Dyspepsia in pregnancy

Page last reviewed: 13/07/2011

Indigestion, also known as dyspepsia, is pain or discomfort in the upper abdomen (tummy).

If you have indigestion, you may experience a number of symptoms, including:

  • heartburn, a burning sensation that is caused by acid passing from the stomach into the oesophagus (gullet)
  • regurgitation (food coming back up from the stomach)
  • bloating
  • nausea (feeling sick)
  • vomiting (being sick)

How common is indigestion in pregnancy?

Most people are affected by indigestion from time to time, but women are often affected by it while they are pregnant. As many as 8 out of 10 women experience indigestion at some point during their pregnancy. Indigestion tends to become more common as the baby develops.

Indigestion during pregnancy is mainly due to changes that occur in the body, such as rising levels of hormones and increased pressure on the abdomen (tummy).

These changes can often result in acid reflux, the most common cause of indigestion. Acid reflux occurs when stomach acid flows back up from the stomach into the oesophagus (gullet) and irritates the lining (mucosa).

Outlook

A number of lifestyle changes may help improve the symptoms of indigestion, such as eating smaller meals or cutting out certain foods. There are also medicines, such as antacids, that can be taken safely during pregnancy to treat indigestion.

Some women may find that their indigestion gets worse as their pregnancy progresses. However, in most cases, after giving birth, the symptoms disappear. Indigestion during pregnancy rarely causes complications.

Abdomen
The abdomen is the part of the body between the chest and the hips.

Acid reflux
Acid reflux is a condition that causes heartburn when acid from the stomach flows up into the throat.

Hormones
Hormones are groups of powerful chemicals that are produced by the body and have a wide range of effects.

Oesophagus (gullet)
The oesophagus is the tube that runs from your throat to your stomach.

Stomach
The sac-like organ of the digestive system. It helps digest food by churning it and mixing it with acids to break it down into smaller pieces.

Page last reviewed: 13/07/2011

If you are pregnant and you have indigestion (dyspepsia), your symptoms will be the same as those of anyone else with the condition.

The main symptom of indigestion is pain or a feeling of discomfort in your chest or stomach. This usually happens soon after eating or drinking, but there can sometimes be a delay between eating a meal and developing indigestion.

You may experience indigestion at any point during your pregnancy, although your symptoms may be more frequent and severe during your third trimester (from week 27 until the birth of the baby).

As well as pain, indigestion may cause:

  • a burning sensation
  • feeling uncomfortably full or heavy
  • belching (burping)
  • regurgitation (food coming back up from the stomach)
  • bloating
  • nausea (feeling sick)
  • vomiting (being sick)

Stomach
The sac-like organ of the digestive system. It helps digest food by churning it and mixing it with acids to break it down into smaller pieces.

Page last reviewed: 13/07/2011

The symptoms of indigestion (dyspepsia) are caused by stomach acid coming into contact with the sensitive, protective lining (mucosa) of your digestive system.

The stomach acid breaks down the mucosa, which causes irritation and leads to the symptoms of indigestion.

When you are pregnant, you are more likely to have indigestion due to:

  • hormonal changes that your body is going though
  • your growing uterus (womb) pressing on your stomach
  • the relaxing of the lower oesophageal sphincter (ring of muscle) that acts like a gate between your stomach and your oesophagus (gullet), allowing stomach acid to leak back up

Risk factors

You may be more likely to get indigestion during pregnancy if:

  • you experienced indigestion before you were pregnant
  • you have been pregnant before
  • you are in the latter stages of your pregnancy

Acid reflux
Acid reflux is a condition that causes heartburn when acid from the stomach flows up into the throat.

Oesophagus (gullet)
The oesophagus is the tube that runs from your throat to your stomach.

Stomach
The sac-like organ of the digestive system. It helps digest food by churning it and mixing it with acids to break it down into smaller pieces.

Uterus
The uterus (or womb) is a hollow, pear-shaped organ in a woman where a baby grows during pregnancy.

