Managing Constipation, Heartburn, and Gas During Pregnancy

Unfortunately, pregnancy isn’t always pleasant. Heartburn, constipation, gas, and bloating can be some of the not-so-fun experiences of pregnancy. They frequently show up in your second trimester and can last until your little one arrives. 

But don’t be discouraged—this is an exciting time! Your baby is rapidly growing and changing, and this means you’re also experiencing an influx of hormones. Some of those hormones relax the muscles in the digestive tract, slowing things down and creating some unpleasant experiences.

If you’re also having nausea and vomiting, which frequently occur in the first trimester, you’ll find strategies for feeling better on our Morning Sickness page.

Unfortunately, constipation will affect about half of all women at some point during pregnancy. But, with a few lifestyle changes, you can make it a little more manageable.

What causes constipation during pregnancy?

Starting at about the second and third months of pregnancy, large amounts of the hormones progesterone and relaxin cause the muscles in your bowels and intestines to relax, slowing digestion and leading to constipation.

The added pressure of your expanding uterus on your intestines and the increased iron in your prenatal vitamins can add to this problem. Sometimes, the combination of constipation and the pressure from baby can lead to hemorrhoids—large, swollen veins in the rectum. Talk to your doctor if you believe you may have hemorrhoids.

It may sound crazy, but constipation actually has an upside. The longer that foods remain in your digestive tract, the more nutrients can be absorbed into your blood stream and carried on to nourish your baby.

How to relieve constipation during pregnancy

Lifestyle tips—to help with pregnancy constipation

• Adjust supplements – Prenatal vitamins can exacerbate constipation because of the iron and calcium. Ask your doctor about slow-release supplements or adjusting your dosage. Magnesium supplements can help, too
• Stay active – Activity encourages intestinal movement. Go for a quick walk
• Consume more fluids – Drink at least 8 12-fl-oz glasses of water or liquids (eg, milk, fruit juice, broth) a day. Research shows that staying hydrated can help alleviate constipation by improving the consistency of stool, making it easier to pass
• Eat smaller meals – They’re not as taxing on your digestive tract and create less gas, bloating, and constipation
• Take probiotics – Yogurt, yogurt drinks, kefir, and capsules with active cultures can increase the frequency of bowel movements
• Go – When you have to go, don’t put it off

Diet tips—to help with pregnancy constipation

• Get 28 to 34 g of fiber per day – Whole grains, bran cereal, vegetables, and fruits, like apples and kiwi, are high in fiber and can work as a laxative. Drinking water with fiber can help increase the benefit
• Skip bananas – Most fruits are going to help with constipation, but bananas can have the opposite effect due to their starchiness
• Resist refined foods – Too much white bread, white rice, pasta, and sugary foods can lead to constipation
• Eat prunes – Prunes and prune juice are a natural laxative
• Drink hot water & lemon – Warm water helps to stimulate the gastrointestinal tract and create peristalsis, the waves of muscle contractions within the intestinal walls that keep things moving. Lemons and limes are high in minerals, vitamins, and pectin fiber, a soluble fiber that can work as a laxative

Try hydration beverages – To improve hydration by increasing your water absorption, try a hydration drink like Pedialyte^®

Maybe you’ve heard that the more heartburn you have while you’re pregnant, the more hair your baby will have when he’s born? Believe it or not, a small study recently showed that there may be a link between the severity of heartburn and the amount of hair your baby has at birth.

While baby’s hair doesn’t cause heartburn, the hormones that contribute to baby hair growth are also associated with heartburn. So, if you’re feeling the burn, your baby may be arriving with a full head of hair!

What causes heartburn during pregnancy?

About 80% of pregnant women suffer from heartburn. It is one of the earliest symptoms of pregnancy, often beginning around month two and carrying on until your little one is born. It happens when large amounts of the hormones estrogen, progesterone, and relaxin relax the smooth muscle tissues throughout the body.

This impacts the gastrointestinal tract, esophagus, and the valve between your stomach and esophagus. This relaxed valve is less able to stop the backflow of contents from your stomach into your esophagus.

This can irritate the esophageal lining and cause a burning sensation in your throat and chest area. Your relaxed digestive tract also slows the movement of food, which contributes to constipation.

Later on, the added pressure of your growing uterus on your stomach and intestines can make things worse. Add in the increased acidity in your stomach caused by your pregnancy, and you feel the symptoms from all these factors. 

Lifestyle tips—to help with pregnancy heartburn

• Relax – Stress leads to heartburn. Put aside the to-do list until tomorrow
• Wait at least 2 hours after eating to lie down – It’s harder for gastric juices to back up when you’re standing or sitting upright
• Keep your head up – Sleep with your head and shoulders elevated about 6 inches and pick things up by bending at the knees, rather than letting your head dip
• Chew sugar-free gum – Sugar-free gum neutralizes throat acid by increasing saliva production
• Walk – Go for a walk after you eat. That movement helps stimulate the action of your digestive system
• Eat small meals – An overly stuffed stomach puts added pressure on the valve
• Avoid foods that produce extra gas – Beans and vegetables like cabbage, broccoli, and brussels sprouts can cause excess gas

Diet tips—to help with pregnancy heartburn

• Avoid trigger foods & drinks – Spicy or greasy foods, acidic foods like tomatoes and citrus, caffeinated and carbonated drinks, and chocolate can cause heartburn
• Chew a calcium carbonate antacid like Tums – Antacids will neutralize the burn and add calcium to your diet. Antacids can interfere with iron absorption, so take them 2 hours before or after you take your prenatal vitamin. As always, check with your doctor to make sure antacids will not interfere with your health conditions

Can heartburn hurt me or my baby?

