My Achy, Breaky Heart- Heartburn During Pregnancy

My achy, breaky heart – Heartburn During Pregnancy

What is heartburn?

Heartburn feels like what it sounds like – a burning pain in the chest, just behind the breastbone. It often occurs after eating or even when lying down or bending over. It may or may not be associated with a bitter taste in the mouth too.

Heartburn happens when stomach acid backs into the esophagus (the tube that connects the throat to your stomach). When you swallow food, this tube should be open to allow for food to pass through, and then close once food has passed through. The sphincter that controls this opening and closing is made up of smooth muscle. If this muscle/ sphincter is not working well, stomach acid and food may flow back up and causes the symptoms known as heartburn.

Why do I only have it during pregnancy?

During pregnancy, it is no secret that hormones change. One of the hormones that change is progesterone. Progesterone does many important things, including raising your body temperature and thickening the endometrial lining which is necessary for implantation. There are some other less-than-fun effects of progesterone too which include a decreased ability to focus, decreased alertness, and decreased cognition. Progesterone also decreases the tone of smooth muscle tissue – and this affects the esophageal sphincter mentioned above.

The decreased tone makes bile more susceptible to flowing back up the esophagus. Additionally, towards the later stages of pregnancy when the little babe is getting bigger, the stomach is displaced upwards which can further contribute to these symptoms.

What can I do about it?

• Eat several small meals instead of large meals
• Eat slowly
•  Drink fluids between meals and not with meals
•  Eat several hours before bedtime
• Do not lie down right after a meal
•  Avoid the following foods/ drinks that can trigger heartburn
  • Spicey food, citrus food
  • Fatty, greasy, and fried food
  • Alcohol, caffeinated, and carbonated beverages (hmmm… these sound like bladder irritants too!)

Fun Facts

True fun fact: the more severe your heartburn is, the more hair your baby will have. The cause of this correlation seems to be related to … hormones!

Not-so-fun-fun-fact: The decrease in smooth muscle tone caused by progesterone also affects the large intestine and can lead to pregnancy-related constipation.

A word of caution

Heartburn should not interfere with your daily life, and if it does, then a trip to your PCP may be warranted to ensure that these symptoms are not going to cause permanent changes over time (such as with GERD – gastroesophageal reflux disease).

Conclusion

If you want to know more about common pregnancy-related changes, and how to address them to make your pregnancy as enjoyable as possible, give us a call at Up and Running Physical Therapy.

This blog was written by our very own Pelvic/Women’s Specialist, Dr. Sam Greig.

 References 

• Costigan KA, Sipsma HL, DiPietro JA. Pregnancy folklore revisited: the case of heartburn and hair. Birth. 2006 Dec;33(4):311-4. doi: 10.1111/j.1523-536X.2006.00128.x. PMID: 17150070.
• https://www.mayoclinic.org/diseases-conditions/heartburn/symptoms-causes/syc-20373223*
• https://www.womenshealth.gov/pregnancy/youre-pregnant-now-what/body-changes-and-discomforts

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