Gastroesophageal Reflux Disease (GERD) During Pregnancy

Topic Overview

Most pregnant women have symptoms of gastroesophageal reflux disease (GERD), especially heartburn, at some point. These symptoms may start at any time during a pregnancy. And they often get worse throughout the pregnancy. Heartburn is common when you are pregnant. That's because hormones cause the digestive system to slow down. The muscles that push food down the esophagus also move more slowly when you are pregnant. And as the uterus grows, it pushes on the stomach. This can sometimes force stomach acid up into the esophagus.

GERD symptoms are common during pregnancy. But they rarely cause complications, such as inflammation of the esophagus (esophagitis). Most of the time, symptoms of heartburn improve after the baby is born.

Treatment for pregnant women with GERD is like treatment for other people who have GERD. It focuses first on lifestyle changes and nonprescription medicines. You can make changes to your lifestyle to help relieve your symptoms of GERD. Here are some things to try:

• Change your eating habits.
  • It's best to eat several small meals instead of two or three large meals.
  • After you eat, wait 2 to 3 hours before you lie down. Late-night snacks aren't a good idea.
  • Chocolate and mint can make GERD worse. They relax the valve between the esophagus and the stomach.
  • Spicy foods, foods that have a lot of acid (like tomatoes and oranges), and coffee can make GERD symptoms worse in some people. If your symptoms are worse after you eat a certain food, you may want to stop eating that food to see if your symptoms get better.
• Do not smoke or chew tobacco.
• If you have GERD symptoms at night, raise the head of your bed 6 in. (15 cm) to 8 in. (20 cm) by putting the frame on blocks or placing a foam wedge under the head of your mattress. (Adding extra pillows does not work.)
• Try over-the-counter antacids for heartburn symptoms.
  • Be careful when you take over-the-counter antacid medicines. Many of these medicines have aspirin in them. While you are pregnant, do not take aspirin or medicines that contain aspirin unless your doctor says it is okay.
  • During pregnancy, do not use antacids that have sodium bicarbonate (such as baking soda), because they can cause fluid buildup. Do not use antacids that have magnesium trisilicate, because they may not be safe for your baby. It is okay to use antacids that have calcium carbonate (such as Tums).

Some doctors may recommend the prescription drug sucralfate, along with lifestyle changes and nonprescription medicines, for treating GERD symptoms during pregnancy.

The medicines listed below are generally safe during pregnancy. But talk to your doctor before you use them.

• Acid reducers, such as cimetidine (for example, Tagamet) or ranitidine (for example, Zantac)
• Proton pump inhibitors, such as omeprazole (for example, Prilosec) or lansoprazole (for example, Prevacid)