By Sara Russell, Ph.D., NTP
Founder, Feed Your Pregnant Body!™ Program
Reflux is a common complaint during pregnancy. Learn what causes it, so you can limit symptoms and stay as comfortable as possible.
What are reflux and heartburn?
Reflux occurs when some of the digestive juices and other contents of your stomach splash up into your esophagus. Heartburn is a very uncomfortable feeling of tightness or burning in the chest that can occur as a result of reflux.
What causes them?
The contents of your stomach move upward when the lower esophageal sphincter (LES), the valve that separates the top of the stomach from the bottom of the esophagus, is not fully closed. Everyone has their own degree of tightness or laxity in this valve. During pregnancy, the hormonal changes (particularly the increase in progesterone) can cause an excessive relaxation of this valve. Add to that the additional pressure on your inner organs as your uterus expands late in pregnancy, and you can definitely find yourself experiencing some digestive distress…
What can I do to prevent, limit or address symptoms?
Hydrate well: Drink plenty of water throughout the day (about 64-80 oz), preferably at room temperature. Sip rather than guzzling, and drink more outside of meals than during meals. Daily meat stock helps with hydration and soothes the digestive tract.
Avoid: Irritating foods such as tomatoes, citrus, mint, spicy food, eggplant, bell peppers, alcohol and coffee
Relief measures: Chiropractic/osteopathic care by a practitioner trained and experienced in pregnancy.
Factors that aggravate reflux
Certain lifestyle habits can definitely make reflux worse. Here are some of them:
- Eating while stressed or in a hurry
- Eating too much at once; delaying meals until ravenous – this may cause you to eat too much and too fast, or to choose unhealthy food options
- Eating while angry or afraid, or during an argument
- Eating protein along with sugars, starches and/or fruit. Proteins require more time in the stomach than starches do. When you eat proteins with sugars, fruits or starches, these will tend to ferment in the stomach and will put pressure on the lower esophageal sphincter, making it more likely for reflux to occur.
- A diet high in starches and sweets
- Tobaccoand/or alcohol, which pregnant moms should not be using anyway. I’m not shaming anyone here! But do reach out for help quitting.
- Ice cold drinks
- Carbonated beverages – sparkling water away from meals is fine for most
Lifestyle and nutrition tips for reducing reflux and heartburn
- Relax before, during and after meals
- Chew food well
- Eat small, frequent meals to prevent over-filling of your stomach
- Avoid combining sweet and starchy foods with high-protein foods
- Exercise gently every day
- Do something relaxing every day
- Follow the nutrition and hydration suggestions above
- Get pregnancy-focused chiropractic/osteopathic care
Stomach acid primer: how digestion and absorption affect mom and baby
➡ Did you know…? Studies have shown that about 90% of Americans produce too little stomach acid, and that reflux, GERD, and other ailments are often results of stomach acid deficiency. So let’s go over some of the consequences of low stomach acid. A great book on the topic is Why Stomach Acid is Good for You, by Dr. Jonathan Wright and Lane Lenard.
But isn’t my reflux caused by too much stomach acid?
Reflux occurs because the passage of food from the stomach to the small intestine through a valve called the pylorus depends on the proper acidity of food in the stomach. So when stomach acid is low, food sits too long in the stomach, where carbohydrates start to ferment, building up gases that open up the sphincter between the esophagus and the stomach and forcing some of the still-undigested food in the stomach to enter the esophagus. Even the small amount of acid present in this mixture is enough to burn the delicate lining of the esophagus.
So to reiterate, people who have reflux generally have too little stomach acid to digest their food but enough to burn and damage the lining of the esophagus. Taking antacids brings the acidity of the stomach down from low to extremely low or even none. This prevents the esophagus from getting burned, but makes it very hard for you to absorb nutrients. Frequent use of antacids during pregnancy may severely limit nutrient absorption in both mom and baby.