Intractable Heartburn of Pregnancy

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HEARTBURN of pregnancy is a symptom usually passed over lightly and given little attention by the obstetrician. It is true that there are mild and intermittent forms which are not intensely disturbing to the patient, and in which the casual use of antacids, alkaline salts, and sedatives gives adequate and prompt relief. But there is another rather large group of patients in whom the symptoms are constant, more severe, and not relieved by any known treatment. It is this group which we designate as having the intractable heartburn of pregnancy. The syndrome usually appears about the twentieth to twenty-fifth week and continues with increasing severity until labor is completed. Following delivery, relief is immediate and complete unless there have been symptoms in the previous non-pregnant state. It was the accidental radiologic finding of one of us (J. R. E.) five years ago that led to the diagnosis of the condition as that of esophageal orifice hernia. Subsequent roentgen studies have shown that this is th...