#65 Heartburn in Pregnancy

Whether you are pregnant or not, Tums are a popular treatment for heartburn. The medical term for heartburn is reflux esophagitis. There is a common misconception that heartburn is caused by excess stomach acid. Rather, heartburn comes from the stomach acid winding up in the wrong place.

Our stomachs are especially designed to tolerate high acid levels because those levels are necessary to digest food. If the acid in your stomach is not acidic enough, food will sit in your stomach for prolonged periods. This undigested food can even lead to vitamin deficiencies because your stomach can’t process food without enough acid.

Heartburn is a common side effect of pregnancy. This is not because you have too much acid in your stomach, but rather because the acid contents of your stomach are in the wrong place. Ordinarily the sphincter muscle between your stomach and esophagus is weak, which allows stomach acid to escape into the esophagus. With the rearranging of the abdominal anatomy during pregnancy, there is increased pressure on the stomach, which pushes the acid into the esophagus, causing heartburn.

Pregnant women may want to take Tums or some other antacid to try to reduce the painful symptoms of heartburn. On the internet, a search of the literature indicates Tums and other antacids are considered safe in pregnancy. Some articles have said you could take one or two tablets every four hours as needed.

I would recommend against taking antacids during pregnancy. By taking Tums or other antacids for heartburn, you are reducing the acid in your stomach.  Although an antacid may lower your stomach’s acid level for a while, your stomach will simply make more acid to raise the acid level back to normal. So, the net result of taking antacids will cause your stomach to make more acid to counteract the effects of the antacids. Your relief from the heartburn will be very temporary. While the acid level of your stomach is reduced by Tums, you body will have a harder time digesting your food and vitamins.

In addition, doctors can recommend Tums as a source of calcium during pregnancy. You should get most of your calcium in the foods you eat and drink. If you are lowering your stomach acid levels with Tums, you are also interfering with your stomach’s ability to absorb nutrients from the food you eat.

There are doctors who would recommend one or two Tums tablets every four hours as needed, but I would recommend much less than that. I would recommend taking Tums at bedtime on an empty stomach.

My experience is that you should avoid Tums or other antacids during pregnancy. A drink of water can help reduce your heartburn simply because the water washes the acid back down into your stomach. Drinking four to six ounces of water several times a day can help manage your heartburn and the price is right.