Acid reflux in pregnancy: Causes, symptoms and treatment

Acid reflux and heartburn are common discomforts during pregnancy. Here you'll learn why acid reflux happens, what it feels like and how to manage it.

In gastroesophageal reflux, or acid reflux, the lower esophageal sphincter (a muscle at the end of the esophagus that acts like a valve and opens and closes when you swallow) doesn't work properly. Early in pregnancy, hormone levels increase. Higher levels of the hormone progesterone can cause the valve to relax. This allows foods and stomach acid to flow backward from the stomach up the esophagus. This can lead to bouts of heartburn (a burning sensation in your throat or chest), indigestion and other bothersome symptoms. Hormones can also cause the digestive process to slow down during pregnancy. Later in pregnancy, your growing baby pushes on the stomach. This can also cause stomach contents to come up into the esophagus.

Acid reflux may cause symptoms, such as:

• Heartburn or a burning feeling in your throat and chest
• A bad taste in your mouth from food or stomach acid
• Trouble or pain when swallowing
• Nausea or vomiting

Acid reflux during pregnancy can often be managed and prevented by making tweaks to your lifestyle. Try these tips:

• Eat several small meals throughout the day instead of three large meals.
• Drink liquids between meals rather than with meals.
• Do not lie down right after eating. Aim to have your last meal two to three hours before bedtime.
• Avoid foods and drinks that trigger your symptoms. Some foods can relax the valve between the stomach and esophagus, which can make symptoms worse. Fatty and spicy foods, citrus, peppermint, chocolate, alcohol and caffeine are common triggers.
• Raise the head of your bed six to eight inches so that your shoulders are higher than your stomach.
• Wear loose, comfortable clothing. Tight-fitting clothes may increase pressure on your stomach.
• Do not smoke. If you smoke, get help to quit.

If these remedies don't ease your symptoms, talk to your healthcare provider about medications. Antacids reduce the acid content in your stomach, and other medications can stop your body from making too much acid. Over-the-counter digestive health and nausea products are available, but not all medicines are safe to take during pregnancy. For instance, pregnant women should avoid antacids that contain sodium bicarbonate. Your healthcare provider or pharmacist can recommend a medicine that's OK to take during pregnancy. If you have severe acid reflux, your provider may prescribe a medication.

While acid reflux can be uncomfortable, take heart in knowing that it rarely leads to complications. In most cases, symptoms improve on their own after the baby is born.

Clinically reviewed and updated by Nora Laberee, medical writer, October 2022.