Top Tips to treat nausea, heartburn and constipation during pregnancy

Pregnancy can put a real strain on our digestive systems and it can sometimes feel like our whole body is in pain from the constant cycle of nausea, heartburn and constipation. When we think about what is happening in our bodies during the 9 months it takes to grow a baby, its unsurprising that our poor digestive system is in revolt against us, it certainly has a lot to contend with, from the huge surge in hormones to the extra space our growing baby takes up which can take up space where our stomach once happily sat, as well as push on our bowels. Often all three of these symptoms are linked and can exacerbate the other in a seemingly never ending cycle. So what causes these painful symptoms and how can we help to soothe our digestive system during these 9 months?

Nausea

Around 80% of all pregnant women suffer with some degree of nausea and sickness during pregnancy. It tends to start between the 2nd-4th week, peaking around week 9-16 and finally disappearing for many around week 22. However, there can be a wide range of severity experienced with this symptom, with some suffering with a more rare form of Hyperemesis gravidarum (HG) which can lead to all day long sickness and nausea. This lasts most of the pregnancy and can sometimes require hospitalisation to protect both mother and baby from dehydration and malnutrition. There have been some links between genetic predisposition and evidence of Helicobacter pylori (H. pylori) a bacterial infection within the stomach of women with HG however often the cause is unknown.

Reflux and Heartburn

These are also common symptoms for many women and can range from just a burning sensation in our stomach and upper middle chest to full on acid reflux, where liquid contents from our stomach rise up into the back of our throat through our oesophageal sphincter, which usually prevents this liquid from rising up and can either actually make you vomit or will leave a burning sensation in the back of your throat. You may also experience a foul taste in your mouth, particularly in the mornings, a horse voice and hiccups that keep coming back. Luckily for the majority of women this is a symptom that will literally vanish the moment you give birth.

Constipation

This symptom really needs no introduction, as it is a very common digestive complaint for non-pregnant women too. Symptoms of constipation include passing a stool fewer than 3 times in a week, finding it hard or painful to pass, as well as the stools themselves become small, hard and dry. If left untreated, this can lead to hemorrhoids, where blood vessels in our rectum become enlarged from straining and can pop outside or stay internally enlarged, leading to blood in our stools or on the paper, as well as pain and itching. Fissures can also be a painful side effect and many women can experience these in the post natal period too. Straining and hard dry stools can lead to a tear in the anus which makes passing a stool extremely painful.

Possible causes for digestive symptoms include:

The huge surge in the hormones Human chorionic gonadotrophin (hCG), progesterone and oestrogen. These hormones all have an important role to play in sustaining a healthy pregnancy, however they can:

• Alter gastric rhythms, increasing gastric intestinal transit time and slowing gastric emptying which may lead to increased nausea and vomiting.

• progesterone and oestrogen can relax smooth muscle, which can make our oesophageal sphincter muscle loose and more likely to allow liquid to move up from our stomach.

• Constipation can further exacerbate reflux and nausea as pressure can build up in our bowels and put more pressure on our digestion further up

Decreased movement during pregnancy if we are tired, low in energy and just want to lie down as much as possible, can exacerbate both constipation and reflux. Particularly lying down after eating can immediately cause the contents of our stomach to rise up

Heavy reliance on processed carbs or high fat dairy products such as cheese during early pregnancy, due to feeling nauseous, tired and having cravings,. This can complete the cycle of digestive discomfort, as these carbs and dairy are often low in fibre and high in sugar which can contribute to nausea, constipation and reflux

Vitamin and Mineral deficiencies and conversely supplementation can exacerbate nausea and constipation. For example deficiencies of molybdenum, magnesium, zinc, B6, B12 and vitamin D have been found to be a risk factor for nausea and sickness. Taking Iron supplementation if you are found to be anaemic can lead to constipation for many

Poor blood sugar control - Our hormone level change during pregnancy can make it harder to control our blood sugar levels. High blood sugar levels for example can slow down the rate at which our stomach empties contributing to nausea, heartburn and constipation

