Gastroenterology clinic

Dealing with reflux in pregnancy

Christopher K Rayner


An updated version is available in the linked supplement


Here is an approach to managing the common complaint of heartburn in pregnancy.

Article Extract

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.