Heartburn during pregnancy is a fairly common phenomenon, often emerging even in those cases, if a woman has never come across a pregnancy with a similar problem. Most often, heartburn begins to disturb pregnant women in late terms, in the second or third semester. What is the reason for the emergence of heartburn during pregnancy and how to deal with it?
Causes of heartburn during pregnancy
Heartburn (acid duspecia) is an unpleasant sensation of burning in the chest and oral cavity. Pregnant heartburn may be accompanied by nausea, vomiting, painful sensations in the throat, abdomen and stomach, as well as a disorder of the swallowing mechanism. Also, heartburn during pregnancy is fraught with a breakdown of sleep and meals.
Consider the main reasons for the appearance of heartburn during pregnancy.
During pregnancy, the level of progesterone production increases, or the so-called pregnancy hormone. He is responsible for relaxing the muscles of the uterus to avoid abortion. The complexity lies in the fact that the effect of this hormone is also applied to the esophagus, stomach and intestines.
There is a sphincter between the esophagus and the stomach, which should close after the food enters the stomach. But under the influence of progesterone, the performance of the sphincter is worsening, because of which food is returned to the esophagus, and with hydrochloric acid, which aggravates the situation. In addition, due to the violation of the hormonal background, the acidity of the gastric juice increases, which also provokes the appearance of heartburn.
From the second trimester, the size of the uterus increases significantly, therefore the pressure on the gastrointestinal organs occurs. The volume of the stomach decreases, which is why conditions are created to pop up the contents of the stomach in the esophagus.
Heartburn may occur due to weight gain, since under the influence of unnecessary kilograms, blood pressure begins to affect the abdominal cavity. It is advisable to avoid close clothes, as if the clothes squeezes and tightens the stomach, it can provoke the selection of an acid from the stomach.
Using certain products.
During pregnancy, heartburn can cause the following types of food:
- Fat food (fish, meat).
- Efficiency products (ipuhenka, kefir, etc.).
- Bakery products.
- Fast food.
- Some kinds of fruits: citrus, kiwi, green apples, honeysuckle, currant.
- Smoked smoked
- Carbonated drinks.
- Hard boiled eggs.
Treatment of heartburn during pregnancy
For the treatment of heartburn during pregnancy in easy cases, it is enough to perform the following items:
- Compliance with diet. For pregnant women recommended oatmeal, natural milk, boiled or baked meat and fish low-fat varieties, omelets for a couple. The diet under heartburn implies certain limitations, especially in plant food, which can lead to a shortage of the necessary organisms of minerals and vitamins. In order to avoid such a situation, vitamin and mineral complexes designed specifically for pregnant women can be taken. To such drugs, for example, relates the complex of pregenotone Mom. It includes folic acid, omega-3, liposomal iron, iodine, selenium, biotin, zinc, and vitamins. All these substances are necessary for the proper formation and development of the fetus. The drug is produced in the form of soft capsules that are easy to swallow. Thus, the mother and kid will receive all the necessary substances even when the diet is met.
- Change lifestyle. Not only for the prevention of heartburn, but in general, during pregnancy, it is necessary to abandon alcohol and cigarettes, including electronic. After each meal, it is better to walk a little or calmly sit. Take a horizontal position and leaning strictly not recommended.
- Right sleep. For the prevention of heartburn, pregnant women shown to sleep with a raised head end of the bed. An extra pillow can be useful here.
- Correct meal. The food must be carefully chewing, not to hurry anywhere. It is better to reduce the volume of servings, but increase the number of food meals.
How to quickly get rid of heartburn during pregnancy?
What helps from heartburn: treatment of folk remedies
- Eating food soda From the heartburn during pregnancy, one of the most common "folk" ways to combat heartburn. This method really gives a quick effect, but it quickly passes, and in addition, the soda interacts with the gastric juice, which leads to the release of additional portions of hydrochloric acid and, accordingly, to heartburn.
- Milk. The drink contains a large amount of proteins and antacids, which reduce the level of acidity. It is often enough to drink one glass of milk so that heartburn retreated. To enhance the effect, you can add a few drops of fennel.
- Potato juice , squeezed from grated raw potatoes, can be an effective means of heartburn during pregnancy, as it normalizes acidity. However, not everyone can make themselves drink potato juice, as he has a kind of taste.
- Ground egg shell. The shell contains calcium carbonate, which reduces the acidity level in the body. Note that with long-term use, this method will give the opposite effect, that is, acidity will increase.
- Carrot juice. Promotes neutralization of acidity.
- Oatmeal It has an enveloping property, due to which it is capable of blocking unpleasant sensations.
However, before resorting to the "people's" ways to combat heartburn, still discuss with your doctor how it is better to cope with the problem in your case.
In the last months of the heartburn, as a rule, weakens, since the body reduces the production of progesterone, and the pressure on the internal organs is reduced, since the stomach is lowered down.
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If after some time after meals, the future mother appears a feeling of heat or burning behind the sternum, it means that this is a heartburn.
Not all antacids can be used during pregnancy. For example, drugs whose includes bismuth nitrate ( Vicalin et al.) should not be taken to future mothers due to the fact that the influence of bismuth on the development of the child is unknown.
Usually, heartburn appears after the 20th week of pregnancy and torments the future mother until the birth of a child.
how she looks like
If after a while after meals, the future mother appears a feeling of warmth or burning behind the sternum, it means that this is a heartburn. And most often these unpleasant sensations arise in the evening. Usually, heartburn appears after the 20th week of pregnancy and torments the future mother until the birth of a child. According to the folk, she is worried about the future mother when the baby grows the hair. In fact, heartburn appears due to the fact that the acidic content of the stomach is thrown into the lower departments of the esophagus. It happens because during pregnancy a muscular sphincter located between the esophagus and the stomach relaxes under the influence of the progesterone hormone. Another reason for the occurrence of heartburn is an increased uterus (and it is just much increased after the 20th week) presses on neighboring organs: stomach, intestine. As a result, the volume of the stomach decreases and even the usual amount of food leads to its overflow and throw food back to the esophagus.
