Medical Treatment Of Gerd During Pregnancy
The challenge of treatment during pregnancy is the potential teratogenicity of common antireflux medications. Lifestyle modification is the key for treating mild symptoms. Smaller meals, not eating late at night, elevation of the head of the bed and avoiding foods and mediations causing heartburn usually relieve the mild symptoms seen in early pregnancy. Chewing gum stimulates the salivary glands and can help neutralize acid. Abstinence from alcohol and tobacco are encouraged to reduce reflux symptoms and to avoid fetal exposure to these harmful substances.
For more troubling reflux symptoms, the doctor must discuss with the patient the benefits vs. the risk of drug therapy. Informed consent is appropriate. Nearly all medications are not tested in randomized-controlled studies in pregnant women because of ethical and medicolegal concerns. Most recommendations on drug safety arise from case reports and cohort studies by doctors, pharmaceutical companies or the FDA. Voluntary reporting by the manufacturers suffers from unknown duration of follow-up, absence of appropriate controls and possible reporting bias.
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If Youre Taking Prescription Medicines
Speak to your GP if youâre taking medicine for another condition, such as antidepressants, and you think it may be making your indigestion worse. They may be able to prescribe an alternative medicine.
Never stop taking a prescribed medicine unless youâre advised to do so by your GP or another qualified healthcare professional whoâs responsible for your care.
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.
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Common Uses For Pepcid During Pregnancy
Pepcid is often a go-to OTC drug for those who have heartburn and indigestion during pregnancy.
There are many people who experience acid reflux in pregnancy due to high levels of progesterone and the increasing size of the uterus, says Rachel Gerber, MD, a reproductive endocrinologist and board certified OB-GYN at Reproductive Medicine Associates.
Pregnancy hormones slow down the muscles of the digestive tract, which causes food to move more slowly, leaving you with a sluggish digestive system.
You may also experience indigestion and heartburn when hormones relax the valve that separates the esophagus from the stomach, causing the food and acids to come back up from the stomach to the esophagus. This process is responsible for the burning feeling that comes with heartburn.
When lifestyle and dietary changes dont help relieve heartburn in pregnancy, Ross says you can take Pepcid AC by mouth once or twice a day with or without food. As always, discuss taking any new medication with your doctor during pregnancy.
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How Can I Manage Symptoms Of Heartburn
You can carry out a few lifestyle changes as a pregnant woman that may help considerably with your symptoms:
Eat small regular meals. This avoids filling up your already squashed stomach. Take measured bites and drink slowly
Refrain from eating up to three hours before bedtime
Use two pillows to keep your head and shoulders above your chest when lying down to avoid acid going up the oesophagus
Avoid bending or stooping positions
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Consider Maalox For Your Immediate Heartburn Relief
If youre still struggling to find something that will help to relieve your heartburn, you could consider Maalox. This is very similar to TUMs and offers immediate relief. Its commonly suggested to patients who have too much stomach acid or are commonly bloated or have issues with belching.
The medication works by breaking up bubbles in the body. It also neutralizes the existing stomach acid. The downside is that it doesnt prevent the problem from occurring again.
This is one of the most debated options when it comes to heartburn relief. There is some aluminum in the medication, which can be harmful to the baby in large amounts. You need to follow the instructions given by your doctor or pharmacist to keep your unborn baby safe.
Get Zantac 75 When Theres No Pepcid
If you run out of Pepcid and you cant get anymore, Zantac 75 is an option. This is another heartburn medication that works on neutralizing the acid in the stomach. It doesnt work on blocking the acid production in the way that the above medication does.
You can get the Zantac 75 without a prescription in both liquid and tablet form. It can be effective for on the spot heartburn relief, but its not the best option. It is one of those for the longer term benefits.
Zantac 75 can also help to relief stomach pains and coughs. It also helps to limit the production of ulcers in the stomach by keeping the acid levels neutral.
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What Makes It Better
For most women, things that help reduce acid production or prevent reux are helpful in avoiding the discomfort of heartburn. Here are tips that may help:
Avoid classic spicy foods, as well as those with lots of fat or grease. Many people recommend avoiding citrus and chocolate, as well.
Eat multiple, small meals spread throughout the day, much like grazing, instead of three big meals.
