Heartburn and Pregnancy (cont.)

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The management of GERD during pregnancy involves many of the same principles as management in of GERD in women who are not pregnant, and the general population that suffers from GERD. Specifically, the so-called "lifestyle" changes should be meticulously followed.

  • The two feet of the head of the bed should be raised on 6 to 8 inch blocks. Alternatively--and perhaps more conveniently--a 6 to 8 inch wedge-shaped foam rubber pad should be used to elevate the upper body. It is important that the foam be firm enough to truly elevate the upper body. The wedge should also extend all the way to the waist so that the entire chest is elevated.
  • Lying on the left side at night may decrease acid reflux just as it does in women who are not pregnant, and other individuals with GERD. (In this position, it is physically more difficult for acid to reflux into the esophagus.) Occasionally, it may be necessary to sleep in a recliner chair at a 45-degree or greater angle.
  • Any specific foods that aggravate heartburn should be avoided (for example, coffee, cola, tea, alcohol, chocolate, fat, citrus juices, etc.)
  • Frequent, small meals should be eaten rather than three large meals, and the last meal of the day should be early in the evening. After meals, women who are with heartburn should not lie down.
  • After the evening meal, no further liquids should be consumed. (The more empty the stomach at bedtime, the less likely there will be reflux of acid.)
  • Smoking, of course, should be discontinued for several reasons, including the fact that it aggravates reflux.
  • Chewing gum also may be helpful. Chewing gum stimulates saliva which contains bicarbonate. The saliva and bicarbonate are swallowed, and the bicarbonate neutralizes the acid that has refluxed into the esophagus.

Medications

If lifestyle changes are not adequate, treatments with substances that are minimally absorbed into the body (and, therefore, not a potential threat to the fetus) should be started. Such treatments include antacids for example, loperamide (Maalox), simethicone (Mylanta), alginic acid/antacid combination (Gaviscon), and sucralfate (Carafate). The most reasonable starting regimen is antacids alone, one hour after meals and at bedtime. It may be necessary to alternate magnesium and aluminum-containing antacids to avoid diarrhea or constipation . If antacids are not effective alone, then the antacids should be continued and alginic acid/antacid added. The antacids and alginic acid/antacid should be taken after meals and at bedtime, more frequently if necessary.

Heartburn and Pregnancy Resources

Doctor written main article on Heartburn (Reflux)

Medically Reviewed by a Doctor on 12/2/2013