If the heartburn appears infrequently and bothers not, then in order to reduce its symptoms, you just need to eat right and change the lifestyle. The simplest thing is that it helps with heartburn:
- Fabric nutrition: Tight often 5-6 times a day at intervals of 1.5-2 hours and small portions. Eat slowly, thoroughly chewing food.
- Healthy food: eliminate greasy and fried dishes, as well as chocolate. All these products provoke additional relaxation of the esophagus sphincter.
- Usually, heartburn occurs in the first two hours after meals, so do not lie immediately after eating.
- Sleep, lifting the head end of the bed, - To do this, lay another pillow.
The simplest thing that helps when heartburn is some products. For example, the burning sensation behind the sternum relieves low-fat milk, just a few sips - and the heartburn passes or significantly decreases. Ice cream also acts, and also grapefruit and carrot juices. Get rid of heartburn, you can eat nuts (walnut, hazelnut, almonds), but they rather prevent heartburn, rather eliminate already appearing. And ordinary seeds help to cope with the heartburn. In general, the future mother remains only to choose the necessary product, but here, as in general, it is necessary to observe the measure. It is not necessary every day every day there is a briquette of ice cream or packaging of seeds, drinking juices or endlessly to eat nuts. Of course, they will help, but in ice cream and nuts there are a lot of fat and calories, and the juices in large quantities beat on the pancreas and increase the level of sugar. A small number of one product is quite cope with the bimmer's attack.
Some medicines, especially antispasmodics (drugs, spasms of smooth muscles of internal organs), for example, But-shp. , Papaverine , relax the esophagus sphincter and thus contribute to the emergence of heartburn. Some herbs also apply, for example, mint. Staging clothes under the breast (gum, belts), changing the position of the body (tilting, turns) can also cause heartburn.
In general, each future mother can carefully watch himself and identify his personal cause of heartburn, then it will be much easier to fight her.
Soda is often used to get rid of heartburn. It really very quickly helps to remove the unpleasant feeling of burning, but at the same time acts quite short. In addition, the interaction of soda with gastric juice is formed by carbon dioxide, which annoys the stomach - as a result, new portions of hydrochloric acid are produced and the heartburn is renewed. It turns out that the teaspoon of soda on a glass of water instantly removes heartburn, however, in response to the reception of soda, the next time the attack of heartburn will be even stronger.
During pregnancy, so-called antacid drugs can be used. (Maalox, Almagel, Renny, Gevisson) . Their composition includes salts of magnesium and aluminum, they neutralize the acid of the gastric juice, form a protective film on the stomach wall, increase the tone of the lower sphincter of the esophagus. True, sometimes some antacids cause constipation (due to calcium or aluminum salts), and magnesium, on the contrary, has a relaxing effect. Therefore, these drugs should not be applied for a long time. Antacids can absorb other medicines, so there must be some time between the reception of antacids and other drugs.
Despite the fact that the heartburn is quite unpleasant for mom, she does not affect the child. Start a struggle with heartburn with proper nutrition, and maybe you will not need drugs.
Heartburn during pregnancy - It is different in the intensity and duration of burning, which is more often felt behind the sternum, less often in the throat, it arises mainly in the second and third trimesters of the gestational period. Most pregnant hearths are caused by physiological causes and independently disappears the field of childbirth. The symptom can also be provoked by the exacerbation of chronic gastrointestinal diseases. To clarify the causes of the progressive burning, an ultrasound and endoscopic examination, pressure gauge, functional tests are carried out. To facilitate the state, antacids are shown, antisecretory preparations, prokinetics.
Causes of heartburn during pregnancy
The burning sensations behind the sternum arise in the second half of pregnancy, when intra-abdominal pressure increases and hormonal perestroika occurs. From the 20th week of gestation, about 1/3 patients complain about heartburn, a few weeks before the birth, 3/4 of pregnant women develop symptom. The burning lengths from a few minutes to several hours and can repeat repeatedly during the day. In the overwhelming majority of cases, the disorder is associated with natural changes in the body aimed at preserving pregnancy and preparation for childbirth. For reasons, heartburns include:
- Influence of progesterone . The side effect of the hormone is the interaction with the receptors of the sleeper muscles of the gastrointestinal muscles, leading to the oppression of motility, throwing acid content in the esophagus. Women can feel the periodic stiffness from the first trimester of pregnancy, but the highest intensity symptom reaches 33-36 weeks of gestation. Heartbag is enhanced with the slopes of the body.
- Growing uterus . The burning sensations in the throat, behind the sternum appear in a horizontal position, which contributes to the passive pensions of the acid due to the relaxation of the lower esophageal sphincter against the background of increasing intra-abdominal pressure. The intensity and frequency of attacks of heartburn increases in proportion to the period of pregnancy, 1-2 weeks before birth, it often comes to relief due to a small omission of the uterus.
- Error in diet . Most women notice that heartburn arises after the use of some products: strong tea, acute or oily food, meat dishes. The unpleasant sensations begin on average after half an hour after eating, they can be long and combined with acid exhaust (eructation). The stubbornness is observed after overeating due to the stretching of the stomach and the lack of digestive enzymes.
- Aerophagia . Feed meals "On the go", habit of talking during meals cause enhanced air swallowing, which stretches the stomach and causes a reflex reduction in the smooth muscles with the back of the contents of the content. Women complain about a moderate heartburn, which lasts up to 10 minutes. The burning sensations are often accompanied by a loud exhaust air. In pregnancy, psychogenic aerophagy is also possible.
- Uncomfortable posture for sleep . In the third trimester, a woman becomes difficult to find a comfortable sleeping position due to a constantly increasing belly. Pregnant women notice an increase in the intensity of the progressive burning position in the position on the left side associated with the squeezing of the stomach, which sometimes causes sleep disorders and frequent night awakening. Heartburn more often worries patients in the morning, combined with nausea on an empty stomach, an acidic eructation.