Try elevating the head of your bed by several inches, and wait a while after eating before going to bed or lying down.
Some women find that its better to drink fluids between meals, rather than with a meal. This can increase the amount of contents in the stomach.
If your symptoms do not improve after the above recommended diet and lifestyle changes are in place, talk with your healthcare provider about over-the-counter medicines. Antacids are available as chewable tablets and liquids. They work by coating the lining of the esophagus and stomach and neutralizing stomach acid. Heartburn medicines called H2-blockers work by reducing the amount of acid made by your stomach. Although most of these are considered safe in pregnancy, as with all medicines, these should be avoided in the first trimester.
What Is Acid Reflux During Pregnancy
People use the terms heartburn and acid reflux to mean the same thing. But they have different definitions:
- Acid reflux refers to the LES not tightening as it should. This allows the stomach acid to travel from your stomach up to your esophagus.
- Heartburn, the feeling of pain or burning in your chest, is a symptom of acid reflux.
Women may have acid reflux during pregnancy and experience heartburn due to changing hormone levels and the baby growing.
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When Should I Talk To My Doctor
If you have heartburn that often wakes you up at night, returns as soon as your antacid wears off, or creates other symptoms , you may have a more serious problem that requires attention.
Your doctor may diagnose you with GERD. This means that your heartburn needs to be controlled to protect you from complications such as damage to the esophagus.
Your doctor may prescribe certain acid-reducing medications to reduce your symptoms. Research indicates that medications called H2 blockers, which help block the production of acid, appear to be safe.
Another type of medication, called proton pump inhibitors, is used for people with heartburn that doesnt respond to other treatments.
If youre concerned about the effects of medications, be sure to talk to your doctor. Doctors can help you control your symptoms while keeping your unborn child safe.
Manage Acid Production With Prilosec
This one is debated among doctors, but some do prescribe Prilosec for those who are struggling to manage their heartburn. Instead of balancing out and neutralizing the acid, this medication helps to keep the stomach acid to a minimum. It blocks some of the production.
There are downsides to this. Since there will be less stomach acid, it will be harder for the food to break down in the body. This is already difficult when it comes to pregnancy since there is less space in your abdominal cavity.
You dont get the immediate relief from heartburn with this. Its a long-term option, and TUMS is still recommended for the more immediate effects.
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Heartburn And Indigestion In Pregnancy
Heartburn causes a burning feeling in the chest or throat. Its uncomfortable, but is not usually harmful to pregnant women or their babies.
8 out of 10 pregnant women experience heartburn. You’re most likely to get heartburn in the third trimester of your pregnancy.
The symptoms of heartburn include:
- a burning feeling in your chest or throat
- acid coming up into your mouth
- feeling sick
Discuss H2 Blockers With Your Doctor
If an antacid isn’t working, it may be time to consider stronger medications.
Your first option will likely be an H2 blocker like Tagamet or Zantac. These drugs suppress stomach-acid production. All four H2 inhibitors on the market are now available without a prescription and considered to be safe during pregnancy. But talk to your doctor before taking them.
“They really work,” says Einarson. “You only have to take one or two a day.”
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Antacids You Shouldnt Take
You should always read the labels and ask your doctor before using OTC medicines, herbs, or home remedies while youre pregnant. Even though it may seem like something should be safe, it isnt always. Some conventional treatments for heartburn that you shouldnt use during pregnancy are:
Its called heartburn, although that burning feeling in your chest has nothing to do with the heart. Uncomfortable and frustrating, it bothers many women, particularly during pregnancy.
The first question you may have is how to make it stop. You may also wonder if treatments are safe for your baby. Learn what causes heartburn during pregnancy and what you can do about it.
What Causes Heartburn During Pregnancy
During normal digestion, food travels down the esophagus , through a muscular valve called the lower esophageal sphincter , and into the stomach.
The LES is part of the doorway between your esophagus and your stomach. It opens to allow food through and closes to stop stomach acids from coming back up.
When you have heartburn, or acid reflux, the LES relaxes enough to allow stomach acid to rise up into the esophagus. This can cause pain and burning in the chest area.
During pregnancy, hormone changes can allow the muscles in the esophagus, including the LES, to relax more frequently. The result is that more acids may seep back up, particularly when youre lying down or after youve eaten a large meal.