Page last reviewed: 13/07/2011

See your GP or midwife if you are pregnant and experience severe or recurring indigestion (dyspepsia).

Your GP will usually be able to diagnose indigestion from your symptoms and by asking you a number of questions. For example, they may ask:

  • how the symptoms are affecting your day-to-day life
  • what your usual eating habits are
  • if you have tried any treatments already
  • if you experienced indigestion or any other stomach conditions before you were pregnant 

Your GP or midwife may also examine your chest and stomach. They may press gently on different areas of your chest and stomach to see whether this is painful.

Stomach
The sac-like organ of the digestive system. It helps digest food by churning it and mixing it with acids to break it down into smaller pieces.

Page last reviewed: 13/07/2011

In some cases, changes to your diet and lifestyle may be enough to control indigestion (dyspepsia), particularly if the symptoms are mild.

If you have severe indigestion, or if dietary and lifestyle changes do not work, your GP or midwife may suggest using medication to help ease your symptoms. Several indigestion medicines are safe to use during pregnancy. However, check with your GP, midwife or pharmacist before taking anything that they have not recommended.

The types of medicine that may be prescribed for indigestion during pregnancy are described below.

Antacids

Antacids are a type of medicine that can provide immediate relief from indigestion. They work by neutralising the acid in your stomach (making it less acidic), so that it no longer irritates the protective lining (mucosa) of your digestive system.

See the Health A-Z topic about antacids for more information about this type of medicine.

Alginates

Some antacids are combined with another type of medicine known as an alginate. This helps to relieve indigestion caused by acid reflux. Acid reflux occurs when stomach acid leaks back up into your oesophagus (gullet) and irritates its protective lining (mucosa).

Alginates work by forming a foam barrier that floats on the surface of your stomach contents. This keeps stomach acid in your stomach and away from your oesophagus. In most cases, antacids and alginates can effectively control the symptoms of indigestion during pregnancy.

Choice and dosage

A number of antacids are available over-the-counter (OTC) from your pharmacist without a prescription. Ask your pharmacist for advice about which ones are suitable for you.

You may only need to take antacids and alginates when you start to experience symptoms. In other cases, your GP may recommend that you take these medicines before your symptoms are expected, such as:

  • before a meal
  • before bed

It is safe to use antacids and alginates while you are pregnant, as long as you do not take more than the recommended dosage. Follow the instructions on the patient information leaflet that comes with the medicine to ensure that you take it correctly.

Side effects from antacids are rare, but can include:

  • diarrhoea (passing loose, watery stools)
  • constipation (an inability to empty your bowels)

If you experience side effects, ask your GP or pharmacist about trying a different medicine.

Iron supplements

If you are prescribed an antacid medicine and you are also taking iron supplements, do not take them at the same time. Antacids can prevent iron from being properly absorbed by your body. Take your antacid at least two hours before or after your iron supplement.

Acid-suppressing medicines

If antacids and alginates do not improve your symptoms of indigestion, your GP may prescribe a different medicine that suppresses the acid in your stomach.

There are two acid-suppressing medicines that are safe to use during pregnancy:

  • ranitidine
  • omeprazole

As with antacids and alginates, follow the dosage instructions on the patient information leaflet or packet.

Ranitidine

Ranitidine is usually prescribed as tablets to be taken twice a day. Follow the dosage instructions as your medicine may not work if you only take it when you have symptoms. Ranitidine rarely causes any side effects.

Omeprazole

Omeprazole is usually prescribed as a tablet to take once a day. After five days, your symptoms should have improved. If not, your dose may need to be increased. In some cases, omeprazole may cause side effects, such as:

  • headaches
  • diarrhoea
  • nausea
  • vomiting

Referral

If the medicines you are prescribed are not effective, your GP or midwife may refer you to a gastroenterologist (a doctor who specialises in treating conditions that affect the digestive system).

You may also be referred for specialist treatment if your GP or midwife thinks that your indigestion may be caused by an underlying condition, irritable bowel syndrome such as (a long-term condition that affects the digestive system).