- Wrong posture . Lack, scoliosis, constantly lowered shoulders - all this causes an increase in the pressure of the internal organs on the stomach during pregnancy, which worsens the state of the woman. In case of violations, the posture is worried about constant discomfort with burning in both the sternum, and in the throat area, accompanied by the approach. The intensity of heartburn is enhanced after a long seating in an uncomfortable posture, transportation in transport.
- Constipation . The stuffy burning in the violation of the chair is associated with an increase in the pressure inside the bowel and the reflex reduction of the muscles of the stomach. The intensity of heartburn varies from light discomfort behind the sternum to strong burning, which significantly worsens the quality of the woman's life. It is characteristic of the strengthening of symptoms with a long lack of defecation, in this background there is an exterior of air or rotten.
GERB during pregnancy
In 55-70% of pregnant women proceeding without morphological signs of the lesion of the mucosa of the esophagus, the symptomy intensity does not depend on the form of the GERD. Periodic prudent discomfort is already observed in the first trimester, but the greatest excretion of heartburn delivers in the 2nd half of the gestation. At the initial stages, the symptom arises several times during the day, the duration of the stubborn burning does not exceed 5-10 minutes. The unpleasant sensations are provoked by the use of acute or smoked food, physical exertion, tilt of the body.
With the progression of GERD, the intensity and duration of genuine attacks increase, the discomfort for the sternum is especially expressed in the morning. Strong burning sensations may be accompanied by acid exhaust, pain in the bladed area with irradiation in the blade and neck. Against the background of pronounced heartburn, the appetite decreases, women refuse to eat food so as not to provoke new attacks. It is characterized by constant discomfort and burning throat, salivation is enhanced.
Gostels pregnant women
Heartburn Against the background of stagnation of bile is observed in women after the 30th week of pregnancy. The stubbornness is distinguished by intensity, duration. It is not always possible to trace the pattern of the occurrence of intelligent sensations - in most patients their appearance is not associated with intake of food or other provoking factors. Heartburn is accompanied by a bitter eructation, constant subtaching. The severity of the strying burning is enhanced as they approach the delivery time. As a rule, such heartburn disappears independently in the first 2 weeks of the postpartum period.
Other diseases of the tract
During the launch of the child, changes occur in all organs associated with violations of the regulatory influences of the brain structures, an increase in the effects of sex hormones. The appearance of heartburn during pregnancy contributes to the exacerbation of organic and functional pathologies of the gastrointestinal tract. In this situation, the burning is accompanied by other symptoms of dyspepsia, the intensity of which depends on the disease. The most frequent causes of heartburn are:
- Chronic gastritis . With inflammation of the stomach in pregnant women there are periodic uncomfortable sensations in the course of the esophagus, due to errors in the diet, disruption of the power mode. The burning sensations are localized by the sternum, in the field of a sword-shaped process. Occasionally, attacks of strong heartburn with nausea and vomiting are noted. Women are also complaining about squeezing and burning throat after awakening.
- Duodenitis . Complaints on the heartburn behind the sternum during pregnancy are characteristic to exacerbate the inflammatory defeat of the 12-rosewoman. An unpleasant feeling occurs at any time of the day, but more often, the stomach is developing on an empty stomach. Heartburn is provoked by an annoying effect of bile on the esophagus, therefore combined with bitter exhaust and nausea. The increase in symptoms predisposes the reception of oily or fried food.
- Pancreatitis . The stubborn heartburn is associated with a disorder of food digestion due to the enzyme lack of pancreas during pregnancy. With the exacerbation of pancreatitis, it is preceded by other dyspeptic phenomena (belching, nausea). Heartburn may continue for several hours, its intensity is not related to the position of the body or physical exertion. Diarrhea and polyfecalia are possible.
- Hepatitis . At the beginning of the disease, the sad heartburn worries 2-3 times a day due to the use of "heavy" food, overeating. As the progression of the liver pathology is progressing, burning becomes constant, complaints about bitter eructation and blunt pain in the right hypochondrium. Sometimes against the background of strong heartburn, it opens up vomiting of food eaten with impurities of bile, not bringing relief.
- Functional dyspepsia . The stubborn burning is one of the symptoms of disruption of the nervous regulation of digestion due to pregnancy. Women note that the frequency and duration of the heartburn of Nonodynakov in different days - the symptom is enhanced after the emotional stress, against the background of stress. The discomfort in the throat or behind the sternum usually completely disappears after the normalization of the psycho-emotional state.
Most of the cases of heartburn during pregnancy are associated with physiological causes, but all women with complaints about the Zagzniki, a gastroenterologist prescribes instrumental and laboratory studies to eliminate the organic basis of complaints. The diagnostic plan includes only safe child and future mother techniques. The most informative to detect the causes of heartburns in pregnant women are considered:
- Ultrasound procedure . Ultrasound of the abdominal cavity is the main way to diagnose diseases of the gastrointestinal tract in pregnancy, since the method is safe for a child and allows you to estimate the morphological features of the digestive organs, to discover signs of organic pathology. According to the indications, a targeted study of individual organs is carried out.
- Endoscopy. . EGDS can be assigned to women on any gestation period in the absence of contraindications from other systems. The study is informative for the diagnosis of lesions of the mucous membrane of the esophagus during GERD, the method also helps to identify signs of chronic diseases of the upper digestive tract.
- PH-METERY . The heartburn of any etiology is accompanied by a change in the acid-producing function of the stomach secretory cells, a daily measurement of acidity is carried out to estimate the degree of these disorders. High diagnostic value has an internal pH-metry, which is made to control the treatment and definition of the forecast.
