Feeling the burn

Acid reflux, heartburn, or indigestion: No matter what you call it, the burning sensation in the middle of your chest or bottom of your throat after eating can become very unpleasant, explains nutritionist Jessica Giljam-Brown.

More than half of all mums-to-be will experience acid reflux at some point in their pregnancy. Acid reflux is when the stomach acid comes up into the oesophagus (the tube which goes from the mouth to the stomach). The oesophagus doesn't have a protective mucous layer like the stomach does, which is why you experience a burning feeling as stomach acid touches the walls of the oesophagus.

What is it?

This not-so-lovely side effect of pregnancy happens for two reasons. Firstly, the hormone progesterone, produced by the placenta, causes muscles to relax in order for the uterus to stretch. However, this also causes the sphincter (valve) between the stomach and oesophagus to relax. When this sphincter relaxes, acid is able to move up into the oesophagus, when normally the sphincter would be tightly closed, preventing stomach acid from passing.

The second reason acid reflux occurs is because as your pregnancy progresses, your stomach gets compressed by other organs as the baby grows. While the stomach doesn't actually shrink, the space around it, in which it would normally stretch out to, has been compressed. As a result, less food can be consumed at one meal than earlier in pregnancy. If there is too much food and not enough space, then some will be pushed back towards the oesophagus.

Why did I get it?

If you have a history of acid reflux before pregnancy, are overweight, or are having multiple babies, then you are at a much higher risk of suffering from acid reflux during your pregnancy. For most women, the acid reflux experienced during pregnancy won't have lasting health effects.

What can I do about it?

You don't need to suffer in silence. There are lots of things that can be done to prevent and reduce acid reflux. Your primary care provider may choose to prescribe you antacids or medication to reduce the amount of acid that is produced by the stomach. Antacids work by neutralising the acid in the stomach, so that if the stomach liquid does come up the oesophagus, it won't burn. Reducing the production of stomach acid can help, as there will be less acid in the stomach to cause reflux. Carefully consider the use of these treatments, as both of these options may disrupt effective digestion. Stomach acid plays an important role in the breakdown of your food. If food leaves the stomach without being properly broken down by the stomach acid, it can
lead to bloating and gas further down the digestive tract.

What else can I try to avoid acid reflux?

Chew your food properly: Well-chewed food is easier and faster to digest, meaning food will empty out of the stomach more quickly, preventing buildup which can result in acid reflux.

Have small, frequent meals: Instead of three large meals, try having six smaller meals each day. This is especially appropriate if your acid reflux starts later in your pregnancy as the stomach becomes compressed.

Eat sitting up: Let gravity help you. Sitting up helps the stomach acid to stay below the sphincter, between the oesophagus and stomach.

Elevate the head of your bed: If acid reflux occurs at bedtime, then you can try elevating the head of your mattress by placing a few pillows underneath it. This
slight elevation of your head is enough to use gravity in your favour to keep the stomach acid where it should be.

Avoid eating two hours before bedtime: Allow your stomach sufficient time to empty before laying down to sleep. This will dramatically reduce the chance of acid reflux at night.

Avoid smoking and secondhand smoke: It is well known that smoking during your pregnancy can have serious long-term effects on the health of your baby, but it can also contribute to acid reflux. The nicotine in cigarettes causes the sphincter between
the oesophagus and stomach to relax. If you would like help to quit smoking, talk to your health care provider or visit quit.org.nz for info.

Avoid trigger foods: There are many foods which are known to trigger acid reflux, including coffee, chocolate, alcohol, chilli, spices, garlic, raw onion, citrus fruit, tomatoes, soda, fizzy drinks including sparkling water, and black tea. Hard-to-digest meals such as protein-rich meals or particularly fatty meals like fish and chips may also trigger reflux, as these foods can sit in the stomach for a long period of time before they are digested and moved out of the stomach. Try keeping a food diary to see if you can pinpoint which foods are causing your reflux.

Avoid peppermint tea and food flavoured with peppermint oil: Peppermint is well known for calming an unhappy digestive system, but calming the already relaxed sphincter at the top of the stomach will just make acid reflux worse.

Don’t drink with your meals:
It is best to drink water 30 minutes before or after eating, regardless
if you suffer from acid reflux or not. Water dilutes the stomach acid, making it less effective at digesting your food. Water with your meal may also cause your stomach to become over-full, causing acid reflux.

Before resorting to medication, there are things you can try to minimise or prevent acid reflux.

 

Jessica Giljam-Brown is a holistic nutritionist. wellnessbyjessica.com

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