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Feature Article

Managing common luminal GI disorders during pregnancy

Ian Lockart, Blake Knapman, Ria Kanazaki, Christopher S Pokorny

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Abstract

Gastrointestinal disorders experienced during pregnancy, such as nausea and vomiting or gastro-oesophageal reflux, can often be controlled by lifestyle and dietary modification but medication may be needed. Women with coeliac disease or inflammatory bowel disease should have the condition under good control before becoming pregnant as active disease can adversely affect pregnancy outcomes.

Key Points

  • Gastrointestinal symptoms are common in pregnancy and can result in significant morbidity.
  • Some conditions, such as gastro-oesophageal reflux, may occur for the first time during pregnancy or may be exacerbated by pregnancy.
  • A careful history and physical examination are essential for diagnosis.
  • Nausea and gastro-oesophageal reflux may respond to lifestyle and dietary modification, although medications are often required.
  • When indicated, medications should be used judiciously with knowledge of the potential risks to the fetus.
  • Active coeliac disease and inflammatory bowel disease (IBD) have potential adverse effects on pregnancy outcomes.
  • Recurrent miscarriages may be a clue to undiagnosed coeliac disease.
  • In general, uncontrolled IBD in pregnancy poses a greater risk to the unborn fetus than many of the medications used in treatment.
  • Management of IBD in pregnancy needs to be in consultation with an experienced obstetrician.

    Picture credit: © Antoniodiaz/Stock.adobe.com. Model used for illustrative purposes only.

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