- Manometry . Measuring the pressure indicators in the body and the lower third of the esophagus, in combination with the pressure gauge of the lower sphincter of the esophagus, it allows you to estimate the motor function of the tract and the coordination of the operation of muscle groups, identify signs of functional disconesia. In patients with heartburn more often detect cardius failure.
- Functional tests . A quick alkaline test is carried out to confirm the presence of gastroesophageal reflux - the result is positive, if, after receiving antacids, a woman notes a decrease in the progressive burning. Confirm the diagnosis helps an omeprazole test - the appointment of omeprazole in a standard dose is stopped by non-standard symptoms.
Pregnant women are carried out a standard river study, determine the level of elastase and the fecal antigen of the Helicobacter infection. A standard biochemical blood test is performed, the level of gastrogen and pepsinogen are measured. All women prescribe a complex gynecological examination, some cases measure the concentration of sex hormones.
Normalization of the diet - the basis of combating heartburn during pregnancy
The heartburn of moderate intensity arising from the second half of the gestational period is usually caused by natural causes and is well amenable to non-drug correction. Woman is recommended to normalize the power mode: avoid using sharp or salty dishes, eating 5-6 times a day with small portions. After meals, it is impossible to occupy a horizontal position, lean to not provoke reflux. Sleep better on a high pillow in a convenient position, you can use a special cushion for pregnant women.
Prior to the setting of a clinical diagnosis to reduce unpleasant sadness, unsupported antacids helps, which do not penetrate the systemic blood flow and do not affect the child's body. For the relief of symptoms, prokinetics are recommended, antisecretory preparations are prescribed with strong and long-lasting sludge. Intensive heartburn during pregnancy, accompanied by other dyspeptic disorders, abdominal pain, is an indication for contacting a specialist.
An extremely unpleasant feeling known as heartburn occurs when the lower esophageal sphincter (the muscle covering the entrance in the stomach) relaxes or is not completely closed. Because of this, part of the contents of the stomach with hydrochloric acid falls into the lower third of the esophagus, provoking irritation. Heartburn is manifested about 50% of pregnant women in 2 and 3 trimesters, usually after eating or before bedtime. But what can be from heartburn during pregnancy, what means and methods are safe? There are five tips that help facilitate the state.
Overeating aggravates heartburn. When a woman is pregnant, growing uterus presses on the stomach, reducing its volume. A reasonable diet helps to reduce the risk of heartburn throughout pregnancy, because the increase in weight above recommended creates a greater load on the stomach, which can cause the content of the contents in the esophagus. Instead of three meals, the day is worth moving into frequent fractional food by small volumes.
What can be from heartburn during pregnancy: elimination of triggers
It is necessary to define products that enhance the symptoms of heartburn and exclude them from the diet. Despite the fact that there are no universally "prohibited" products, heartburn occurs more often when drinking acidic food - citrus and tomatoes, oily or fried food, sharp dishes, chocolate, coffee and carbonated drinks.
Liquid products with a smaller probability cause problems than dense food, as they move faster through the stomach. It is necessary to determine what can be from heartburn during pregnancy. Soups, smoothies, yogurts, milk cocktails, protein cocktails and puddings are a good choice.
Useful liquids that contain a lot of protein, such as milk and drinking yogurt. However, the use of a large amount of fluid during meals can aggravate heartburn, because drinking stimulates the swallowing of larger air. If a woman feels thirst while eating, you can only make small throats between slices of food.
Sleep in the right position
To avoid heartburn at night during pregnancy, you should not eat at least three hours before sleep. You need to raise the headboard, putting an extra pillow. It is useful to sleep on the left side. Gastric juice will need to rise to reach the esophagus. Pregnant women also should not lie or lean immediately after eating.
Preparations from heartburn
If nothing helps, the doctor will determine what can be from heartburn during pregnancy. It may be antacids with calcium. However, the excess calcium can block the absorption of iron, therefore, there must be at least 3-4 hours between the reception of polyvitamins and antacids.
According to research, heartburn during pregnancy can provoke nausea and vomiting. It is permissible to use some antacids, histamine-2 receptor antagonists and proton pump inhibitors. Large studies did not reveal the adverse effects of these drugs for the fetus.
It is important to avoid the use of antacids, which includes aluminum (for example, aluminum hydroxide or aluminum carbonate), as well as large doses of drugs. Pregnant women also do not use antacids containing sodium bicarbonate (food soda) or sodium citrate. Both have a high sodium content, which causes water delay and provokes swelling.Pass the test Test to assess your well-being This test is calculated only for women. How do you feel physically? Let's check it with the test proposed by Portuguese experts. It will help you determine the level of your well-being.
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Causes of heartburn during pregnancy
As a rule, the causes of heartburn during pregnancy differ from the causes of heartburn outside this state. Even with the observance of the diet, a woman may suffer from burning in the area of the stomach throughout the duration of the baby.
On the first trimester of pregnancy in the body of a woman there are sharp hormonal restructuring. They can cause heartburn in a pregnant woman. The feeling of burning occurs when acid from the stomach falls into the esophagus, which is not adapted to such a "poisonous" environment.
These two digestive tract offices are separated by a sphincter or valve that prevents the reverse course of food. But during pregnancy in the body of a woman, the level of progesterone hormone is increasing. This hormone acts relaxing on all the muscles, including the sphincter and reduces the effectiveness of its work.
Therefore, food, acid and bile can fall into the esophagus and cause a sharp feeling of burning and discomfort. Another reason for heartburn during pregnancy is improper nutrition. Some products increase the risk of refund and acid fall into the esophagus.
For example, soda can cause belching and badly affect the already relaxed esophagus sphincter. Therefore, it is worth eliminating such products from the diet in order not to strengthen and without that significant feeling of discomfort from heartburn.
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Why arises heartburn during pregnancy?
Why is the heartburn during pregnancy happening more often than in the usual condition? There are several reasons here. Pregnancy is a big load on the whole body. In addition, pregnancy causes sharp changes in the whole body of a woman who affect not only country bodies, but also on all other organs and systems of the female body.
