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Gastroenterology clinic

Dealing with reflux in pregnancy

Christopher K Rayner

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An updated version is available in the linked supplement

Abstract

Here is an approach to managing the common complaint of heartburn in pregnancy.

Article Extract

Most women experience symptoms of gastro-oesophageal reflux during pregnancy. Here, Dr Chris Rayner outlines an approach to this common complaint.

Remember
  • Up to two-thirds of women report daily heartburn during pregnancy. The symptom is most troublesome in the third trimester.
  • For most women, heartburn is a new symptom that begins in pregnancy and resolves with delivery.
  • Pregnancy is associated with a progressive decline in basal lower oesophageal sphincter pressure, possibly due to the effects of oestrogen and progesterone on smooth muscle. Raised intra-abdominal pressure and impaired oesophageal peristalsis may contribute. The role of transient sphincter relaxations (the major mechanism of most reflux disease) has not been studied in pregnant women.

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