The Second Trimester: Constipation, Gas, & Heartburn

Written by the Healthline Editorial Team | Published on March 15, 2012
Medically Reviewed by Joan K. Lingen, MD


By the fourth month of pregnancy, many women notice their digestive system has slowed down and they are distressed by infrequent, hard stools. An increase in the hormone progesterone during pregnancy contributes to constipation by slowing the waves of muscle contractions that move food down the digestive tract. Digestion is slowed so that nutrients have more time to be absorbed in order to supply the developing fetus. As the uterus grows larger and presses on the lower bowel, this can also add to constipation. Ab

There are many ways you can cope with pregnancy-induced constipation:

  • increase the amount of fiber you consume, including fruit (prunes are great), vegetables, and bran;
  • drink large amounts of water;
  • use the bathroom as regularly as you can-whenever you have to go, you should. Be aware of the signals your bowel is giving you; and
  • exercise, which can help move food through your system.

Talk to your doctor about other measures for easing constipation if these methods fail. You may be advised to take a mild laxative such as milk of magnesia, a fiber supplement such as psyllium (Metamucil), or a stool softener such as docusate sodium (Colace). Avoid such remedies as enemas, cod liver oil, and harsh laxatives.

Excess Gas

Excess gas comes in all forms: burping, flatulence, and bloating. Gas is caused by the same mechanisms that cause constipation. As the level of progesterone increases in the pregnancy, the gut slows down and more gas may be retained. To help reduce the symptoms of excess gas, try not to eat foods like cauliflower and cabbage, which produce a lot of gas. Avoid big fatty meals as well, and chew your food thoroughly before you swallow.


When the stomach's contents, including stomach acid, back up into the tube that brings food to the stomach (the esophagus), it can cause a burning sensation at the level of your heart. This is known as heartburn or indigestion. Pain is caused by the irritation of the esophageal lining by the gastric acid from the stomach.

Whether or not you have experienced heartburn before pregnancy, pregnancy increases the likelihood of heartburn. There are a number of reasons why. As with constipation, the slowed digestive system means that there is more food sitting around in the stomach and esophagus. Progesterone causes the stomach's upper valve to relax, which means that food can more easily move in the wrong direction, bringing acid with it. Add the fact that your uterus is getting bigger and pushing on your stomach, and it's no wonder you have occasional bouts of indigestion. There are, however, some ways you can avoid it:

  • don't eat large meals or meals that are high in fat. They take longer to digest and will sit in your stomach longer, potentially aggravating heartburn;
  • eat small meals frequently rather than big meals infrequently;
  • sit up straight-keep gravity on your side to move food through the digestive tract. Try not to lie down after a big meal; and
  • talk to your doctor if your symptoms don't improve-you may need a low-salt antacid.
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