It's no secret that the woman passes through colossal hormonal changes and races at all phases of pregnancy. These hormonal restructuring heads a list of causes of heartburn during pregnancy.
In addition, natural physiological changes arise in the body. The fruit grows and begins to put pressure on all the internal organs and the gastrointestinal tract. It remains less and less space for him, because the child takes almost all the abdominal cavity.
Therefore, squeezing the stomach. If the woman overeating the movement of the fetus or "tesne" in the abdominal cavity can cause the return of food back from the stomach to the esophagus. It is there that there is a feeling of a sharp and even painful burning sensation.
The sphincter does not withstand pressure and opens. In the esophagus, not digestible food, bile and acid falls. This mixture irritates the mucous membrane of the esophagus and the heartburn occurs during pregnancy.
Heartburn is an unpleasant feeling of burning or heat behind the sternum or in the opposite region. The symptom occurs after a meal or on an empty stomach and is associated with food reflux, that is, a throwing food treated with gastric juicy juice back to the esophagus. Since the mucous membrane of the esophagus is not adapted to the action of gastric juice, its irritation arises, which is subjectively felt in the form of heartburn.
Heartburn in pregnant women - an independent symptom, which appears only during the period of having a child against the background of the absence of chronic diseases that cause a gastric juice reflux 1. According to statistics, heartburn is worried about 30-50% of pregnant women, there is evidence that more than 80% of pregnant women are complaining of heartburn, especially in the third trimester 4.
Causes of heartburn during pregnancy
Heartburn in pregnant women is a state that is caused by changes occurring with the female body during the fetal tool period. All factors that can cause heartburn in women in an interesting position can be divided into physiological (natural) and pathological (related diseases).
The physiological heartburn of pregnant women may arise for two reasons:
- Hormonal - associated with the weakening of the tone of the lower esophageal sphincter. This is the name of the circular muscle between the stomach and the esophagus, regulating food intake in the stomach and the warning movement in the opposite direction. When pregnancy in the blood, the level of progesterone rises, which relaxes the muscle of the uterus, in parallel and acting on all other muscles of the body, including the esophageal sphincter. As a result, the sphincter does not close after meals, but remains open. Any change in body position or reduction of the stomach causes food reflux 4. Heartburn also occurs if it is disturbed by the promotion of food on the esophagus, for example, if the frequency of "reverse" cuts of the esophagus increases from the stomach to the esophagus 1.
- Physical - due to an increase in the size of the uterus, the location of the internal organs changes and an intra-abdominal pressure increases, which is transmitted to the wall of the stomach and promotes reflux 4.
Due to such changes in the gastrointestinal tract during pregnancy, all pathologies causing heartburn may exacerbate.
The pathological causes of heartburn during pregnancy include the following cases:
- Gastroesophageal reflux disease (reflux-esophagitis) - the pathology of the esophagus sphincter, which occurs more often in the hernia of the diaphragm, when natural bending warning reverse cast is disappeared between the esophagus and the stomach 4.
- Other diseases of the gastrointestinal tract - gastritis, ulcerative disease of the stomach and duodenum, pancreatitis, liver disease and biliary tract, inflammatory bowel disease 2. In gastritis and ulcers, the acidity of the stomach increases, and the pathology of other digestive organs cause bloating, constipation, an increase in the liver, which increases intra-abdominal pressure.
- Reception of drugs that relax the lower esophageal sphincter - cardioprants, theophylline, anti-inflammatory drugs, progesterone, antidepressants 4.
What to do with heartburn during pregnancy?
In the first two hours after meals, hydrochloric acid is produced in the stomach, which is needed for processing food. It is at this time that the heartburn is more often tormented, especially if a woman uses fat, fried and acute food 7. The burning of the sternum can last a few minutes or a few hours. Heartburn can be repeated several times during the day. It is characterized by its gain in a horizontal position, with the slopes of the body, as well as when turning on the other side.
To reduce the severity of heartburn, first need to adjust the power and some habits. It helps to reduce the increased acidity of the stomach and warn throwing food back to the esophagus.
Pregnant women should comply with the following dietary recommendations 4:
- Do not use excessive calorie food.
- Eliminate night snacks and especially overeating.
- Feed often and small portions.
- Do not lie right away after eating, do not sleep in a strictly horizontal position, it is necessary to raise the head end of the bed.
- After a meal to be like for 30 minutes.
- Dinner no later than 3-4 hours before sending to sleep.
- Do not lift gravity, not to make strong and frequent slopes of the body, do not overvolt the muscles of the abdominal press.
- Do not wear corsets, bandages, tight belts that increase intra-abdominal pressure.
From the diet when heartbud should be deleted 4:
- Roasted drinks (they increase the pressure in the stomach and stimulate the formation of hydrochloric acid).
- Cream, whole milk, fatty meat grade, fatty fish, goose, pork (fatty products are long digested).
- Chocolate, cakes, cakes, spices (relax the lower esophageal sphincter).
- Citrus, tomatoes, onions, garlic (irritate the mucous membrane of the esophagus).
With a heartburn, you can have the following products 6:
- Wheat bread, dry biscuits, dry cookies;
- Baked pies with apples, boiled meat or fish;
- Soups from meat, fish, vegetables;
- non-fat beef meat, bird, fish;
- Eggs Skump and Omelet;
- sugar, copper, cream cream;
- tea, cocoa, sweet fruit juices, jam, compotes.
Pregnancy preparations from heartburn during pregnancy
80% of pregnant heartburn disappears after childbirth, however, a strong heartburn during pregnancy, especially if it lasts for a few weeks, may remain after the child's birth 4.
Often, proper nutrition and compliance with the recommendations on the lifestyle do not always help get rid of heartburn. If the heartburn is caused by any disease, adequate treatment of the main pathology with the help of drugs helps to eliminate unpleasant symptoms.
