What should you know about extreme heartburn in pregnancy?

Pregnancy hormones can relax the valve between the stomach and food pipe, while the growing uterus can increase pressure on the stomach. Acid may then move upwards, causing burning behind the breastbone, a sour taste, belching or discomfort after meals and when lying down. Reflux can be intense without damaging the baby, but symptoms that do not fit this pattern should not be self-diagnosed.

Chest pressure, severe upper abdominal pain, repeated vomiting, trouble swallowing or pain with exertion may have causes other than heartburn. Heartburn-like upper abdominal pain can also occur with pre-eclampsia, particularly alongside headache, visual changes or raised blood pressure.

Try smaller meals, eat slowly and remain upright after eating. Identify personal triggers such as rich, spicy or acidic foods, and avoid eating close to bedtime. Raising the upper body for sleep may help; do this safely with suitable support rather than lying flat immediately after a meal.

Ask your pregnancy clinician or pharmacist which antacid or reflux medicine is suitable. Some products are not appropriate in pregnancy or may interfere with other medicines, so check before using a new treatment. Keep a note of meals, timing, severity and associated symptoms to make the consultation more useful.

Seek urgent care for chest pain with breathlessness, sweating or faintness; vomiting blood; black stools; inability to keep fluids down; or severe pain that is sudden or worsening. Contact your maternity team promptly for heartburn with a severe headache, visual changes, swelling, high blood pressure or pain beneath the ribs, because these can be signs of pre-eclampsia.

Ask whether your symptoms match reflux, which foods or medicines may be contributing, and which treatments are safe at your stage of pregnancy. Ask how to distinguish ordinary burning from warning signs and when persistent symptoms should be reassessed.