Indigestion

Indigestion, also known as dyspepsia, in pregnancy is partly caused by hormonal changes and, in later pregnancy, by the growing womb pressing on your stomach. The symptoms of indigestion can include feeling full, feeling sick or nauseous and burping. The symptoms usually come on after eating food.

Heartburn is more than just indigestion. It is a strong, burning pain in the chest that is caused by stomach acid passing from your stomach into your oesophagus (the tube that leads from your mouth to your stomach). This can happen because the valve between your stomach and the oesophagus relaxes during pregnancy.

You can help to ease the discomfort of indigestion and heartburn by making changes to your diet and lifestyle, and there are antacids that are safe to take in pregnancy. Talk to your midwife, GP or pharmacist.

Avoiding indigestion

The following tips can help to prevent indigestion:

•try eating smaller meals more often

•sit up straight when you are eating as this takes the pressure off your stomach

•avoid particular foods which cause you trouble, for example, fried or highly spiced food

Make sure you are still eating a healthy diet, including starchy foods (bread, rice, pasta, potatoes) and fruit and vegetables. Find out more self-help tips for preventing indigestion, including stopping smoking.

Avoiding heartburn

To avoid heartburn you could:

•sleep propped up by pillows: heartburn is often brought on by lying flat

•avoid eating and drinking for a few hours before you go to bed

•ask your midwife or doctor for advice: he or she may be able to prescribe an antacid if the problem won't go away

To ease heartburn, try drinking a glass of milk. You could have a glass of milk by your bed in case you wake up with heartburn in the night.

Don't take any antacid tablets or remedies before checking with your midwife, doctor or pharmacist that they are safe for you to take in pregnancy.

Treating indigestion

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.

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, such as irritable bowel syndrome (a long-term condition that affects the digestive system).