Gastroesophageal reflux disease in pregnancy.
Gastroesophageal reflux disease during pregnancy is common. Altered structure and function of the normal physiological barriers to reflux of gastric contents into the oesophagus explain the high incidence of this problem in pregnant women. For the majority of patients, life-style modifications are helpful, but are not sufficient to control symptoms and medication is required. The optimum management of reflux in pregnant patients requires special attention and expertise, since the safety of the mother, foetus and neonate remain the primary focus. Gastroenterologists and obstetricians should work together to optimise treatment. Typically, one utilises a step-up program that starts with life-style modifications and antacids. If those methods fail, histamine-2 receptor antagonists and proton pump inhibitors are tried. Rarely, promotility agents are used. Initiation of these medications must be undertaken after a careful discussion of risks and benefits with patients. In patients without a prior history of reflux, symptoms usually abate after delivery.
Ali
Raja Affendi Raja
RA
University College Hospital, Galway, Ireland. draffendi@eircom.net
Egan
Laurence J
LJ
D000818:Animals; D000863:Antacids / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001942:Breast Feeding; D018492:Dopamine Antagonists / Q000627:therapeutic use; D005260:Female; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000628:therapy*; D005773:Gastroscopy; D006635:Histamine H2 Antagonists / Q000627:therapeutic use; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000628:therapy*; D011379:Prognosis; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D013392:Sucralfate / Q000627:therapeutic use
D000863:Antacids; D000897:Anti-Ulcer Agents; D018492:Dopamine Antagonists; D006635:Histamine H2 Antagonists; D054328:Proton Pump Inhibitors; D013392:Sucralfate