Heartburn is a common symptom in pregnancy caused by acid reflux. It can be quite annoying and sometimes downright unbearable to such an extent that it can affect sleep and make a pregnant woman miserable. Unfortunately it is largely part and parcel of a healthy pregnancy even once the morning sickness subsides. Nevertheless pregnant woman should not have to suffer in silence with acid reflux. There are several means to minimize reflux but as is common in modern life, medication is often preferred as a quick fix solution.
So which heartburn medication can be used safely in pregnancy?
The three most commonly used medication for reflux and heartburn can be used in pregnancy. These are antacids, acid-suppressing drugs like proton pump inhibitors (PPIs) and raft-forming agents. It is important to understand how each medication works and which would be better avoided even though it is deemed relatively safe for pregnancy.
Why Reflux Occurs in Pregnancy?
First one should understand what causes acid reflux in pregnancy. Acid reflux is also known as GERD which stands for gastroesophageal reflux disease. It can occur in any person of any age but is frequently seen in pregnancy. Reflux arises when stomach acid and digestive enzymes flow backwards out of the stomach and up into the esophagus. Since the esophagus cannot withstand these corrosive substances, it causes inflammation which is often felt as heartburn.
However, it is important for pregnant women to verify that the heartburn they are experiencing is indeed due to acid reflux and not some other disease.
Normally a band of muscles at the lower end of the esophagus (food pipe) prevents stomach contents from entering. It is known as the lower esophageal sphincter (LES). When it is dysfunctional then conditions like acid reflux arise. The pregnancy hormones are believed to weaken the LES temporarily and the growing uterus further presses against the stomach which pushes the contents upwards. It is for these two reasons that reflux is so common.
Types of Drugs
These drugs neutralize stomach acid but the ingredients can be absorbed into the bloodstream.
These drugs reduce or block stomach acid production and gives longer term relief. The constituents are absorbed into the bloodstream.
These drugs form a foamy barrier on top of the stomach acid to prevent the acid from making contact with the wall of the esophagus. The ingredients of these drugs are largely not absorbed into the bloodstream.
Safer Options For Pregnancy Reflux
The safest option for pregnancy is to not use any medication at all but instead manage the reflux and heartburn conservatively through dietary and lifestyle measures. However, this is not always practical or desirable. When medication is to be used, pregnant women may want to consider raft-forming agents first since most of the ingredients are not absorbed into the bloodstream. Therefore it would not have any effect on the growing fetus. When these drugs are not sufficient then antacids may be tried. Proton pump inhibitors and H2-blockers should be considered as the last option. It is always advisable to first consult with a doctor before starting any of this medication in pregnancy.