The use of folk and non-traditional ways to eliminate heartburn during pregnancy is also not effective enough and even potentially dangerous. Many of the medicinal herbs during pregnancy can harm both a woman and her future child 4.
Therefore, the choice of a drug is desirable to discuss with a doctor who will help to choose the necessary remedy for the heartburn during pregnancy, paying attention from the security position for the fetus and the potential impact on the course of pregnancy 4
Results of epidemiological studies Omez ® 10 mg in the treatment of heartburn in pregnant women indicate the absence of a clinically significant negative impact on pregnancy and the health of the fetus or newborn 5.
Omeless ®10 mg is released without a doctor's prescription, but you can take it yourself without recommendations of a specialist for no longer 14 days 5.
There are contraindications, you need to get acquainted with the instructions for medical use or consult with your doctor.
List of references:
- Viuchnova E.S., Yuren G.L., Mironova E.M "Application of proton pump inhibitors in pregnant women: testimony and choice» Article in the journal "Evidence Gastroenterology" - 2016 .
- Zimmerman Ya.S., Mikhaleva E.N. "Pharmacotherapy capabilities in the treatment of gastroenterological diseases during pregnancy" Scientific Review - 2015
- Harkevich D. A. "Pharmacology" Tutorial - 2010.
- Trukhan D.I., Grishechkina I.A. Therapy of pregnant warriors: focus on alginates. Consilium Medicum. 2016;
- Instructions of the drug Omez ® 10 mg
- Dietary recommendations of the scientific society of gastroenterologists of Russia for patients with GERD
- "Obstetrics. National Guide "Edited by G.M. Savelieva - 2018.
How does this pathology manifest?
Heartburn - This is a symptom characterized by discomfort, burning pain, burning behind the sternum, propagating upwards from the stomach to the throat. This symptom often appears during Pregnancy What significantly worsens the quality of the patient's life.
According to statistics with heartburn during pregnancy, 40% to 80% of women are faced. The appearance of this symptom is also associated with the period of gestation ( Pregnancy ), which is explained by an increase in the uterus in the amount. So, in the first trimester, the frequency of occurrence of heartburn is 26% of cases, in the II trimester - 36% of cases and in the third trimester - 52% of cases. According to research, heartburn in the III trimester reduces the quality of life by 30%.
Symptoms of heartburn during pregnancy are:
- The feeling of burning, pain behind the sternum and in the opposite region;
- sour taste in the mouth;
- increased salivation;
- vomiting ( seldom );
- "Sour" belching.
Heartbag appears in half an hour - an hour after meals, when changing the position of the body ( With slopes forward, horizontal body position ), when wearing close clothes, consuming oily and acute food.
According to the degree of severity, heartburn distinguish:
- Easy degree - heartburn rarely appears - up to 3 times a week;
- Central degree - heartburn bothers almost every day;
- severe degree Heartburn arises every day, in some cases after each meal.
Medical term heartburn - gastroesophageal reflux, gastrointestinal reflux, acid dyspepsia. Reflux means throwing the contents of hollow organs above their level, reverse content current compared to its normal movement. The gastric juice contains hydrochloric acid and gastric enzymes necessary to digest food. Salonic acid is able to digest and stomach, but this does not occur due to special protective mechanisms. The protective mechanisms include constant updating of the cells of the stomach walls, the presence of a special mucosa barrier, the incessant blood supply to the gastric walls and others. The esophagus has no such protective mechanisms, since it is normal there is no hydrochloric acid and digestive enzymes. At the site of the transition of the esophagus in the stomach is a sphincter - the lower sphincter of the esophagus ( NSP ). Normally, the sphincter prevents the content of the contents of the stomach in the esophagus. If the contents of the stomach fall into the esophagus, there is damage to its walls, which is accompanied by discomfort behind the chest and burning.
During pregnancy, the uterus increases in the amount, intraperous pressure increases, which leads to the stomach compression, its movement up and throwing the gastric content to the esophagus. Another factor leading to the appearance of heartburn is hormonal restructuring. The pregnancy increases the level of progesterone, which relaxes the smooth muscles in the body. This is necessary for the fact that the uterus ( Smooth muscle organ ) It was not in the tone that would negatively affect the course of pregnancy and raised the risk of premature births. Progesterone affects not only on the muscles of the uterus, but also on all smooth muscles of the body. As a result, there is a relaxation and lower esophageal sphincter. As a result, its main function is disturbed - the obstacle to the gastric content in the esophagus.
Heartburn may appear both in early pregnancy and late time. The cause of heartburn in the early pregnancy is the relaxation of the lower esophageal sphincter when exposed to progesterone. In the late pregnancy, the influence of this hormone decreases, but the uterus increases significantly in the amount, which leads to compression of the stomach and throwing its contents in the esophagus.
It is believed that if a pregnant woman is worried about heartburn, then the fetus grow hair and nails. This is nothing more than fiction and the appearance of heartburn is not associated with the growth of hair and nails in the fetus. Also, the presence of heartburn is in no way affects the development of pregnancy.
But not always heartburn is a consequence of physiological changes in the body of a pregnant woman. Often accompanying pathologies ( which are exacerbated during pregnancy ) Also become the cause of heartburn. If not all pregnant women appear in the norm of heartburn, then in the presence of these diseases of the heartburn is a permanent satellite of pregnancy.
The pathologies provoking the appearance of heartburn include:
- Gastroesophageal reflux disease ( GERB ) - refers to a chronic recurrent disease in which the contents of the stomach in the esophagus regularly occurs with the defeat of its lower department;
- Gastritis - inflammation of the gastric mucosa;
- Dyspepsia - violation of the normal function of the stomach, characterized by severe painful digestion;
- cholecystitis - inflammation of the gallbladder;
- Pancreatitis - inflammation of the pancreas;
- cholelithiasis - pathology characterized by the presence of stones in the bustling bubble;
- oncological diseases - The presence of tumors in the organs of the gastrointestinal tract ( Zhkt. );
- Diseases of the Operated Stomach - pathologies arising after surgical interventions on the stomach;
- peptic ulcer and / or duodenal ulcer - The presence of a ulcer defect in the mucous membrane of the stomach and / or duodenum.
