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Nighttime GERD in Pregnancy

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Updated March 21, 2013

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Question: Nighttime GERD in Pregnancy
Heartburn can become a common complaint during pregnancy that can be especially bothersome at night; it may be part of a condition called gastro-esophageal reflux disease (GERD). How often does GERD occur in pregnancy? What are the symptoms suggestive of GERD? What treatment options are recommended during pregnancy?
Answer:

Nighttime GERD occurs in about 25% of pregnant women, and it occurs in every trimester. The cause is thought to be due to multiple factors, including elevation of the hormone progesterone. Reflux of acid from the stomach into the esophagus can also damage the lining and affect sleep.

The most common symptoms of GERD include:

  • Heartburn
  • Indigestion
  • Regurgitation
  • Nausea
  • Vomiting
  • Water brash
  • Chest discomfort
  • Coughing
  • Choking
  • Sore throat
  • Hoarseness

Pregnant women are limited in what medications have been shown to be safe and effective without risk of harm to the developing baby. Antacids, or sucralfate, are the first choice, though lifestyle and dietary changes may be recommended instead.

It can be useful to elevate the head of your bed, or to sleep on your left side. Frequent, small, bland meals during the day may decrease the occurrence, as will not eating spicy, acidic, and fried foods. Meals close to bedtime should likewise be avoided. Some 82% of pregnant women will resort to sleeping upright in an easy chair, most commonly during the third trimester. The symptoms will typically quickly abate after delivery of the newborn.

Source:

Kryger, MH et al. "Principles and Practice of Sleep Medicine." ExpertConsult, 5th edition, 2011, p. 1582.

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