Many women experience heartburn during pregnancy. It can be extremely uncomfortable and can negatively affect women’s experience of pregnancy and their quality of life.

Dietary changes may help to reduce or stop heartburn. The NICE guideline on gastrooesophageal reflux disease and dyspepsia in adults includes recommendations about dietary and lifestyle advice such as raising the head of the bed, reducing caffeine intake, reducing intake of fatty foods, and reducing the size and frequency of meals.

Antacids and antacid plus alginate based reflux suppressants

Efficacy

Antacids, alginates, and sucralfate are considered the first-line medical therapy relieving the symptoms of heartburn in pregnancy.

The NICE guideline committee recommended that antacids and antacid plus alginate based reflux suppressants should be considered for the treatment of heartburn during pregnancy because there was evidence that antacids were effective on alleviating heartburn compared to placebo with no increases in gastrointestinal side effects and evidence that both antacids and alginate-based reflux suppressants were as equally effective as each other in alleviating heartburn.

·        Improvement of heartburn frequency

Moderate quality evidence showed no clinically important difference between alginate-based reflux suppressant and antacid on the number of pregnant women whose heartburn frequency improves after 2 weeks of treatment.

·        Improvement of heartburn intensity

High quality evidence from showed no clinically important difference between alginate-based reflux suppressant and antacid on the number of pregnant women whose heartburn intensity improves after 2 weeks of treatment. 

Quality of Life

There were no differences between intervention groups on quality of life or any reported gastrointestinal side effect during treatment. Data for three side effects – constipation, diarrhoea, and nausea – were reported in both of the two studies.

Generally, the committee noted that there was a lack of evidence about whether using pharmacological interventions to alleviate heartburn can have harmful effect on the baby.

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