Top tips for soothing our digestive system during pregnancy

1) Eating small meals, frequently can help reduce the risk all three symptoms, as it is easier for our digestive system to process small amounts of food and reduces the risk of our blood sugar levels dropping which can contribute to nausea

2) Reducing our intake of high fat foods and ensuring we eat a small amount of carbs and higher amount of protein in each meal, as high fat foods may further delay gastric emptying. Ensuring a good source of protein will also help balance our blood sugar levels and reduce those sugar spikes we get from carbs

3) Ensuring you get enough fibre each day from fruit and vegetables as well as other sources

3) Keeping hydrated throughout the day, by drinking small amount of water between meals

4) Changing our sleep habits can help to reduce reflux and heartburn. Avoiding sleeping on your right hand side can help due to the position of our stomach being lower than our oesophagus when on our left. Ensuring that we leave at least an hour after eating, before we lay down, as well as propping yourself up slightly with a pillow can help.

5) Keeping moving in a way that feels good for you, wether thats a pregnancy yoga class, stretching, walking or swimming, can all help keep our digestive system moving reducing risk of constipation and reflux

6) Correcting vitamin and mineral deficiencies. As well as taking your pregnancy multivitamin, consider supplementing with B6 and Magnesium, as both have been linked to incidence of constipation and nausea. It is best to consult a qualified nutritional practitioner before taking these, as they will be able to advise the best dosage, way to take and most effective formulation

7) Ensure you are taking your multi vitamins in the correct way. For example, taking them after eating, not on an empty stomach can help hugely. Also, if you are found to be anaemic and require iron supplementation, try to find a less constipating formulation such as Iron Bisglycinate and take this an hour before bed to reduce gastrointestinal symptoms. Not only is Iron Bisglycinate more absorbable than the Ferrous Fumerate that the NHS will prescribe, but it can also reduce the risk of constipation.

8) Include Ginger in your diet daily, this can be used in the form of fresh root ginger, chopped in hot water and left to steep before drinking or you can buy herbal tea varieties. Ginger can also be brought in lozange form just watch out for lots of added sugar and try to find ones that have as little added ingredients as possible

9) Try to find ways to build rest into your days as much as possible as well as talking to friends and family about any worries you are having in your pregnant journey. Having feelings of anxiety, depression, isolation and loneliness when pregnant is very normal, as it's a huge life change and feels overwhelming at times. Evidence suggests that mental health symptoms such a these, can increase the incidence and severity of nausea, sickness and other digestive symptoms, so its important to let your midwife/GP and support network know

Digestive friendly meal/snack suggestions for pregnancy

• Rice cake topped with avocado and chopped hard boiled egg

• Whole grain wrap with turkey or chicken, avocado, hummus, and spinach

• Handful of nuts such as almonds or cashews and some berries

• Whole grain or spelt pasta mixed with your favourite veggies roasted

• Homemade energy balls

7 medjool dates, pits removed (roughly 3/4 cup)

2 tbsp water + 1 tbsp water if your dates are on the dry side

1 cup gluten-free certified oats

1/2 cup good quality peanut butter

3 tbsp flaxseed powder

2 tbsp cacoa powder

1 tbsp coconut oil melted and cooled

Blend all ingredients together in a nutri bullet or food processor till combined and

form into balls

• Anti nausea smoothie - blend all ingredients

1 frozen banana

½ cup frozen mango

2 Tbsp peanut butter

1 Tbsp chia seeds

1 cup spinach

1 tsp grated root ginger

1 cup dairy free milk eg almond or coconut milk (coconut water is also a great idea

instead as full of electrolytes to hydrate you)

If you would like help to manage your digestive symptoms and stay healthy and

energised during pregnancy and beyond, book your free 30 minute health review

now, using the below link.

https://my.practicebetter.io/#/6053af492a832607e0c6b3c9/bookings