What should you know about bad heartburn in the third trimester?

As pregnancy progresses, the stomach has less room and the valve that normally limits backflow may relax. This can produce burning in the chest, sour fluid in the throat, belching or discomfort after meals. Bending and lying down can intensify it. Acid reflux is a common cause, but gastritis, a hiatus hernia or a peptic ulcer may need consideration when pain is unusual, ongoing or accompanied by vomiting or bleeding.

Choose modest portions, chew thoroughly and avoid meals close to bedtime. Remain upright after eating and use extra support to raise your upper body during sleep. Keep a note of foods and drinks that bring symptoms on; common triggers include fatty meals, chilli, citrus and caffeine, but personal triggers differ. Before using an antacid, alginate or acid reflux medication, check with your obstetric clinician or pharmacist. Mention iron supplements and other medicines, since timing can matter.

Arrange a review if heartburn is happening repeatedly, waking you, limiting food or failing to settle with lifestyle measures. Seek urgent care for severe chest pain, breathlessness, collapse, blood in vomit, black bowel movements, repeated vomiting or trouble swallowing. In late pregnancy, upper-abdominal or rib pain with severe headache, visual symptoms or sudden swelling also needs urgent maternity assessment.

Ask what treatment is suitable for your trimester, how to separate it from supplements, and whether your symptoms fit reflux or need another evaluation. Tell the clinician when symptoms occur, what you have tried and whether swallowing or sleep is affected.