Author: RICHTER, J. E.

Source: Alimentary Pharmacology & Therapeutics, Volume 22, Number 9, November 2005 , pp. 749-757(9)

Publisher: Wiley-Blackwell

Abstract:

Summary

Heartburn is a normal consequence of pregnancy. The predominant aetiology is a decrease in lower oesophageal sphincter pressure caused by female sex hormones, especially progesterone. Serious reflux complications during pregnancy are rare; hence upper endoscopy and other diagnostic tests are infrequently needed. Gastro-oesophageal reflux disease during pregnancy should be managed with a step-up algorithm beginning with lifestyle modifications and dietary changes. Antacids or sucralfate are considered the first-line drug therapy. If symptoms persist, any of the histamine₂-receptor antagonists can be used. Proton pump inhibitors are reserved for women with intractable symptoms or complicated reflux disease. All but omeprazole are FDA category B drugs during pregnancy. Most drugs are excreted in breast milk. Of systemic agents, only the histamine₂-receptor antagonists, with the exception of nizatidine, are safe to use during lactation.

Document Type: Review article

DOI: http://dx.doi.org/10.1111/j.1365-2036.2005.02654.x

Publication date: 2005-11-01

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