Lorna Kemble Pregnancy and Birth

251 Gastritis and peptic ulcer during pregnancy

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During prcgnancy, motility changes occur throughout the gastrointestinal tract. These changes are largely attributed to increased levels of progesterone and estrogen. The mechanisms promoting gastroesophageal reflux during gestation primarily involve decreased lower esophageal sphincter (LF.S) pressure and a decrease in the sphincter's adaptive responses, but mechanical factors may also be important.

Gastroesophageal reflux and heartburn are common during pregnancy. In mild cases, lifestyle and dietary modifications alone may be all that is required to improve the symptomatic relief. If drug treatment is indicated, first-line therapy includes antacids or sucralfate. H2-blockers or proton-pump inhibitors should be reserved for patients with more severe symptoms, refractory to antacid or sucralfate therapy (Katz 1998).

Interestingly, in contrast, the frequency, symptoms and complication rate of pcptic ulccr disease appear to decrease during pregnancy (Cappell 1998).