clinic:
- Eat several small meals throughout the day (instead of three large ones)
- Eat slowly
- Drink between your meals, not with meals (which can make your stomach overly full)
- Avoid fried, spicy, or fatty foods
- Avoid citrus fruits and juices
- Limit caffeine
- Don’t smoke and avoid alcohol
- Sit up straight when you eat
- Try not to eat late at night
- Avoid lying down right after eating
When to see a doctor
While pregnancy indigestion and heartburn can be seriously annoying (and, let’s face it, miserable at times), the good news is that they’re usually harmless and go away once you give birth. But if your digestive discomfort is getting severe, you have other symptoms, or the home remedies for acid reflux during pregnancy are not working, tell your OB/GYN ASAP. See your doctor or midwife right away if you have any of the following symptoms, per the Cleveland Clinic:
- Heartburn that wakes you up at night
- Trouble swallowing
- Spitting up blood
- Black poop
- Weight loss
Sometimes heartburn can also mimic more serious conditions like a heart attack or preeclampsia (a pregnancy complication characterized by high blood …
