How soon can heartburn start in pregnancy

There are so many noticeable changes going on in your body when you’re pregnant. But there are also subtle symptoms of pregnancy you may have before you know you're pregnant. You might be wondering, is heartburn an early pregnancy sign? 

Let’s take a look at heartburn and how it might relate to pregnancy symptoms, as well as how to manage some discomfort you might be experiencing.

So, Is Heartburn an Early Sign of Pregnancy?

It is—for some women.

Let’s back up a second and define “heartburn” because, for some women, it might be the first time they’ve experienced this digestive symptom. Heartburn is a term that describes a burning sensation in your chest. You feel heartburn when stomach acid refluxes, or seeps back up, into your esophagus, the part of the digestive track that connects your mouth to your stomach.

While every woman’s body is different, and you can certainly experience heartburn and indigestion without being pregnant, heartburn can occur at any point in a pregnancy1. So, a woman may experience heartburn as an early pregnancy symptom—even before she knows she’s pregnant.

If you have recently been experiencing symptoms of heartburn and indigestion and think you might be pregnant, see your doctor. 

Will I experience heartburn while I am pregnant?

Possibly—and likely. Many women experience heartburn beyond their first trimester of pregnancy2. There are a few reasons why:

Hormones relax muscles…

During pregnancy, a rising level of the hormone progesterone relaxes the valve (known as the lower esophageal sphincter) that separate the stomach and esophagus. As a result, stomach acids can flow back into your esophagus2 and lead to some of the classic uncomfortable heartburn feelings that come with acid indigestion.

…and slow digestion

Additional hormones slow digestion, which mean food may stay in your stomach longer2 and lead to a higher likelihood of acid indigestion.

The uterus crowds other organs

Later, as a pregnancy progresses and the uterus expands, it puts pressure on other organs in the abdomen3—including the stomach.

So, a stomach getting pushed out of place, with the food in it lingering longer, and a valve to the throat that’s a bit looser. The result? Heartburn.

A baby with lots of hair?

You might have heard the old wives’ tale that having heartburn while pregnant means you’ll deliver a baby with a more hair on its head. One small scientific study years ago did find a correlation4! Make of that what you will.

Treatment for Heartburn and Acid Indigestion During Early Pregnancy

Before jumping into the possible treatment options for pesky heartburn, confirm you are indeed pregnant with your trusted health care provider. They can help you better understand how to approach your symptoms and decide next steps.

If you are indeed pregnant and experiencing heartburn, we recommend taking the following measures to keep your heartburn symptoms at bay.3

• Avoid foods that flare up your symptoms. These might include spicy foods, fried foods or meals, caffeine such as coffee or soda. Create a  journal  of foods that you’ve noticed might cause upset stomach.
• Stay away from large meals just before bedtime. This can trigger acid reflux due to your sleeping position.
• Sleep with a pillow wedge that raises your head to deter acid reflux.
• Consult with your doctor to determine whether an antacid, like TUMS, would be right for you.

While it’s no fun to experience heartburn and acid indigestion, talk to your care provider about the many tools and resources to help you manage. Whether together you decide you should use TUMS to help manage your symptoms or find comfort in pairing antacids with other preventative measures, you have options.

Heartburn is common in adults – especially during pregnancy. While some research suggests women who have moderate heartburn during pregnancy give birth to babies with fuller heads of hair, having symptoms more than twice a week might be a sign of gastroesophageal reflux disease (GERD), or recurrent heartburn.

According to a study of 510 pregnant women, approximately 26% have GERD symptoms during the first trimester. The rate jumps to 36% in the second trimester and 51% during the third trimester. That’s substantial compared with the 20% of adults in the U.S. who experience heartburn.

Why the increase in symptoms during pregnancy? Progesterone, a hormone that increases early in pregnancy, relaxes smooth muscle in the body. It helps your uterus stretch to accommodate the growing fetus, but also reduces the reliability of the esophageal sphincter – a ring-like structure that seals off stomach contents from the throat.

Increased pressure placed on the stomach externally from the growing uterus, especially in the third trimester, can also worsen heartburn symptoms such as:

• Burning pain in the center of the chest, especially after eating
• Sour or bitter taste in the mouth
• Sore throat or cough

Thankfully, there are several pregnancy-safe ways to deal with acute heartburn and ongoing cases of GERD.

Medications

Heartburn and GERD symptoms are less severe when there is less acid in the stomach. That said, you need a certain amount of acid to properly digest food. Three types of medication can help create that balance.

Oral antacids like aluminum and magnesium hydroxide (think Maalox or Mylanta) and calcium carbonate (like TUMS) neutralize acid already present in the stomach. Calcium carbonate has the added benefit of supplementing calcium intake during pregnancy. It’s safe to follow the directions on the package – there’s no need to change the dosage or schedule due to pregnancy.

On the flip side, two types of medications actually reduce acid production before it can enter the stomach.

H2-receptor antagonists (H2-blockers) reduce H2 histamine, which stimulates cells in the stomach to produce acid. Thus, less stomach acid is produced. Examples include ranitidine (Zantac), cimetidine (Tagamet HB), and famotidine (Pepcid). All of these are available over the counter and in generic forms.

Proton pump inhibitors (PPIs) block an enzyme in stomach cells that’s needed to produce acid. These drugs are available over the counter but can take several days to provide maximum relief, so you might consider trying an antacid or H2 blocker first. Examples of PPIs include lansoprazole (Prevacid) and omeprazole (Prilosec), as well as generic versions. Both brand name and generic are considered safe during pregnancy.

Please note, because stomach acid is necessary for iron absorption, H2 blockers and PPIs can decrease the effectiveness of iron supplements. Talk to your doctor if this might be an issue for you.

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