An updated version is available in the linked supplement
Here is an approach to managing the common complaint of heartburn in pregnancy.
Most women experience symptoms of gastro-oesophageal reflux during pregnancy. Here, Dr Chris Rayner outlines an approach to this common complaint.
- Up to two-thirds of women report daily heartburn during pregnancy. The symptom is most troublesome in the third trimester.
- For most women, heartburn is a new symptom that begins in pregnancy and resolves with delivery.
- Pregnancy is associated with a progressive decline in basal lower oesophageal sphincter pressure, possibly due to the effects of oestrogen and progesterone on smooth muscle. Raised intra-abdominal pressure and impaired oesophageal peristalsis may contribute. The role of transient sphincter relaxations (the major mechanism of most reflux disease) has not been studied in pregnant women.