Pregnancy and heartburn

May 7, 2010 3:23:12 PM PDT
Many people are familiar with one of the major side effects of pregnancy, which is nausea.

But fewer people recognize that "heartburn" is also a very common problem during pregnancy. It can be serious enough to require medication.

Medical estimates say GERD (Gastro Esophageal Reflux Disease), or more popularly called acid reflux or heartburn, is experienced in 40 to 85 percent of all expectant women. It can be mild or it can be serious enough to require medication, which could pose a concern to pregnant women who don't wish to take medication.

It's a second pregnancy for Beatrix Patton, so she knows what to expect from a sonogram.

Unfortunately, she also knows what to expect from another pregnancy experience.

"I had severe heartburn my last pregnancy. I had to be put on medication," she said.

"Heartburn can be a very important problem in pregnancy. Sometimes if heartburn is bad enough, it can interfere with a woman getting enough calories and maintaining good nutrition during their pregnancy," Dr. Robin Kalish of NY Presbyterian at Cornell said.

Obstetricians usually suggest women first try changes in eating habits; Changes such as cutting out spicy, greasy food, and acidic ones such as orange juice. There may be help in eating yogurt and drinking milk. They also suggest eating smaller, more frequent meals.

Also, it's important that after they eat they don't lay down. They should sit up or walk around and let gravity help a little bit.

If the problem continues, women are encouraged to try over the counter medications such as Tums or Mylanta .

But last pregnancy nothing worked for Beatrix, and Nexium was prescribed for her during her third trimester.

The Food and Drug Administration rates prescription drugs for pregnancy. Nexium is in category B, the second of 5 categories of increasing risk.

Another reflux drug, Prilosec, is in category C. That's a lower level of confidence to be used only when benefit outweighs risk.

Whenever we give medications in pregnancy, there can always be some risks and benefits, so it's important for patients to talk to their doctors. It's always important for women to take the least amount of medication for the least amount of time, especially trying to avoid the first trimester period.

Beatrix, who is a nurse, understands the need for her own medication.

"Even though I don't want to take anything, my health means more because if I am not healthy, my baby won't be healthy," she said.

Heartburn can be very distressing for some women so a good conversation with the doctor is very necessary and if drugs are given, women should well understand any risk. Most drugs have not been thoroughly tested in pregnant women.

For more information on the FDA categories for medicines used in pregnancy, please visit: