Gaviscon is (most likely) the most well-known brand of liquid antacid. Antacids are used to relieve symptoms of heartburn and indigestion (dyspepsia). Heartburn is a common symptom experienced during pregnancy. Today I will look into the use of Gaviscon in pregnancy by looking at the main recommendations of heartburn treatment in pregnancy. I will conclude which particular Gaviscon product is the best to use in the pregnancy.
- What is Gaviscon?
- Gaviscon range
- Guide on the management of heartburn in pregnancy
- Can you take Gaviscon in pregnancy? (Is it safe to take Gaviscon in pregnancy?)
- List of Gaviscon alternatives for heartburn in the pregnancy
What is Gaviscon?
Gaviscon is a brand name of a medicine called antacid. Antacid help with the symptoms of indigestion/heartburn by neutralising stomach acid. Gaviscon Advance and Double Action contain sodium alginate, which creates a ‘hj‘ in the stomach, preventing acid from escaping and therefore help to control symptoms of heartburn.
Gaviscon, like many other antacid products, is available over the counter from supermarkets and pharmacies. Certain Gavison products may be restricted to the sale from a pharmacy counter due to their size, for example.
When looking at different medicines for the management of heartburn, Gaviscon and other antacids are perceived as least effective; however, they can still provide relief from symptoms.
What is dyspepsia?
Dyspepsia is defined as a condition which affects the upper gastrointestinal tract (GI) and is characterised by the following symptoms (ICGT, 2019):
- upper abdominal pain or discomfort,
- heartburn: burning feeling in the chest
- acid reflux,
- nausea, or
What causes dyspepsia in pregnancy?
Two main factors contribute to the presence of dyspepsia in the pregnancy:
- hormonal changes
- reduction in lower oesophagal sphincter pressure: sphincter muscle which is located at the end of the ‘food’ pipe relaxes which allows stomach acid to escape causing the burning sensation characterised to dyspepsia.
Gaviscon range of products include:
- Gaviscon Original (liquid, chewable tablets and liquid sachets)
- Gaviscon Double Action (liquid, chewable tablets and liquid sachets)
- Gaviscon Advance liquid and chewable tablets
I explained the difference between Gaviscon antacids in the previous post: Gaviscon alternatives.
Guide on the management of heartburn in pregnancy
National Institute of Health (NICE) recommends lifestyle advice as first-line management of indigestion in the pregnancy, for example (NICE, 2017):
- Eating smaller portions more frequently throughout the day
- Avoiding eating at night
- Avoiding foods and drinks that may cause indigestion, such as spicy and fatty food, juices, and caffeine.
When self-care measures fail to minimise indigestion symptom, pregnant women may be offered treatment with medication.
Antacids are regarded as a first-line treatment for mild symptoms which are not controlled by lifestyle changes. The NICE guide does not recommend using antacids that contain sodium bicarbonate or magnesium trisilicate.
Both Gaviscon Original and Gaviscon double action contain sodium bicarbonate.
Pregnant women with moderate to severe symptoms (complicated dyspepsia) may be offered a drug, which stops acid production rather than neutralising it. Two medicines are mentioned in the guide: ranitidine and omeprazole.
The use of ranitidine is out of the question due to safety concerns and consequent withdrawal of this drug from the market. Read more about ranitidine recalls and ranitidine alternative medicines. Omeprazole, a proton pump inhibitor (PPI), is one of the most commonly prescribed drugs in the UK. PPIs are considered as most effective in stopping the production of stomach acid.
Can you take Gaviscon in pregnancy? (Is it safe to take Gaviscon in pregnancy?)
Advice based on the treatment guide
I already briefly mentioned in the previous paragraph recommendations related to Gaviscon and pregnancy. The NICE guide does not recommend the use of antacids which contain sodium bicarbonate. Gaviscon Advance is the only product in the range which does not contain sodium bicarbonate.
Advice based on product information
For Gaviscon Advance, the following advice is given:
Gaviscon can be used in the pregnancy if clinically needed. Furthermore, it is said that clinical studies of over 500 pregnant women and data from ‘post-marketing experience indicate no adverse effects or toxicity on babies in the pregnancy. The same advice applies to Gaviscon Advance chewable tablets.
Can you use Gaviscon Double Action or Gaviscon Original in pregnancy?
Product information leaflets for Gaviscon Double Action and Gaviscon Original advice that both products can be used in pregnancy if clinically needed. A clinical study of 281 women did not show negative side effects or adverse health effects on unborn babies.
- GETS TO WORK INSTANTLY - Gaviscon Double Action's formulation gets to work in seconds to create a protective barrier that lasts up to 4 hours. In fact, 9 out 10 people would use Gaviscon Double Action again (based on a survey of 45 heartburn and indigestion sufferers compared to control)
- LASTS UP TO 2X LONGER THAN ANTACIDS - Unlike antacids, Gaviscon Double Action forms a raft, or layer, on the top of your stomach contents and to help keep stomach acid in your stomach, where it belongs
- UNIQUE FORMULATION/COMBINATION FOR DUAL RELIEF OF HEARTBURN & INDIGESTION - Gaviscon Double Action neutralises excess stomach acid to help relieve discomfort. It also forms a protective barrier over the stomach contents to help soothe the burning sensation in your chest
List of Gaviscon alternatives for heartburn in the pregnancy
There are plenty of Gaviscon alternative options for the management of indigestion. Some antiacids have a similar combination of ingredients as Gaviscon. Pregnant women who struggle with indigestion may be prescribed proton pump inhibitors (PPIs), for example, omeprazole and its alternatives. PPIs are considered the best treatment of indigestion. Clinical studies in pregnant women indicate no adverse effect on pregnancy or the health of the newborn child (eMC, 2021). Omeprazole is not known to be harmful in pregnancy (BNF, 2021).
Antacids, such as Gaviscon, can be used in pregnancy. Lifestyle modifications are commended in the first instance to pregnant women who experience symptoms of indigestion. Although there is no clinical trial evidence for the effectiveness of lifestyle modification on dyspepsia in pregnancy, some studies suggest that symptoms may be resolved in up to 25% in non-pregnant individuals (NICE, 2017).
Antacids are recommended when lifestyle modifications fail to control symptoms. The national guidelines on the management of dyspepsia do not recommend the use of products containing sodium bicarbonate or magnesium trisilicate because of possible adverse effects on the mother or fetus. Product information for Gaviscon range, including antacids containing sodium bicarbonate state, sate that Gaviscon range can be used in pregnancy.
Gaviscon Advance, which does not contain sodium bicarbonate or magnesium trisilicate, would be the best choice for pregnant women with symptoms of dyspepsia.
BNF (2021). Omeprazole. Available at: https://bnf.nice.org.uk/drug/omeprazole.html Accessed on 21/05/2021
eMC (2021). SmPC: Losec Capsules 20mg. Available at: https://www.medicines.org.uk/emc/product/1509/smpc#PREGNANCY Accessed on 21/05/2021
ICGT (Internal Clinical Guidelines Team ), 2019. Dyspepsia and Gastro-Oesophageal Reflux Disease: Investigation and Management of Dyspepsia, Symptoms Suggestive of Gastro-Oesophageal Reflux Disease, or Both. London: National Institute for Health and Care Excellence (UK); 2014 Sep. (NICE Clinical Guidelines, No. 184.) 1, Overview. Available at: https://www.ncbi.nlm.nih.gov/books/NBK328171/ Accessed on 22/05/2021
NCIE (2017). Dyspepsia – pregnancy-associated: Scenario: Management. Available at: https://cks.nice.org.uk/topics/dyspepsia-pregnancy-associated/management/management/ Accessed on 17/05/2021