The appearance of heartburns can provoke:
- consumption of oily, acidic, acute food, sweets, coffee, carbonated drinks;
- tightening, dense clothing;
- a small gap between food intake and waste to sleep;
- sharp movements ( Turns, slopes );
- physical efforts in which the abdominal muscles are strained;
- Wrong posture ( slouch );
- Fast food treatment;
- poorly chewed food.
To the risk factors for the appearance of heartburn during pregnancy include:
- multiple pregnancy - With multiple pregnancy, the uterine sizes are much more compared with the size of the uterus during pregnancy with one fruit, which leads to greater stomach compression;
- gestation period - heartburn is much more common in late pregnancy, which is associated with an increase in the uterus in the size and squeezing of the gastrointestinal tract;
- Related pathology - neurological disorders, diabetes and other pathologies may violate the normal operation of the gastrointestinal tract;
- obesity - The risk of heartburn during obesity rises by 2 times.
Since the appearance of heartburn is associated with physiological changes during pregnancy, it is often unable to avoid it, despite the proper nutrition and knowledge of a healthy lifestyle.
The diagnosis and treatment of heartburn in pregnant women are engaged in an obstetrician-gynecologist, therapist or a gastroenterologist. Since often heartburn during pregnancy is temporary and caused by physiological changes, it is not required to special diagnostics of this state. Specialist needs to establish whether the appearance of heartburns with pregnancy or the patient suffers from other diseases leading to the appearance of a symptom.
The diagnosis of heartburn in a pregnant woman is more likely to survey and external inspection. The diagnosis is established on the basis of clinical data and complaints. The doctor asks in detail about the complaints - as the heartburn is manifested, for what period, as often, when it first appeared, with which the woman binds the appearance of heartburn ( Reception of certain food, changing body position ), whether a heartburn was tormented to pregnancy, etc. Also, a specialist is interested in the nature of the patient, bad habits, the routine of the day. These data will allow you to more accurately determine the cause of heartburn, as well as adjust the lifestyle and nutrition of a woman.
To instrumental heartburn ( Upper endoscopy, daily pH-metry of the esophagus ) During pregnancy, it is extremely rare. Indications for instrumental research are - the presence of complications, painful heartburn, non-treating, etc. When conducting these studies, doctors carefully monitor the function of the cardiovascular system of the fetus and its oxygenation ( Oxygen saturation ). When choosing tool diagnostics tactics, the doctor estimates the risk ratio and the benefits of each method.
The tool diagnosis of heartburns include:
- Ezophagogastroduodenoscopy - The diagnostic procedure in which the doctor examines the inner surface of the esophagus, the stomach, duodenum with an optical tool ( Endoscope ) introduced through the oral cavity;
- ultrasound procedure ( Ultrasound ) organs of the gastrointestinal tract - Explore the state of the gastrointestinal bodies using a special apparatus that passes ultrasonic waves through the human body and builds the image on the computer monitor;
- Impedance-pH-metry - the study of the acidity of gastric content, based on the measurement of the resistance in the alternating current between several electrodes, entered into the cavity of the esophagus;
- Laboratory study of stomach material on Helicobacter Pylori - Helicobacter pylori is a bacterium causing a stomach and duodenal ulcer.
Heartburn can significantly worsen the quality of the patient's life, so this state needs correction. But in the case of pregnancy, the doctor is responsible for the life and health of the fetus, so therapy is selected very carefully. In no case should not be engaged in self-medication. The same drugs may have different efficiency and side effects in two patients. Therefore, treatment is selected strictly individually, and the patient is constantly under the supervision of the attending physician.
For greater efficiency, as well as reduction ( If possible ) Reception of drugs to the treatment of heartburns are suitable comprehensive - from changing the lifestyle before receiving plant agents.
Heart disease is divided into:
- non-drug treatment;
- Medical treatment.
Non-drug treatment is a good method of therapy, as it does not carry risks and complications for the mother and fetus. Doctors prefer to begin the therapy of heartburn without taking medication. Only in the event of the ineffectiveness of this method, medications are appointed. Non-drug therapy includes a diet, lifestyle change, plant reception.
The advantages of non-drug treatment include:
- unlimited treatment time;
- No contraindications, side effects;
- No need for constant control of the attending physician.
The non-drug treatment includes:
- lifestyle change;
- Reception of plant drugs.
Changing lifestyle under heartburn is aimed at eliminating those factors that provoke the appearance of this symptom. For this, the patient needs to closely monitor its condition and celebrate all the factors provoking heartburn.
A pregnant woman is recommended to wear lightweight free clothes, avoid slopes, physical efforts in which the abdominal muscles are strained.
The diet is one of the main non-medical methods for the treatment of heartburn, since it is often that the reception of certain products provokes the appearance of this symptom. To the observance of the diet also need to be approached very carefully, since during pregnancy a woman should eat diverse in order for the fetus to receive all the necessary vitamins and minerals for their development.
The main rules of nutrition when heartbuilding pregnant women are:
- fractional food - eating up to 7 - 8 times a day;
- Eating in small portions - It should be avoided over and eating in small portions;
- Avoiding food intake before bed - food should be consumed for 2 - 3 hours before the deposit to sleep;
- Avoid horizontal body position after meals - Immediately after receiving food, it is better to go to bed, it is better to walk for an hour;
- Proper cooking - Fried food should be preferred by food prepared for a pair, baked and boiled;
- Exclusion of applying spices for cooking - For a period of pregnancy, it should be excluded from the diet of spices, spices, seasonings;
- Warm food - You should avoid using too hot or cold food.