In addition, as your fetus grows during the second and third trimesters and your uterus expands to accommodate that growth, your stomach is under more pressure. This can also result in food and acid being pushed back up into your esophagus.
Heartburn is a common occurrence for most people at one time or another, but it doesnt necessarily mean youre pregnant. However, if you also experience other symptoms, such as a missed period or nausea, these could be signs that you need to take a pregnancy test.
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Talk To Your Doctor About Alginates
Antacids are the most commonly bought heartburn medicine/ medications, but you can get some that also have alginates. These medications help to line the esophagus to eliminate the pain and discomfort that you feel, giving you immediate relief.
At the same time, they create a barrier over the top of your stomach acid. This foamy barrier stops the acid from getting through, preventing the reason for the heartburn in the first place. Its a long-term option.
If you suffer from bad acid reflux during the night, you will want to discuss these as an option during pregnancy with your doctor. They can give the lining throughout the night to help you sleep and then you stick to immediate or other options during the day.
Treatment Of Heartburn During Pregnancy
Medications may include:
Over-the-counter antacids such as calcium carbonate or magnesium hydroxide. These are generally safe to use during pregnancy. You may find that liquid heartburn relievers are more effective in treating heartburn, because they coat the esophagus.
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Can I Take Over
Nonprescription heartburn relievers, such as TumsÂ® or MaaloxÂ®, can help you feel better. But talk to your healthcare provider before taking antacids. They may contain high sodium levels, which can cause you to retain water. Some also have aluminum in them, which isnt safe to consume during pregnancy. Your provider can recommend an antacid thats safe during pregnancy.
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Take Serious Action With Ranitidine
Doctors will be able to prescribe Ranitidine if your acid reflux doesnt give up. This is important if you constantly feel like you need the help of the medications mentioned above to help settle the heartburn. It is possible that rather than being acid reflux that it has become GERD, which is far more serious.
Ranitidine reduces the amount of acid that your body is able to make. The downside is that this can lead to some problems with digestion. Therefore, its given when GERD is a problem because this means too much acid is being produced.
Your doctor will want to keep the amount of the heartburn medicine you take to a minimum. It is usually given in tablet form and is a long term option.
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Which Diet And Lifestyle Changes Relieve Heartburn During Pregnancy
The management of heartburn during pregnancy involves many of the same principles as management in the non-pregnant state. Lifestyle changes may include:
Learn What Causes Heartburn For Youthen Avoid It
Fat, caffeine, chocolate, citruspregnant women with heartburn have been advised to avoid all of the above at one time or another. But what causes reflux in one woman might not be a trigger for another.
Rather than tell his pregnant patients to avoid a specific food, Dr. Richter says he advises them to stay away from foods that specifically aggravate them. Everybody’s different, Dr. Richter says. Some pregnant women can chow down on spicy Mexican food or a plate of spaghetti and meatballs with no ill effects.
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Why Is Heartburn Common In Pregnancy
When youâre pregnant, youâre more likely to have indigestion because of:
Pressure on your stomach caused by the baby
The changing hormonal levels in your body
Stomach acid rising up due to the muscles between your stomach and throat relaxing
The growing uterus also moves up from the pelvis to push on the stomach in the upper abdomen. This leaves little space for the stomach to sit comfortably and can also force stomach acid to move into the oesophagus. This is experienced as heartburn.
Heartburn Symptoms And Pre
If your heartburn symptoms don’t go away with medicine, it’s important to see your doctor as it may be a sign of something more serious, such as pre-eclampsia. A pregnant woman with pre-eclampsia usually has high blood pressure and problems with her kidneys. Pre-eclampsia could also seriously affect a woman’s liver, blood and brain. Any pregnant woman can experience pre-eclampsia â almost 1 in 20 Australian women will develop it.
Because pre-eclampsia is dangerous for both you and your baby, you should let your doctor know if your heartburn medicine is not working. This is especially important if you’re also feeling very unwell or you have:
- sudden swelling of your hands, feet or face
- a headache that doesn’t go away with simple painkillers
- problems with your eyesight such as blurring or seeing flashing lights or dots
- a strong pain below your ribs
Find out more about how pre-eclampsia is treated here.
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