Topic Overview

Most pregnant women have symptoms of gastroesophageal reflux disease (GERD), especially heartburn, at some point during pregnancy. These symptoms may begin at any time during a pregnancy and often may become worse as the pregnancy progresses. Heartburn is common during pregnancy, because hormones cause the digestive system to slow down. The muscles that push food down the esophagus also move more slowly during pregnancy. Also, as the uterus grows, it pushes on the stomach and sometimes forces stomach acid up into the esophagus.

Although these symptoms are common during pregnancy, 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 similar to treatment for other people who have GERD, focusing 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.)
• Use nonprescription antacids such as Rolaids or Maalox for relief of heartburn symptoms. Antacids that contain sodium bicarbonate should not be taken by pregnant women, because these antacids can lead to fluid retention. Antacids that contain calcium carbonate (such as Tums) are okay to take.

Along with making lifestyle changes and taking nonprescription medicines, some doctors may recommend the prescription drug sucralfate for treating GERD symptoms during pregnancy.

And although the following prescription and nonprescription medicines are generally safe during pregnancy, don't use them without first talking to your doctor:

• 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)