Don’t worry, heartburn is not harmful to your baby, and the process is actually beneficial to your developing baby. This big digestive slowdown is by design and allows for better absorption of nutrients into your bloodstream, through the placenta, and into your little one. This means baby gets more of what she needs to develop and grow.

Heartburn won’t harm you either, unless it becomes severe and prevents you from eating enough nutritious foods. If you can’t find relief with natural and over-the-counter remedies, check with your doctor. If you’re diagnosed with gastroesophageal reflux disease (GERD), medication may be an option.

Feeling a little more bloated than usual these days? Pregnancy is known to bring out uncomfortable gas in almost all moms-to-be.

What causes gas and bloating in pregnancy?

The hormone progesterone, and its relaxing effect on your digestive tract, is one of the main causes of gas during pregnancy.

In the coming months, the increasing size of the uterus and the fetus will create pressure on your abdominal cavity. As your intestinal muscles relax and grow crowded, digestion slows, allowing gas to build up and leading to those symptoms of bloating, burping, and flatulence.

But, don’t worry, that discomfort can actually be helpful to your baby. Slowed digestion gives the nutrients from the food you eat more time to enter your bloodstream and reach your little one.

How to relieve pregnancy gas and bloating

• Stay regular – See our tips above for constipation relief
• • Go easy on certain foods – Cabbage, onions, beans, fried foods, sugary sweets, dairy, and carbonated beverages can increase gas production
  • • Track what you eat – This can help you identify which foods may be causing more gas for you
    • • Slow down & chew – Try to chew your food at least 20 times to reduce the amount of air you’re swallowing
      • Eat small meals – Big meals can overtax your digestive system. If eating larger meals causes discomfort, try smaller more frequent meals or snacks
      • • Drink plenty of water & fluids – If your bloating is caused by fluid retention or eating too much salt, upping your water intake can help
        • • Reduce stress – Cortisol and other stress hormones can throw off your gut microbiome. Practice deep breathing and find other stress-relieving strategies
          • • Try prenatal yoga – Certain yoga poses can help you pass gas: Try the wind-relieving poses, child’s pose, seated forward bend, or happy baby pose

To learn more about what to expect during your first weeks of pregnancy, visit our
Early Pregnancy page.

Sources 

Heartburn

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Pregnancy and heartburn. Stanford Children’s Health. Accessed March 2, 2020. https://www.stanfordchildrens.org/en/topic/default?id=pregnancy-and-heartburn-134-10

Moazzez R, et al. J Dent Res. 2005;84(11):1062-1065.

Heartburn during pregnancy. What to Expect. Updated May 31, 2019. Accessed March 2, 2020.
https://www.whattoexpect.com/pregnancy/symptoms-and-solutions/heartburn-during-pregnancy.aspx

Pregnancy and heartburn. American Pregnancy Association. Accessed March 2, 2020.
https://americanpregnancy.org/pregnancy-health/heartburn-during-pregnancy/

Baby Hair and Heartburn
Costigan KA, et al. Birth. 2006;33(4):311-314.

Constipation
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https://www.whattoexpect.com/pregnancy/symptoms-and-solutions/constipation.aspx

Popkin BM, et al. Nutr Rev. 2010;68(8):439-458.

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Scaccia A. 5 safe remedies for constipation in pregnancy. Healthline. Updated September 8, 2015. Accessed March 2, 2020. https://www.healthline.com/health/pregnancy/constipation-remedies#6

Gas and bloating
Eske J. What causes gas pain during pregnancy? Medical News Today. Updated January 31, 2019. Accessed March 2, 2020. https://www.medicalnewstoday.com/articles/324332.php

Gas during pregnancy. American Pregnancy Association. Accessed March 2, 2020.
https://americanpregnancy.org/pregnancy-health/gas-during-pregnancy/

Corleone J. Does drinking water reduce bloating? Livestrong. Updated May 21, 2019. Accessed March 2, 2020.
https://www.livestrong.com/article/495550-does-drinking-water-reduce-bloating/

Astorino DM. Here’s exactly how–and why–stress is making you boated (and how to fix it). PopSugar. Updated January 1, 2018. Accessed March 2, 2020. https://www.popsugar.com/fitness/Can-Stress-Cause-Bloating-44317481

Bloating and gas during pregnancy. What to Expect. Updated March 19, 2019. Accessed March 2, 2020.
https://www.whattoexpect.com/pregnancy/symptoms-and-solutions/bloating.aspx