Acid reflux
Acid reflux is a condition that causes heartburn when acid from the stomach flows up into the throat.

Heartburn
Heartburn is a painful, burning discomfort felt in the chest, usually after eating.

Oesophagus (gullet)
The oesophagus is the tube that runs from your throat to your stomach.

Stomach
The sac-like organ of the digestive system. It helps digest food by churning it and mixing it with acids to break it down into smaller pieces.

Page last reviewed: 13/07/2011

If you have indigestion (dyspepsia) while you are pregnant, you may not need medicine to control your symptoms.

Your GP or midwife may suggest some of the following simple changes to your diet and lifestyle. In many cases, these changes are enough to ease the symptoms of indigestion during pregnancy.

Stop smoking

Smoking while pregnant can cause indigestion and seriously affect your health and that of your unborn baby. Smoking during pregnancy increases the risk of:

  • your baby being born prematurely (before week 37 of the pregnancy)
  • your baby being born with a low birth weight
  • cot death

When you smoke, the chemicals you inhale can contribute to your indigestion. These chemicals can cause the lower oesophageal sphincter (ring of muscle) that separates your oesophagus (gullet) from your stomach to relax. This allows stomach acid to leak back up into your gullet more easily (acid reflux).

If you smoke, giving up is the best thing that you can do for your own and your baby's health. See the Health A-Z topic about Quitting smoking for more information and advice, or speak to your GP, midwife or pharmacist.

The National Smokers Quitline offers advice and encouragement to help you quit smoking. Call them on 1850 201 203 or visit the www.quit.ie.

Avoid alcohol

Drinking alcohol can contribute to the symptoms of indigestion. If you are pregnant, it can also put your unborn baby at risk of developing serious birth defects.

The Department of Health recommends that all pregnant women avoid drinking alcohol altogether.

You are more likely to get indigestion if you are very full, so regularly eating large amounts of food may make your symptoms worse. If you are pregnant, it can be tempting to eat much more than you would normally, but this may not be good for either you or your baby.

During pregnancy, you do not need to go on a special diet, but it is important to eat a variety of different foods every day in order to get the right balance of nutrients that you and your baby need.

Change your eating habits

In some cases, you may be able to control your indigestion by making changes to the way you eat. For example:

  • It may help to eat smaller meals more frequently, rather than larger meals three times a day.
  • Avoid eating within three hours of going to bed at night.
  • Sit up straight when you eat because this will take the pressure off your stomach.

Drinking a glass of milk may relieve heartburn (the burning sensation from stomach acid leaking up into your gullet). You may want to keep a glass of milk beside your bed in case you wake up with heartburn in the night.

Avoid triggers

You may find that your indigestion is made worse by certain triggers, such as:

  • drinking fruit juice
  • eating chocolate
  • bending over

Make a note of any particular food, drink or activity that seems to make your indigestion worse and avoid them if possible. This may mean:

  • eating less rich, spicy and fatty foods
  • cutting down on drinks that contain caffeine, such as tea, coffee and cola

Medicines

Speak to your GP if you are taking medication for another condition, such as antidepressants or non-steroidal anti-inflammatory medicines (NSAIDs), and you think it may be contributing to your indigestion.

Your GP may be able to prescribe an alternative medicine. Never stop taking a prescribed medication unless you are advised to do so by your GP or another qualified healthcare professional who is responsible for your care.

Prop your head up

When you go to bed, use a couple of pillows to prop your head and shoulders up, or raise the head of your bed by a few inches by putting something underneath the mattress.

The slight slope should help prevent stomach acid from moving up into your oesophagus (gullet) while you are asleep.

Acid reflux
Acid reflux is a condition that causes heartburn when acid from the stomach flows up into the throat.

Heartburn
Heartburn is a painful, burning discomfort felt in the chest, usually after eating.

Oesophagus (gullet)
The oesophagus is the tube that runs from your throat to your stomach.

Stomach
The sac-like organ of the digestive system. It helps digest food by churning it and mixing it with acids to break it down into smaller pieces.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.

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