Constipation, haemorrhoids, and heartburn in pregnancy.
BACKGROUND
Constipation, heartburn, and haemorrhoids are common gastrointestinal complaints during pregnancy. Constipation occurs in 11-38% of pregnant women. Although the exact prevalence of haemorrhoids during pregnancy is unknown, the condition is common, and the prevalence of symptomatic haemorrhoids in pregnant women is higher than in non-pregnant women. The incidence of heartburn in pregnancy is reported to be 17-45%.


METHODS
We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent or treat constipation in pregnancy? What are the effects of interventions to prevent or treat haemorrhoids in pregnancy? What are the effects of interventions to prevent or treat heartburn in pregnancy? We searched: Medline, Embase, The Cochrane Library and other important databases up to July 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


RESULTS
We found five systematic reviews, RCTs or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: Acid-suppressing drugs, anaesthetic agents (topical), antacids with or without alginates, bulk-forming laxatives, compound corticosteroid and anaesthetic agents (topical), corticosteroid agents (topical), increased fibre intake, increased fluid intake, osmotic laxatives, raising the head of the bed, reducing caffeine intake, intake of fatty foods, and the size and frequency of meals, rutosides, sitz baths, and stimulant laxatives.
Vazquez
Juan C
JC
Instituto Nacional de Endocrinologia, Zapata y D, Vedado, Ciudad Habana, Cuba.
D000863:Antacids / Q000627:therapeutic use; D003248:Constipation / Q000188:drug therapy; D004043:Dietary Fiber; D005260:Female; D006356:Heartburn / Q000188:drug therapy; D006484:Hemorrhoids / Q000188:drug therapy; D006801:Humans; D015994:Incidence; D008019:Life Style; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy
D000863:Antacids; D004043:Dietary Fiber