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This often starts towards the end of the first trimester, just as the morning sickness is easing. The hormones of pregnancy lead to a relaxation of the sphincter that helps keep acid in the stomach. This leads to more acid getting into and irritating the esophagus as the womb/baby grow upwards. The bowels/stomach also don’t empty as quickly which leads to food sitting in the stomach longer and stimulating more acid production.

What to do?
First, make a mental note of trigger foods. For some this could be spice, greasy foods, raw onions or drinking too much water at one time as examples. Try to avoid these triggers.

Next, try sleeping more upright. Adding one to two pillows to elevate your upper body will allow gravity to help keep the acid away from the throat/mouth.

Next, try exercise. Thirty (30) minutes of moderate exercise a day can help increase sphincter tone and decrease acid production which can help alleviate symptoms.

Calcium chews such as Tums® are a good first-line medical treatment if conservative measures don’t work. Taking up to eight (8) of these a day is a safe way to get in additional calcium as well. Simply take when you feel symptoms.

If calcium chews are not cutting it, then my next line recommendation is Ranitidine 150mg (generic of Zantac®) taken twice a day (when you first wake up and just before bed). This works on the histamine receptor in the stomach that down regulates acid production. This can be bought over the counter.

If these steps aren’t helping, please reach out as you may need a stronger medicine such as a proton pump inhibitor like Prilosec or Protonix.

Kyle P. McMorries, MD, FACOG


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