Severe acid reflux in pregnancy: what to know

Pregnancy hormones can relax the valve between the stomach and food pipe, while the growing womb can increase pressure on the stomach. Acid reflux may cause burning behind the breastbone, a sour taste, regurgitation, nausea, cough or difficulty sleeping. Symptoms can be worse after a large meal or when lying down. Chest tightness and abdominal pain have other possible causes, so do not assume every chest or upper-abdominal symptom is reflux. Hiatus hernia and other conditions can also contribute, and a clinician can help separate them.

Try smaller meals, eat slowly and remain upright after eating. Avoid lying down soon after food, and notice whether spicy, fatty or acidic foods trigger symptoms. Raise the upper body during sleep if your maternity team considers this comfortable and safe. Avoid smoking and ask before using antacids, alginates, acid-suppressing medicines or herbal products, because pregnancy and other medicines affect what is suitable. A pharmacist, GP or obstetric team can recommend an option and check persistent symptoms. Mention vomiting, poor intake or weight concerns so dehydration and nutrition can be assessed.

Seek urgent help for chest pain or tightness that is severe, new, spreading or accompanied by breathlessness, sweating or faintness. Contact your maternity team promptly for vomiting that prevents fluids, blood in vomit or stool, severe abdominal pain, difficulty swallowing, black stools, or symptoms with a severe headache, visual changes or sudden swelling. Arrange review if reflux is frequent, worsening or disturbing sleep despite self-care.

Ask which foods or medicines to avoid, which treatment is suitable at your stage of pregnancy, how long to try it, and what symptoms need urgent assessment. Tell them about cough, chest tightness, vomiting, swallowing difficulty, other medicines and any history of hiatus hernia.