It’s a most unpleasant, but common, sensation. About 25% of pregnant women experience heartburn: Higher hormone levels relax the esophageal muscle that’s supposed to keep stomach acid where it belongs, and at the same time, the growing baby presses up against the stomach. But you don’t have to be expecting to suffer from heartburn. Other culprits? Certain foods (like chili), smoking cigarettes, drinking alcohol, being severely overweight, or just lying down or bending over right after a meal can cause heartburn. The good news? There are a number of easy steps you can take to prevent and treat heartburn. [pagebreak]
Prevention
Doctors say that a few simple changes in the way you eat and sleep can douse heartburn. Eat no chocolate, drink no brews. Alcohol, chocolate, fatty foods, mint, and coffee—even decaffeinated coffees contain irritants—are capable of weakening the lower esophageal sphincter, says gastroenterologist Grace Elta, MD, associate professor in the gastroenterology division of the University of Michigan in Ann Arbor. Leaner is better. Fat takes longer to digest than anything else, which gives acid even more time to head back up before digestion is complete, says Barbara Frank, MD, gastroenterologist and clinical professor of medicine at Allegheny University of the Health Sciences MCP-Hahnemann in Philadelphia. Plan meals around veggies and lean cuts of meat and fish, not foods like cheeseburgers and fries, she says. Cut out the citrus. Another common cause of heartburn for many people is citrus fruits (such as oranges or grapefruit) and tomatoes, says Dr. Frank. Pregnant? Skip spicy seasonings. Spicy seasonings are hard to digest, says Jennifer Niebyl, MD, professor and head of obstetrics and gynecology at the Hospitals and Clinics at the University of Iowa in Iowa City. When you’re pregnant, the increase in the hormone progesterone slows down your digestion so much that it takes longer to digest a meal. The harder food is to digest, the more likely you are to get heartburn. “So eat bland foods such as rice and bananas, and avoid cayenne and other types of chili peppers,” she says. Eat a small dinner. “Don’t make your evening meal your heaviest meal,” says Helen Greco, MD, obstetrician/gynecologist at Long Island Jewish Medical Center in Hyde Park, NY. Large meals sit in your stomach longer, which gives stomach acid a greater chance to head back up to your mouth, says Melissa Palmer, MD, a gastroenterologist in private practice in New York City. [pagebreak] Down it with water. Drinking lots of water, especially with meals, helps wash stomach acids from the surface of the esophagus back into your stomach, says Ronald L. Hoffman, MD, a physician in New York City and author of Seven Weeks to a Settled Stomach. Fast before sleeping. “Try not to eat or drink anything for 2 or 3 hours before you go to bed,” says Robyn Karlstadt, MD, a gastroenterologist at Graduate Hospital in Philadelphia. That way, all your food should be emptied from your stomach before you go to bed. Sleep on a slope. If heartburn troubles you often, place wooden or concrete blocks under the headboard of your bed so that you sleep on an incline. By raising the head of your bed six inches higher, it’s harder for stomach acid to flow. That’s because it would have to go uphill. Don’t exercise right after a meal. Your mother was right; you shouldn’t exercise for at least an hour after a meal. “The movement of exercise defies gravity and brings up acid reflux,” Dr. Frank says. Maintain a healthy weight. Try to get to, and stay at, your optimal weight, says Dr. Frank. Obesity and heartburn have long been linked, because excess weight loosens the esophageal sphincter. Kick the habit. Stop smoking. Cigarettes increase the rate of stomach acid production and weaken the esophageal sphincter that keeps food down.[pagebreak]
Treatment
For most of us, certain simple dietary and lifestyle changes will cool down the burning under our rib cage and send the food to our stomach. Stand up. “When gravity is on your side, what goes down will stay down,” says Dr. Frank. Whatever you do, don’t bend over or lie down, or the churning contents of your stomach are more likely to fly upward. Beg, borrow, or buy an antacid. Over-the-counter antacids such as Mylanta or Maalox ease the pain by neutralizing stomach acids, says Dr. Elta. For some people, liquid antacids break down acid faster, but for others, chewable tablets stay in the esophagus longer. Experiment to find out which works better for you, says Dr. Frank. Try an acid suppresser. If antacids are not helpful, try the acid-suppressing medication known as H2 (histamine 2) blockers. Once available only by prescription, Tagamet HB and Pepcid AC can decrease the release of acid in the stomach, says Marie L. Borum, MD, assistant professor of medicine in the Division of Gastroenterology and Nutrition at George Washington University Medical Center in Washington, DC. They’re available over the counter at the drugstore or supermarket. The dose is half of what you’d get if your doctor prescribed the medication. So if the suggested dose isn’t enough to soothe your inner flames, take twice as much—but no more than that, says Dr. Elta. Dr. Borum cautions against using an H2 blocker during pregnancy. Regular antacids are likely safer.
When to See a Doctor
See your doctor immediately if discomfort is frequent and persistent, and if you feel numb, faint, or out of breath.