Diet under the heartburn of pregnant women
It should be used
Advanced reception or exclude from the diet
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Medicinal plants are also a good natural means to combat heartburn. But the use of plant tools must necessarily be coordinated with the doctor, as many herbs are contraindicated during pregnancy.
When idling pregnant women apply:
- Decoration from heath ordinary. To prepare the brave of 5 grams of heather poured with 500 milliliters of water and boiled for 2 to 3 minutes. The decoction insist for an hour and take 1 tablespoon 3 - 4 times a day.
- Potato juice. For the preparation of juice, it is necessary to wash, clean the potatoes from the peel and grate it. From the resulting mass squeeze juice. Take only in a freshly prepared form of 2 tablespoons 20 minutes before meals.
- Infusion of dyagil medicinal. For the preparation of Dried leaves, roots and dyagil seeds crushed. One tablespoon of the resulting powder is poured with 200 milliliters hot boiled water and insist for 20 minutes. Take 1 tablespoon 3 times a day.
- Infusion from the root of a yellow guilty. For the preparation of infusion of 20 grams of chopped yellow pricing root, boiling water is poured with 200 milliliters and insist within an hour. Fix and take 1 tablespoon 30 minutes before meals.
- The infusion of wormwood bitter. For the preparation of infusion of 1/3 spoons of wormwood, bitter is poured with 100 milliliters boiling water. Insist for 2 days. Accepted as needed in warm or cold form.
Medicinal preparations are prescribed for the treatment of heartburns, since other methods in most cases are not effective enough. The doctor individually selects the drug, dose and duration of reception in each case. When taking drugs, an additional periodic laboratory test of blood can be appointed.
The appearance of heartburn can take the reception:
- Anticholinergic drugs - Atropine, scopolamine;
- spasmolytics - DROTAVERIN, PAPAVERIN;
- sedatives - Natural sedatives based on mint;
- progesterone - Ginproges, Prog Intelligent, Utrezhastan;
- Calcium channel inhibitors - Verapamil, nifedipine.
Medical treatment heartburn of pregnant women
Group of medicinal preparations
Representatives of the group
Mechanism of therapeutic action
Approximate duration of treatment
The antacid drugs use a combination of magnesium and aluminum compounds. The mechanism of the data of these drugs is based on chemical neutralization of gastric juice acid.
Take no more than 3 days in a row.
Take an episodically when symptoms appear, but not more than 3 - 4 days in a row.
This drug is distinguished by a long action. There is no data on the negative impact on the fruit, but despite this, this drug should be taken only if the benefit for the mother exceeds the possible risk to the fetus.
It is the safest preparation for pregnant women. Do not take longer than a week.
Take no more than 3 days in a row.
The mechanism of action of alginates is based on neutralization of hydrochloric acid, the formation of a protective enveloping gel on the walls of the stomach and esophagus.
Apply during the week under the supervision of the doctor, as well as periodically, if necessary.
Proton pump inhibitors
The mechanism of action of drugs from a group of proton pump inhibitors is based on the suppression of the final stage of the production of hydrochloric acid. Preparations contribute to the decrease in the production and volume of hydrochloric acid.
Application in the first trimester of pregnancy is contraindicated. In II and III, the trimester apply only by strict indications.
Apply if the benefit for the mother exceeds the possible risk to the fetus.
Medicinal preparations that increase the tone of the lower esophageal sphincter
Medicinal preparations from this group contribute to the restoration of the motility of the esophagus and the stomach, increases the tone of the lower sphincter of the esophagus.
Apply no more than 5 to 7 days in a row.
The prevention of heartburn is:
- compliance with diet;
- rejection of bad habits;
- Changing lifestyle ( Hiking, avoiding slopes );
- scheduled visit;
- Periodic laboratory and instrumental control;
- Pregnancy planning.
Unfortunately, neither prevention nor canceled health women are not able to prevent the appearance of heartburn during pregnancy, since it is often caused by natural physiological processes.
What can not be taken when you heartburn pregnant?
In the treatment of heartburn, pregnant women often arise that it is possible to accept, and what is not, as many products, drugs and herbs can harm the health of the mother and the fetus. Therefore, before applying any means to treat heartburn, you must consult with your doctor.
The most famous health aggravity tool - food soda ( bicarbonate of soda ). The soda contributes to neutralization of gastric juice acid. This tool is inexpensive, always at hand and quickly helps get rid of heartburn. Despite all these positive qualities, you should not use this method to get rid of heartburn. A visual example of soda is the "quenching" of acetic acid soda in cooking. This is a consequence of the formation of carbon dioxide bubbles. As a result, a rich hissing foam is formed. The same thing happens in the stomach. Soda can only be used in emergency cases and extremely rare. It is necessary to get advice from a doctor and pick up effective treatment.
The use of soda to get rid of heartburn is temporary. More often heartburn comes in a while with more power. Doctors call this phenomenon "acid ricochet".
Byerate phenomena of soda are:
- Acid ricochet - repeated, a more pronounced impulse of heartburn in 20 - 30 minutes after taking soda;
- The appearance of edema - Sodium in the composition of soda can lead to swelling;
- irritation of the walls of the stomach - Frequent use of soda leads to irritation of the stomach walls, which can lead to gastritis;
- Negative impact on the cardiovascular system - Sodium salts are negatively reflected on the organs of the cardiovascular system.
During pregnancy, it is impossible:
- St. John's wort increases blood pressure, leads to the appearance of edema, defects of the development of the fetus;
- Donnik - may cause nausea, vomiting, headache, provoke an abortion;
- drying - can lead to the development of allergic reactions;
- Yarrow - contains toxic substances;
- Anis seeds - may provoke uterine bleeding;
- parsley - increases the tone of the uterus;
- dill - leads to meteorism, spasms in the intestines, increases the uterus tone;
- nettle - increases blood clotting;
- Sabelrik ( Air Bolotnaya ) - Enhances muscle tone.