AFTER NEARLY a year of trying to conceive, I embraced my early-pregnancy symptoms with glee. “My boobs are sore, and I’m exhausted!” I nearly shouted into the phone at my best friend. However, as time passed, there were also symptoms I was too embarrassed to mention—like gas so persistent that downward dog could only be done at home, and heartburn that felt like I was chasing every meal with a lit match. If only I’d realized this was par for the course: Nearly three out of four women experience gastrointestinal issues during pregnancy, and while there’s no magic cure, small changes can have a big impact.
Your ovaries are cranking out progesterone, a hormone that relaxes the uterine muscles and the smooth muscles of the gastrointestinal tract. This causes food to move through your body up to 30 percent more slowly than usual, giving the bacteria in your intestines extra time to break down sugars and polysaccharides and create gas. “Some women notice more flatulence, others notice bloating,” says Mary Rosser, M.D., Ph.D., director of obstetrics and gynecology at Montefiore Medical Center, in Bronx, New York.
Cut out foods known to cause gas, like beans, cauliflower, and broccoli, and take an OTC digestive enzyme tablet, like Beano, which breaks down the sugars in vegetables and grains before they reach your colon. Staying active helps too. “A ten-minute walk after dinner can stimulate gastric motility, which tends to mean less gas,” says Karen Deighan, M.D., professor of obstetrics and gynecology at Loyola Medicine, in Illinois.
Progesterone’s gut-slowing effect is one big reason for this problem; mild dehydration is another. Many women have a hard time drinking enough water during the first trimester, when nausea tends to peak. Morning sickness often entails a steady diet of crackers and other low-fiber foods like bagels and white bread, which can make constipation worse. Prenatal vitamins may also make you feel blocked, as many contain iron, which can cause constipation.
“Any time you’re not battling nausea, sip water,” suggests Sarah Krieger, R.D.N., a nutrition consultant in St. Petersburg, Florida. Try to make a concerted effort to eat more fiber too; most of us get just half of the 25 daily grams that doctors recommend. Start your day with bran cereal, or sneak in surprising fiber sources, like raspberries, avocados, and popcorn. Finally, talk to your doctor about pairing your prenatal vitamin with an OTC stool softener, like Colase. Or ask if you can hold off on iron until your nausea eases.
As your uterus grows, it compresses your stomach, causing acid to get pushed back up into your esophagus. The problem is exacerbated by progesterone, which relaxes the valve that serves as a barrier between your stomach and your throat.
Peppermint and chocolate tend to relax the valve even more, so avoiding them may help food stay where it belongs. Alcohol is another relaxant, but don’t assume you’re already in the clear because you’ve sworn off vodka tonics. “Sorbitol, which is common in sugarless chewing gum, is also a type of alcohol, and it can make heartburn worse,” says Sharon Holley, director of the nurse-midwifery faculty practice at Vanderbilt University, in Nashville.
If you tend to eat a late dinner, try moving mealtime earlier. “The more time you can give your GI tract to move food along before you go to bed, the better,” says Dr. Rosser. For heartburn that keeps you awake, try propping yourself up with a pillow or two so gravity works in your favor.
If diet and lifestyle tweaks aren’t enough, get the thumbs-up from your doc to use a calcium-based antacid, like Tums, or in more severe cases, Pepcid or Prilosec. And no matter which end ails you, rest assured: Most tummy troubles should improve swiftly after you give birth.
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