Heartburn in Pregnancy

Most of us commonly take over-the-counter (OTC) medications for things like cuts and bruises, aches and pains, headaches, stomach aches, or heartburn. But should we think twice before taking some of these common medications during pregnancy?

What Causes Heartburn?

     Whether you are pregnant or not, many people use Tums to treat heartburn. The medical term for heartburn is reflux esophagitis. Heartburn is not a matter of excess stomach acid. Rather, heartburn comes from stomach acid being in the wrong place. Our stomachs are especially designed to tolerate high acid levels because those levels are necessary for digesting food. If the pH level in your stomach is inadequate, food will sit in your stomach for prolonged periods and can even cause vitamin deficiencies because your stomach can’t process food.

Why Do Pregnant People Often Want to Take Tums?

    Heartburn is a common side effect of pregnancy. This is not because the pH of your stomach is too acid, but rather because the acid contents of your stomach are in the wrong place. Ordinarily the sphincter muscle between yours stomach and esophagus is weak, which can result in your stomach contents escaping into your esophagus, causing heartburn when you are not pregnant. But with the rearranging of the abdominal anatomy during pregnancy, there is increased pressure on the stomach. This pushes stomach acid into the esophagus, causing heartburn. People want to take Tums or some other antacid to try to reduce the painful symptoms of heartburn.

Are Tums Safe in Pregnancy?

     A search of the medical literature indicates Tums and other antacids are safe in pregnancy. Some articles have said you could take one or two tablets every four hours as needed. I would recommend against taking antacids during pregnancy. By taking Tums or other antacids for heartburn, you are changing the Ph (acid level) of your stomach acid.  Although an antacid may decrease your stomach acid for a while, your stomach will simply make more acid to put the pH back to normal. So, the net result is that your stomach will make more acid to counteract the effects of the Tums and your relief from the heartburn will be very temporary. And while the pH of your stomach is offset by Tums, your stomach will have a harder time digesting your food and vitamins.

Are There Limits to How Many Tums You Can Take?

     Doctors can recommend Tums as a source of calcium during pregnancy. You should get most of your calcium by the foods that you eat and drink, and if you are lowering your stomach acid levels with Tums, you are interfering with your stomach’s ability to absorb nutrients from the food you eat, including calcium.

Besides Antacids Such as Tums, What Other Ways Can You Reduce Heartburn?

My recommendation would be to avoid Tums or other antacids. A drink of water can help simply because the water washes the stomach acid back down into the stomach. Drinking four to six ounces of water several times a day can help manage your heartburn and the price is right.

What Other OTC Medications Are Available for Heartburn?

Gaviscon, an OTC medication for heartburn, is considered safe for pregnancy and nursing women. However, if you consider how this medication works, you might want to think twice about taking it. This medication treats heartburn by raising the pH of the stomach. I believe it is not a good idea to try to change the pH of the stomach during pregnancy when your baby depends upon your digestion for nutrients.  

Instead of trying to medicate the heartburn, consider trying to figure out which foods cause your heartburn and if the times at which you eat can be related to the heartburn. If you still cannot find relief from your heartburn, talk to you physician about what medications you might take to reduce your discomfort.