Heartburn And Indigestion In Pregnancy

How to help your pregnant patient


Heartburn and indigestion are common pregnancy problems. While indigestion often accompanies the nausea of the first trimester, heartburn tends to peak in the third trimester. 

Feeling the burn

There is a misconception that pregnant women are more acidic, and that this causes heartburn and indigestion. In fact, they tend to greater alkalinity, so that’s not the cause! Rather, progesterone reduces gastric and intestinal tone as well as motility and relaxes the valve between the stomach and the oesophagus. If this sphincter does not close tightly, acidic stomach content may repeat into the oesophagus and predispose to heartburn.  

Also, as pregnancy progresses, the enlarging uterus causes increased gastric pressure, which may also exacerbate the flow of acidic stomach contents through to the alkaline oesophagus. The result is heartburn and indigestion. 

Indigestion also occurs when when the stomach lining is damaged, or when too much acid is produced and eats away at the mucous layer that protects the wall of the stomach.

Spicy, fatty and rich foods in the diet of some women might cause or aggravate heartburn and indigestion. 

Naturally speaking

Interestingly, women who are driven, hot-headed or tense tend to suffer more from these uncomfortable symptoms! Show them how to help themselves naturally:

  • Eat smaller meals more regularly, rather than big meals.
  • Do not eat for three hours before sleep as heartburn is worse when lying prone before food has moved out of the stomach.
  • Reduce spicy, fatty and rich foods considerably.
  • Take a homeopathic remedy for heartburn, or the tissue salt Nat phos.
  • Add a few drops of peppermint essence to a cup of hot water, and sip that slowly. 
  • Chew a mint leaf or a small piece of liquorice.
  • If necessary, raise the head of your bed a little or sleep on a continental pillow or two.
  • Do the heartburn stretch!
  • Facing a wall, kneel down and then sit on your legs. Keep your knees splayed wide, about 30 cm from the wall. Your toes should be together and your heels opened away from each other. 
  • Keep your buttocks firmly down on your feet and place your hands palm-down against the wall.
  • ‘Walk’ your hands up the wall, keeping buttocks and shoulder blades as low as possible, until you feel stretching between your shoulder blades and less pressure from baby on the diaphragm area.

And what about antacids?

For women who have not found relief naturally, acid-controlling drugs are a good option for handling heartburn and indigestion:


Acid-controlling drugs What they are What they do Side effects Contraindications
  • Aluminium hydroxide, calcium carbonate, magnesium hydroxide and sodium bicarbonate.
  • Antacids may be combined with other substances (alginates and antifoaming agents such as dimethicone). 
  • Over-the-counter medicine.
  • Simple chemical compounds that are mildly alkaline.
  • Consist mainly of aluminium, magnesium, calcium and/or sodium.
  • Neutralise gastric acidity and acid secretions.
  • Aluminium compounds may cause constipation, and interfere with the absorption of phosphate.  
  • Large dosages of magnesium compounds can cause diarrhoea.
  • Sodium bicarbonate may cause an increase in bloating and belching.
  • Check contraindications for patients with impaired renal function or coronary problems.
  • Antacids can interfere with other drugs – discuss usage with the patient and doctor.