COMMON CONCERN: Indigestion

What happens?

Dyspepsia is a clinical term given to upper digestive symptoms and covers the commonly mentioned “heartburn”, “reflux” and “indigestion”. These are often described as the feeling of heaviness, fullness, sickness and belching.

These sensations are common during pregnancy and become more prominent as pregnancy progresses. The reasons behind this are thought to be in relation to the effect of increasing oestrogen and progesterone on the sphincter between the food pipe and the stomach. The “sphincter” is a piece of muscle that acts a gateway for food moving down the food pipe and entering the stomach. When the control of this gateway is affected, it allows stomach contents to move back up the food pipe – this action is known as reflux.

What can you do?

There are several lifestyle changes that can reduce the likelihood of experiencing heartburn, reflux and associated symptoms.

These include: eating smaller meals and more frequently (in contrast to three large meals a day), avoid eating late at night (the NHS suggests a three-hour window between the last meal of the day and bedtime), avoiding known trigger foods (fatty, spicy), sitting upright when eating and shortly after finishing to reduce pressure on the stomach and when going to bed, raising the head slightly (guidelines state raising by 10cm-15cm).

Raising the head of the bed should only be done by something hard like blocks and not pillows.

Over-the-counter?

In conjunction with lifestyle measures, over-the-counter options include antacids and alginates. Antacids work by neutralising the stomach acid removing the feelings of indigestion and alginates work by forming a raft sealing the stomach contents preventing them refluxing up food pipe.

Always check with a healthcare professional first. If there is occasional indigestion, antacids can be considered (short-term use) and if reflux is troublesome, alginates are preferred. Rennie is a branded example of an antacid and Gaviscon is a branded example of an alginate.

Caution – mothers requiring iron supplements should not take them at the same times as antacids as the change in stomach acidity may reduce the absorption of iron.

What next?

If symptoms worsen or don’t improve despite use the over-the-counter options, GP advice should be sought. If there is a long-term reliance on the use of over-the-counter preparations to alleviate these symptoms, once again, GP advice should be sought. Sometimes pre-existing medicines such as anti-inflammatories, steroids and antidepressants can exacerbate digestive symptoms, so it is important to notify your GP about these as well.

Usually your GP would suggest a trial of medicines that affect the stomach acid more directly. Ranitidine is an example of one and suppresses the pathway of stomach acid production. Omeprazole is another example and affects how much acid is pumped into the stomach.